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Go Digit General Insurance Ltd.

Schedule/Certificate
Digit Private Car Liability Only Cover UIN No.: IRDAN158RP0004V02201819

0 YOUR DETAILS PARTNER DETAILS

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Name: SAJJAD ELAHI MALIK Partner Name: ADITYA BIRLA INSURANCE BROKERS
0 LIMITED
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Registration Number: HP48B5670

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N0 Partner Code : 1001894

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0 Policy Number: D050080710 / 18112021

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Partner Mobile Number: --

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G Mobile Number: xxxxxxxxx6227

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03 Partner Email : clientfeedback.abibl@adityabirlacap

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10 Email: dxxxxxxxxxxxxk@gxxxl.com

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0 17 YOUR POLICY DETAILS

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B From 18-Nov-2021 13:29:00 NCB % (Current Policy) --

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N Period of Policy for
Own Damage Cover

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To 17-Nov-2022 23:59:59 Additional Excess (`) --

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From 18-Nov-2021 13:29:00 Voluntary Deductible (`) --

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Period of Policy for

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0 Third Party Liability
--

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To 17-Nov-2024 23:59:59 Compulsory Deductible (`)

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From 18-Nov-2021 13:29:00
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Period of Policy for
fal PA Owner-Driver
108 To 17-Nov-2022 23:59:59
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0 Add-Ons Opted Cancelled Coverages Opted Liability Only Cover

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Address VILLAGE BHADRAM P.O RAJPURA TEH,CHAMBA-176310

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YOUR VEHICLE DETAILS

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Chamba,HIMACHAL Model/Vehicle Variant (Sub- HECTOR PLUS/1.5 SHARP

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RTO Location PRADESH Make MORRIS GARAGES Type) HYBRID MT

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Year of Regn./ 2021/

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IG Seating Capacity 6 Fuel Type Petrol Manufacturing 2021
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Engine No. 18M42020067 Chassis No. MZ7HD1D3K4H072216 Cubic Capacity 1451 CC

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Odometer FASTag NA Financier Details UNION BANK OF

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Number INDIAGURGAON
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FASTag NUMBER DECLARATION

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0 The Policy has been issued subject to your affirmative declaration that a valid FASTag has been affixed on the insured vehicle.
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145 Call us at 1800-258-5956 to update your contact details. This will help us give you a smooth claim process.
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1003
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100
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YOUR VEHICLE IDV

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Year Vechicle IDV Non-Electrical Electrical CNG/LPG Trailer Total PA Owner

(`) Accessories IDV (`) Accessories IDV (`) IDV (`) IDV (`) IDV (`) Driver

Year 1 -- -- -- -- -- 0.00 1500000

Year 2 -- -- -- -- -- -- --

Year 3 -- -- -- -- -- -- --

Policy No: D050080710

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Go Digit General Insurance Ltd.
Schedule/Certificate
Digit Private Car Liability Only Cover UIN No.: IRDAN158RP0004V02201819
OWN DAMAGE PREMIUM [A] (`)
LIABILITY PREMIUM [B] (`)
Total Basic Own Damage Premium (`) Cancelled Basic Third-Party Liability (`) 9534.00
NCB Discount Amount (`) PA cover for Owner-Driver (`)
Others (`) Legal Liability to Employees (`)
Own Damage Premium (`) Cancelled Legal Liability to Paid Driver (`) 150.00
Add-Ons Premium (`) 0.00 PA cover for 6 passengers 100000 (`) 600.00
CNG/LPG Premium (`)
PA cover for Paid Driver (`)

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Total OD Premium (`) Cancelled Total Act Premium (`) 10284.00

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Net Premium (`) 10284.00 0 9534
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1851.12 600
IGST @18%=(`1851.12) 0

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Final Premium (`) 12135.12

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Note: The above total OD premium is inclusive of all applicable loading / discounts viz (automobile association memberships, voluntary excess, anti-theft

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handicap person, driver tuition, fiber glass, CNG/ LPG unit, geographical extension, imported vehicle etc., wherever applicable).

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Imp note: Own Damage cover shall end on completion of first year of this comprehensive bundled policy. The policy will continue as a third party cover

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governed by standard wordings of Act only till the end of remaining period of policy .

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If the “Own Damage Cover” under your policy is cancelled during the policy period, then your policy shall be governed by the standard terms and conditions
of “Act only” policy for the Third Party Cover during the remaining period of policy .

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ENDORSEMENT

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Invoice Number Invoice Date Net Premium Igst Cgst Sgst Utgst Cess Gross Premium

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IA052930413 2021-11-18 45206.63 8137.19 0.00 0.00 0.00 0.00 53343.82

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IA079724320 2022-11-18 0.00 0.00 0.00 0.00 0.00 0.00 0.00

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2 1-
IA088169669 2023-02-16 51.00 9.18 0.00 0.00 0.00 0.00 60.18

IA088247074 2023-02-17 0.00 0.00 0.00

20 0.00 0.00 0.00 0.00
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IA088391185 2023-02-18 0.00 0.00 0.00 0.00 0.00 0.00 0.00

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OTHER DETAILS
Previous Insurer --
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Previous Policy No. -- Previous Policy Expiry Date --

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IMT - Endorsements IMT-16,IMT-22,IMT-28,IMT-4,IMT-7

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GSTIN/UIN No. State Code 6

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Unregistered
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Payment Mode -- Cheque/Transation No --

Bank Name IFSC/MICR No --
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Premium Payment Details Receipt Number Receipt Date --

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--
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Nominee Details MAMTA DEVI

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SPOUSE
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18-Nov-1981
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Other Details --
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Details of Existing Damages --

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Follow these rules like you follow the rules of the road.
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Geographical Area: Any accidental loss, damage and/or liability caused, sustained or incurred within India shall be covered subject to Policy Terms and Conditions, unless specifically agreed and endorsed.. Limitation as
to use The policy covers use of the vehicle for any purpose other than hire or reward, racing, pace making, reliability trial, speed testing and use for any purpose in connection with the Motor Trade. Person or Class of
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persons entitled to drive: Any person including the insured 1) Provided that a person driving holds a valid & effective driving license at the time of the accident and is not disqualified from holding or obtaining such a
license. 2) Provided also that the person holding a valid & effective Learner’s License may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989 and
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any subsequent amendment as applicable. Limits of Liability: 1) Under Section I of the policy _ IDV as shown in the schedule. 2) Under Section II - 1 (i)of the policy: Death of or bodily injury _ Such amount as is necessary to
meet the requirements of the Motor Vehicles Act, 1988. 3) Under Section II _ 1 (ii)of the policy: Damage to Third Party Property _ `750000 4) P.A. Cover for Owner Driver under Section III (CSI) - `1500000
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NCB Declaration: The premium has been charged and policy has been issued subject to NCB declared by you as an insured. In the event of NCB found wrongly declared at any point of time during policy period, all
benefits and coverages under the Policy in respect of section I of the Policy will stand forfeited. If there is any disagreement, write to us within 7 days from the date of issuance of policy or before the start date of period of
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insurance whichever is earlier.PUC Declaration: The Policy has been issued subject to valid Pollution Under Control (PUC) Certificate disclosed by you as an insured on or before the date of commencement of the Policy .
Cheque dishonor / Non-receipt of payment premium paid through Cheque, the policy is void ab-initio in case of dishonor of Cheque or non-receipt of payment. Violation of Motor Vehicle Act: This policy is issued in
accordance with the provision of Chapter X and Chapter XI of MV act, 1988 and any subsequent amendment as applicable. Any violation will forfeit all benefits and coverages under the Policy. The insured is not
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indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by the Company by reason of wider terms appearing in Certificate in order to comply with the Motor Vehicle
Act, 1988 is recoverable from the insured. See the Clause headed (Avoidance Of Certain Terms And Right Of Recovery) in the policy. Pre-existing Damages: All types of pre-existing damages or cost of repair of such
damage will be excluded at the time of claim settlement,as per the attached images. Important Notice: The company may cancel the policy by sending 7 days notice in case of fraud, misrepresentation, non disclosure of
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material fact or non co-operation of the insured. This policy is subject to the standard policy wordings, warranties and conditions applicable for this product in addition to Indian Motor Tariff. Break in Insurance: In case of
a break-in, the company may conduct pre-inspection of the vehicle and in such a case, Own Damage cover (Section -I) of the policy would not commence unless the pre-inspection of the vehicle has been done and the
acceptance of risk is subject to evaluation of the vehicle inspection report. In case of any adverse findings in the report, the Company, at its discretion, may cancel the Policy as per the Motor Tariff.
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Note: The policy is issued in utmost good faith, relying on the information shared by insured at the time of obtaining the policy. The terms and conditions detailed in this policy schedule as well as the policy document sent
by Digit shall prevail in case of any dispute.
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Policy No: D050080710

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31
Go Digit General Insurance Ltd.
Schedule/Certificate
Digit Private Car Liability Only Cover UIN No.: IRDAN158RP0004V02201819
For & On Behalf of Go Digit General Insurance Ltd.

In case of claim or any other query, please

contact our 24-hour Call Centre at
1800-258-5956 or email us at
hello@godigit.com or visit our Praveen Bhat
website www.godigit.com. Senior Vice President - Customer Experience
praveen.bhat@godigit.com
Authorized Signatory
Printed, Signed, and Executed at Bengaluru
Consolidated Stamp Duty has been paid as per
Letter of Authorization No.67-B/04/2017-18 Date:
30th May 2017 issued by Department of Stamps

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and Registration , Bengaluru- 560009 -
KARNATAKA.

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Hey, our document is now digitally signed

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Click here to view the certificate.

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For instant resolution, you can ping us “Hi” on
WhatsApp at 702 606 1234

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Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095. IRDAI Reg No. 158 CIN U66010PN2016PLC167410, GST Reg. No.:

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07AACCO4128Q1Z2 HSN: 997134/General Insurance Services, GSTIN Address:Delhi Business Centre,5th Floor, B Wing, IFCI Tower, 61, Nehru Place,New Delhi,Delhi,PIN-110019

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Policy No: D050080710

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