Go Digit General Insurance Limited Schedule/Certificate

Digit Commercial Vehicle Liability Only Policy

UIN No.: IRDAN158RP0001V01201718

Policy Number D029267647 / 04022021 Issue Date 04-Feb-2021

Period of Policy From 04-Feb-2021 23:55:00 Mobile xxxxxxxxx7564
5
To 03-Feb-2022 23:59:59 Email sxxxxxxx2@gxxxl.comm
CGST GST State Code 27
GSTIN 27CZBPS1552D1ZI

Name LALIT YATIN SHINDE Partner Code 1041248 / 1041248

A/P P NO 9 HARI OM NAGAR NEAR , Partner Name Direct
616 Address WAGHESHWARI MANDIR,NANDURBAR, Partner Contact --
NANDURBAR -425412,Nandurbar-425412 Partner Email support@godigit.com
AN

DR
FH
1
G01
Registration, Make Policy Type CubicCapacity/Power Registration/ Trailer Reg.
N Engine, Model Fuel Type GVW Manufacturing No. IMT Endorsements
Chassis No. Variant Body Type Licensed Capacity Year
DRS
N Public
MH39N3211 JCB 4765 CC 2015
Carrier

H00079462 3DX XTRA Diesel 7520 Kg IMT-28

HAR3DXSST01 BACKHOE --
BACKHOE LOADER 1
872574 LOADER

Premium Details
KH Third Party Liability Premium (Including CNG) (`) 6847
Legal Liability for Paid Driver (Persons:1)(`) 50
Net Premium ` 6897
50
1 CGST @ 9% = (`621 ) + SGST/UTGST @ 9% = (`621 ) ` 1242
6847
Dies Total Premium ` 8139

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

IA029985365 2021-02-04 8139.00 0.00 621.00 621.00 0.00 0.00 6897.00

0
Nominee Details

--
Misc D
CGST
vehicles Financier Details --

Previous Insurer Policy Exp.

Name: -- Policy Number: -- --
Date:

Other Details

Receipt Details

Die Receipt No. RA031883225

Invoice No. IA029985365
Receipt Date 04-Feb-2021

05/1 Invoice Date 04-Feb-2021

PolicyNumber :-D029267647
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Go Digit General Insurance Limited Schedule/Certificate
Digit Commercial Vehicle Liability Only Policy
UIN No.: IRDAN158RP0001V01201718

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 only under a permit within the meaning of the
Motor Vehicles Act 1988 or such a carriage falling under sub-section (3) of Section 66 of the Motor Vehicles Act, 1988. The Policy Does not cover. (1) Use for
racing, pace making, reliability trial or speed testing.(2) Use for the carriage of passengers for hire or reward.(3) Use whilst drawing a trailer except the
towing (other than for reward) of any one disabled mechanically propelled vehicle. Person or class of persons entitled to drive - Any person including the
insured 1) Provided that a person driving holds an valid and 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 an vaild and 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 any subsequent amendment as applicable. Limits of Liability - Under
Section II - 1 (i) of the policy - Death of or bodily injury: such amount is necessary to meet the requirements of Motor Vehicle Act, 1988 and any subsequent
amendment as applicable Under Section II - 1 (ii) of the policy - Damage to Third Party Property ` 750000 P.A. Cover under Section IV for Owner - Driver
(CSI): ` 0
PA Owner Driver Declaration:The Policy has been issued without Compulsory Personal Accident Cover to Owner Driver on the basis of your declaration that
you do not hold a valid Driving License on or before the date of commencement of this Policy / already have an alternate Personal Accident insurance cover
of Rs. 15 Lakhs
Important Notice : 1) *Cheque dishonor / Non-receipt of payment: If premium paid through Cheque, the policy is void ab initio in case of dishonor or non-
receipt of payment. 2) Violation of Motor Vehicle Act: This policy is issued in accordance with the provision of Chapter X and Chapter XI of MV act, 1988
subsequent amendment as applicable. Any violation will forfeit all benefits and coverages under the Policy. 3) This policy is subject to the standard policy
wordings, warranties and conditions applicable for this product in addition to Indian Motor Tariff 4) Policy would be void on the ground that it was obtained
by non- disclosure of material fact or by a representation of fact which was false in some material particular. 5) The insured is not indemnified if the vehicle is
used or driven otherwise than in accordance with this Schedule. Any payment made by Company for 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.
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.

For & On Behalf of Go Digit General Insurance Ltd.

Consolidated Stamp Duty is Deposited

Authorized Signatory with Department of Stamps, Bengaluru
Praveen Bhat HSN: 9971/General Insurance Services In
Vice President - Customer Experience
praveen.bhat@godigit.com Hey, our document is now digitally signed
Printed, Signed, and Executed at Click here to view the certificate.
Bengaluru

Go Digit General Insurance Ltd. Address: Atlantis, 95, 4th B Cross Road, Koramangala Industrial Layout, 5th Block, Bengaluru, Karnataka 560095. A
Company incorporated under Indian Companies Act, 2013 and licensed by Insurance Regulatory and Development Authority of India [IRDAI] vide Reg No.
158, Corporate Identification Number U66010PN2016PLC167410 | GST Reg. No.: 27AACCO4128Q1Z0 GSTIN Address: Nasik Business Centre,Office No
301, 3rd Floor, B-Square, College Road,Nashik,Maharashtra,PIN-422005

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 website
www.godigit.com.

PolicyNumber :-D029267647
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