rninted On: GUJARAT MOTOR VEHICLE DEPARTMENT — MOTOR VEHICLE OEPARTMENT State Transport Department ‘SURAT,Gujarat RECEIPTIAPPL No: ‘GJ5R230300009085/6,23033194700052 Vehicle Class: Goods Carrier Received From PURVIBEN Receipt Date: Vehicle No: Chassis No: MaTaso062E3F 12123 Rega Date: ‘Service Type: ‘Goods Service Pecmit Type Particular Amount~.Fine/Penalty/Addl.Foe ‘Total 22400 7 000 GRAND TOTAL (in Rs): 22400/- (TWENTY TWO THOUSAND FOUR HUNDRED ONLY) ‘Note This is computer generated stip, no need of signature (htips:/parivahan.gov.n). ‘YOGESHKUMAR AMBARAMBHALCHAUOHARI © scanned with OKEN ScannerBajaj Allianz General Insurance Company Ltd, Registered and Head Office: Bajaj Allianz He ise, Airport Road, Yerwada, Pune ‘Transcript of Proposal for Commercial Vehicle Package Policy Dear PURVI HETALKUMAR PATEL, ‘We wish to inform you thatthe contact under policy number ‘OG-23-2203-1811-00000161 has been finalized based on the ine {Formation and declaration given by you, the ranseript whereof is mentioned below. You are requested to reconfirm the same 4m case of any disagreement or objection or any changes with respect to infarmation mentioned below, we request you to Please revert back within a period of 15 days from date of your receipt ofthis, filing which it wll be deemed that you ae sat. isfied with the correctness of the details mentioned below. Kindly note that as the contents and declarations contained in this ‘ranscript isthe basis on which we have issued the policy to you, we advise you to please ensure that you have provided. 9oueansu 190010 2p tog 1D ON) GON 6 ‘4st, foujodsnowsaad anos Buunp amok wo pascal pu 0d hq pa ZR Stade one py aonb safeono> go ow A WN ‘sfryan aso sieoynn2o ssounry paren ane NO oC “L1 WN 2yotyaa au jo ayou9 ang pea axey NOK o¢ “91 oo'sto's a ‘1 uodn pooi8e pue poronb a8Rs9n00 c10 20 mata ‘st ‘oes ‘st wodn paoiBe pu paronb “azonoo YN: spyaa ayy a seu ON, Asounaes 01 porounsas Gk S12 YI seuosseq sod paunsuy ng YN siouasseg JO s9quiny, oN ‘uafossad 0) pando stsano9 Ve Jou. 1 YN 2a pied 4a pasnsuy wing = (9944 Pied 10 29quIMy, p pred 20} poido 8139809 V4 2FUAN “OL 190 OAL Pre 30} Wostad 01 71 6 x sass feaydsT098 yoyo oF s94IUN0> Jo EG wowsuDyx9 waNe [OHNO sous {BAY sou wR 20403 pido sousu>yueyy 30 ninowy pe ue sty Bauspsoun 305 poido st 19409 YJ pando ss20x9 Axeunjon #9409 SOMO$8399\! 19} NMDA tewIND WHEK pang aI>IUOA.nO« Sf -Z Pan OL (eH t0:00 zz0e" oununsu Jo pound “1 PMO MENTS © scanned with OKEN Scanner‘Bajaj Allianz General Insurance Company Lf. ‘Bajaj Allane House, Airport Roa ‘COMMERCIAL VEHICLE PACKAGE POLIC\ i, Yerwadla, Pune -411006(ndla) 'Y CERTIFICATE CUM POLICY SCHEDULE 2 ice request, notice, summons, ung office and Correspondence aderess for communication by poleyhoder for claim, service rey seat! Stn Fe hoe Data: Noms Poa eae on orcs request nate sume Policy Number’ 0G23-203-161-00000101 Product Commercial Venice Package Pacy Vehicle Type Misolaneous& Spc Types Of Vehicles Period Of surance From: 122022 00:01 Polley esued on c2.1us2022 To: t4Ju2023 Might CoverNoteNo Applestin No Serutny No 12067200 Insured Name PURVI HETALKUMAR PATEL Zone e Insured Address APBHATLAICHORVASH, .BHATHA, - Sto Customert® 11771505 Premium Payer 111771605 “ransacton i. HYPOTHECATED WITH: KOTAK MAHINORA BANK LTD Policy Status issuED NI 2aasnepoaraczzH Placo of Suppyistate 24 Gujrat stm un us Bac tS Invole No 79523069 Company GSTNo _24AABCo=7300123 Company PANNe _ AABCBSYS06 [Resyee ] Racor] Make | Subtype_|— Node [CORR Wig year Sat Cap | Vena] Engine Wma ion” | rogtre ‘Chassis No ton [SRSGURGET [SURAT [TATA [TRANSIT WIR | EBRDSTOTS] ofa} Ore Tres EX Fost type | VeticeTOv | lee Aee [Won lec Ace | —Traler | —Wraly Rago | GNGLPG UAT] Tat Son oes bese | —iai9a75 | —o ° v T5185 SOREDILE OF PRERT ATURE THB otal Ow Damage Femur [E0500 [ane Ted Pay Cay F270 LL For Operaionttaintenanco Ford Pamson 0.00 Tat iby Prema: Fait 05 rater oy Special cert co Net rerio Pty State GST Ry (ize [conrar GST TER rae Final Prema RS 14,7080 | AN Prema Figures ae HRS ‘Geographical Area No Glaim Bonus 45% Voluntary Excess: Nr Nome Det Name na Titoraip wa eee oe te Sepegeoy Deacwes pasnons Comper Ceduna Previous nee: lan evr me oi Prva Foley No-06.22.220881 anon Sonn te RAR Ren eet teeter te te ni nay Cena sete Seperne Cerne Ges Cog Un crac SaiSoned Vols anaes eso Man ahtues/artloeh bs Smoke Siren irtman vst eon etter eee es en IER a Oc 3 et ty: py ee rpcmot teens draenei SO RR a tn: eng rca ome re einen of te ATOMS RU Rate ome seat met merece tmese so er Secon of the Mot eh Ac ihe RE hn he mening of ram og A Skeet a ne 4 UE eset nr snc tcc one Fig FE SS ect les as een oregano (ona span es i Sen recuse roman yore: padi epnsir teri en rt is sees the Company by reason of wider terns apis fed “eri vith the Motur Vehicle Act, Brecon ge EE SoEREENUe ea aS EHS NSES AS HR Biche iP ehy ‘Setjet To Encrsomert os 217.2839, 47 (Ris, Maranted that inured named herein or ower ofthe vehicle ned tear ‘arn Ceri onthe date of commencomen oF han {eral on he atc of commencement ofthe Policy, he Coney eee Agency Code BAGIOOOZ7165 gency RITESH SHAH [Contact No : 09924099210/09924099210 Email - RITESH.VRINDAINVE! Exdosamet at Sa Schl Seu aies ae covered) 8 Pay wordings a hedberot id Paton Under Cnt (PLC) and andor ness Cente nt faa 0 ht to consider the pally void gb (Channel Name? ML ‘ST@GMAIL.COM a te pete nc, © scanned with OKEN Scannerfone um Sacer se tanta rn cede 2 atc tomy a yf ble eah or amca 180-1025 (Toll Free) 91-020-30208858 (chargeable, aa area {case of any cai, pe ‘9f mobile call or mall us at‘Bagichelpebblaaliane sean code before this num sraseauestoarireamas SRenouseieenys tmartmnoaterreateymntnenrmetntanetrte SER nS ek re tt Aon mapa dnt oon Ay 284 terme by encase cope pinecone ag Cope ae es et Ting coe ans eee 7 . : : aft © scanned with OKEN Scanner[RENEWAL OF PERMIT] Date of Approval : 18-Jan-2023 1. Permit No 2. Name Of The Permit Holder 3, Father's/Husband’s Name 4. Address 5.(i) Registration Mark of the Vehicle (ii) Registration Date (ii) Make/Model (iv) Chassis Number (v) Engine Number (vi) Class of Vehicle (vil) Number of Persons to be carried (vii) Replacement Of Vehicle (ix) Other Criteria Field (x) Manuf. year of the motor vehicle (xi) Service Type TRANSPORT DEPARTMENT, GUJARAT PERMIT IN RESPECT OF GOODS PERMIT (HGV) PART-A GJISIGCIHGV/2018/155 PURVIBEN HETALKUMAR PATEL AIPBHATLAI CHORYAS! , Gujarat Surat-394510 GJosBussst 21-Jul-2014 TATA MOTORS LTD/LPK 2518 TC MAT448062E3F12123 8591803241663379086 Goods Carrier 3 22-Jan-2018 2014 Goods Service 6. The route or routes of the area for which the permit is valid: ROUTE DETAIL Route Cod Fi re Vi Route joute Code rom a ia ae 02 SURAT REGION | GUJARAT STATE] WHOLE GUJARAT STATE 500 Region Covered 7. Validity of the Permit : 8. Load Capacity of Vehicle : () Gross Weight of Vehicle ) Unladen Weight (ill Pay Load 9. Nature of Goods to be carried Date 18-Jan-2023 WITHIN STATE From: 25-Jan-2023 To: 24Jan-2028 28000 6890 21110 NON HAZARDOUS::OTHE! © scanned with OKEN Scannerivans: (aw) heey _pavanvto GW) Aq payadsuy “ vibee zine-zp uo pajuig tyeG mnths €z0z-Aew-9z : eng uopsedsuy. xen, 1zoz-Inr-z : uo pajadsuy ECOEIN=Pe: UO euidxe jms OLOUIIED AOH: Ue Jo KoBayeD, { yhoz: = dea, Buunyoenueyy é Aes N3do AdaNdo: 4 Apog jo adAy, ‘ (aAya Bupnjouy) ¢: 5 Ayoeden Buneag 9 060805) 26081659 : ON eubuy EeIZLseazo0gyh Lyn ON sISs2UO, “ yeoz-ine-60 : areq ydisoay 4 3 + 8Z99ZBOSOLOIZPO : ON idisosy 9e4 uonoadsu} : Veespeansozorzr ON uopealiddy “bespnasore : ON uonensibay ‘yepun esau epew seins axp pue gg6) “PY SEIDIUSA JO}OW Auf Jo SuoISIACId OU UpiAA BuIAIdwIOD se pAy}199 Si (JeLUeD spooD)LESPNASOFD “ON I214aA, (Ajuo sajatyen prodsues 30 seo ayy uy aqeoyddy) SSANLUa4 AO SLVOISILYaD [(1)29 any aes] g¢ WYOd vans quawyiedeg yodsues ayeyg LNFWLYVdad FISIHSA YOLOW ivavrno © scanned with OKEN ScannerVehicle Class Goods Carrier bNe= Used DIESEL Wheel Base 003886 mm Cubic Capacity oosea3 Cylinder No 5 Cylinder Validity Month & Yr. of Mfg. June 2014 LadenUniaden wt o2scaq/o068a GJOSBU4581_ 21/07/2014 Chassis No, Owner {GS MAT44806263F12123 Sr.No. Engine No. Ownership Tr. Date B591803241663379086 ‘Owner Name PURVIBEN HETALKUMAR PATEL | { i Son/Daughter/Wile of i , f ABUT cHonvast Sut Gi 390510 I f Maker's : FATA MOTORS LTD. Madel Name LPK 2578 TC i ; i } | ‘ } 4 i © scanned with OKEN ScannerAddress: : S/O: Prabhudayal Yadav, Gahani Gopalpur Post Mirzapur; Ghhni, Ghazipur; Mirzapur, Uttar Pradesh, 275204 BeAsS te © scanned with OKEN Scannerfaate area Vinod Yadav seat fafa / DOB : 12/10/1989 gy / Male 3447 5151 © scanned with OKEN Scanner(aot any Z wed ® © scanned with OKEN ScannervOTSLZ UN AIZIUD VEY AYE Sd: Ainawzaiwt ‘Od B= THdOS INYHYD THA y * “SSSIDDY 2 : = poner pc aHavad — JO syyyseiySneg/uos Z n JOudg UeBi :dnoas poojg 68SE-OL-Z1 ‘YuIgyosIeg : z aa ie site ~ AVA CONIA ‘SWEN é iZOT-BO-8i -F ajeq anss} _ K69BOOORLOT LodA @ : ysepeid seyp Aq panss; Ss aouasly HUANG UOlUp LelpLUy (wLOm-oO-8i) © scanned with OKEN ScannerForm 69 {S00 rulos 115 (2) Date 28/03/2023 Time : 44:27:11 PM Validity upto : 27/09/2023 Teriicate SU No. . ‘Gi00501170019731 Registration No, (Gy058U4581 Date of Registration Month & Year of Manufacturing DIESEL 30050117 s,100,00 (GST to be pald extra as applicable) observation No Vehicle Photo with Registration plate 60 mmx 30 mm Measured Pollutant (as Units (as sein 7 sr.No. ponuaaat(s aust (G5, Emission timits Value (upto 2, 1 2 3 4 5 Carbon Monoxide (CO) _percentage (%) Idling Emissions 5 Hydrocarbon, (THC/HC) pm i co percentage (%) High iting RPM Rem 2500 + 200 Lambda a 1 £0.03 e Light absorption a ‘Smoke Density ne shear met 2.45 0.61 vrated through the national register of motor vehicles and does ‘This PUC certificate Is system gener not require any signature. Noto 1. Vehiale owners to fink their mobile numbers to regislered vehicle by logging to hitas:/puc:parivahan.gov.n ‘Ruthorised Signature with stamp of PUC operator {60mm x 20 mm © scanned with OKEN Scanner