Go Digit General Insurance Ltd.

Schedule/Certificate
Digit Private Car Liability Only Policy UIN No.: IRDAN158P0002V01201718

Name VIVEK VERMA Vehicle Registration No. UP32ES1003

293/24 OLD HAIDER GANJ , Partner Name Direct

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Address LUCKNOW,LUCKNOW, -226003,Lucknow- 1018867
226003 Partner Code
1018867
Mobile xxxxxxxxx0020 Partner Mobile No. --

Email axxxxxxxxxxa@gxxxl.com Partner Email support@godigit.com

Aadhar No. -- For Claims,contact us at 1800-258-5956

YOUR POLICY DETAILS

Policy No. D022242323 / 08092020 Policy Issue Date 08-Sep-2020 Invoice No. IA020784545
From 09-Sep-2020 00:01:00 Invoice Date 08-Sep-2020
Period of Policy
To 08-Sep-2021 23:59:59

YOUR VEHICLE DETAILS

Seating
RTO Location Lucknow,UTTAR PRADESH 5
D Capacity

Make TOYOTA Model/Vehicle Variant (Sub-Type) ETIOS LIVA/GD

Engine No. 1ND1298500 Chassis No. MBJK4ZBT700035152 Cubic Capacity 1364 CC

Fuel Type Diesel Year of Mfg. -- Year of Regn. 2013

ENDORSEMENT
E Invoice Number Invoice Date Gross Premium Igst Cgst Sgst Utgst Cess Net Premium
1
N IA020784545 2020-09-08 4191.00 0.00 320.00 320.00 0.00 0.00 3551.00
IU
CG
LIABILITY PREMIUM (`)
290 Basic Third-Party Liability (`) 3221 PA cover for Owner-Driver (`) 330
PA cover for 5 passengers 0 (`) -- TP for Bi-fuel kit (`)
Legal Liability for Operation / Maintenance (`) -- Legal Liability to Paid Driver (`) --
Net Premium (`) 3551

CGST @ 9% = (`320) + SGST/UTGST @ 9% = (`320) 640

3221

Final Premium (`) 4191

OTHER DETAILS
Previous Insurer IFFCO Tokio General Insurance Co. Ltd.
F 13-Jan-2020
Previous Policy No. M5429290 Previous Policy Expiry Date
IMT - Endorsements IMT-7
GSTIN/UIN No. Unregistered State Code 9
Payment Mode Online Cheque/Transation No 12_dp-DIC3974BA400FF-1
Bank Name IFSC/MICR No --
Receipt No. RA022414817 Receipt Date 08-Sep-2020
Nominee Details --
Financier Details UNION BANK OF INDIA

Other details --
G0
Geographical Area: Any liability 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 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 any subsequent amendment as applicable. Limits of Liability: 1) 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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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 . If the PUC Certificate is not found valid at any point of time during the policy period, the Company reserve the right to cancel the policy.

Important Note: Please inform the Company in case of change on account of addition of CNG/PNG kit.
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 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. This policy is subject to the standard policy wordings, warranties and conditions applicable for this product in
addition to Indian Motor Tariff. 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.

Note: 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.

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 Praveen Bhat
our website www.godigit.com Vice President-Customer Experience
praveen.bhat@godigit.com
Authorized Signatory
Printed, Signed, and Executed at Bengaluru
Consolidated Stamp Duty is Deposited with Department of
Stamps, Bengaluru
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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.:09AACCO4128Q1ZY HSN: 9971/General Insurance Services, GSTIN Address:Lucknow Business Centre 5th floor Halwasiyas
Commerce House 11 Mahatma Gandhi Marg Hazratganj Lucknow Uttar Pradesh PIN 226001