Go Digit General Insurance Limited Schedule/Certificate

Digit Commercial Vehicle Liability Only Policy

UIN No.: IRDAN158RP0001V01201718

Policy Number D057641937 / 19022022 Issue Date 19-Feb-2022

Period of Policy From 26-Feb-2022 00:00:01 Mobile xxxxxxxxx3436
To 25-Feb-2023 23:59:59 Email ixxxxxxxe@rxxxxxxxxxxxxxxxxxy.in
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CGST GSTIN 24ANIPP2824N1ZO GST State Code 24
Name PATHAN SAKIRKHAN NADIRKHAN Partner Code 1085000
B/6 GULNAR NAGAR CO OP SOCIETY LTD Partner Name HIMANI NIRAV SHAH
616 MAYUR TENEMENT NEAR VATVA
Address Partner Contact 8866566445

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GRAMPANCHAYAT VATV,A

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AHMEDABAD,Ahmedabad-382445 Partner Email insurance@rajshrreconsultancy.in

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PAN (POSP) ESFPK7369H

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FH Registration, Policy Type

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Make CubicCapacity/Power Registration/ Trailer Reg.

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G01 Engine, Model Fuel Type GVW Manufacturing No. IMT Endorsements

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Chassis No. Variant Body Type Licensed Capacity Year

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Private
ESF GJ16BS2274 GROVE 1 CC 2018 IMT-28,IMT-

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POS Carrier

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42,IMT-

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N 000NA0 GMK 4090 Diesel 48000 Kg 47(Overturning

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-- covered)

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G12235 CRANE CRANE 1

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Premium Details

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Third Party Liability Premium (Including CNG) (`) 6847.00

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Legal Liability for Paid Driver (Persons:1)(`) 50.00

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POSP

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Legal Liability for Paid Cleaner (Persons:1)(`) 50.00
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Net Premium ` 6947.00
Age CGST @ 9% = (`625.23 ) + SGST/UTGST @ 9% = (`625.23 )
26

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` 1250.46
2-
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501
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Total Premium ` 8197.46

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6847
Dies
90

ENDORSEMENT
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Invoice Number Invoice Date Gross Premium Igst Cgst Sgst Utgst Cess Net Premium
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IA059419267 2022-02-19 8197.46 0.00 625.23 625.23 0.00 0.00 6947.00

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Nominee Details
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Financier Details --
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CGST Previous Insurer The New India Assurance 210600312002000079 Policy Exp.
Misc D Policy Number:
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Name: Co. Ltd. 33 Date: 25-Feb-2022

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Other Details
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FASTag Number NA
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Receipt Details
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Receipt No. RA061203515

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Invoice No. IA059419267

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Receipt Date 19-Feb-2022

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Invoice Date 19-Feb-2022

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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 - Use in connection with the insured's business.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 greater number of
trailers in all than is permitted by law. 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

PolicyNumber :-D057641937
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 Go Digit General Insurance Limited Schedule/Certificate
Digit Commercial Vehicle Liability Only Policy
UIN No.: IRDAN158RP0001V01201718
Important
The Policy Notice
has :been
1) *Cheque
issueddishonor
subject/ Non-receipt of payment: declaration
to your affirmative If premium paid through
that Cheque,
a valid the policy
FASTag has isbeen
void ab initio inon
affixed case
theofinsured
dishonorvehicle.
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.

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For & On Behalf of Go Digit General Insurance Ltd.

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Consolidated Stamp Duty has been paid as per Letter
of Authorization No.67-B/04/2017-18 Date: 30th May

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Authorized Signatory 2017 issued by Department of Stamps and

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Praveen Bhat

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Registration , Bengaluru- 560009 - KARNATAKA.
Senior Vice President - Customer Experience HSN: 997134/General Insurance Services In

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praveen.bhat@godigit.com
Hey, our document is now digitally signed

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Printed, Signed, and Executed at Bengaluru

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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. A

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Company incorporated under Indian Companies Act, 2013 and licensed by Insurance Regulatory and Development Authority of India [IRDAI] vide Reg No.

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158, Corporate Identification Number U66010PN2016PLC167410 | GST Reg. No.: 24AACCO4128Q1Z6 GSTIN Address: Ahmedabad Business Centre,10th
Floor, 1001-1002,Ratnaakar 9 Square, Near Kesav Bagh Party Plot, Vastrapur,Ahmedabad,Gujarat,PIN-380015

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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

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www.godigit.com.

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PolicyNumber :-D057641937
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