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Policy No. USGI/WEBAG/0889304/00/000 LUXURY RIDE INDIA PVT LTD, GT ROAD ROAD NEAR BHARAT PETROL PUMP KARNAL 132001 491 9873574501, INSURANCE@LUXURYRIDE.IN Dear LUXURY RIDE INDIA PVT LTD, ‘Thank you for choosing us as your insurance partner for GOODS CARRYING PACKAGE POLICY Policy. We're extremely delighted to have you on-board. And we are going to be with you every stap of the way. ‘To make your insurance experience seamless, we have introduced below tech-baced solutions, USGI PULZ App - One stop solution for all your insurance needs. Now enjay below complimentary value added benefit with our app. surance Wallet ~ Manage insurance policies on the go with buy and renew Option + Claim Management - Intimate claim online and track claim status + Complete Auto Care Solutions — Online car service appointment, road side assistance, extended warranty, buy spare parts and accessories, sell car online, self-drive car discount, tips to maintain your vehicle + 24X7 Road Side Assistance* ~ In case you are in distress due to flat tyre, drained battery, minor repairing or towing, of vehicle in case of break down or accident of your vehicle, Key locked in car or lost, fuel run dry or arrangement of taxi/ ambulance + Location based Service Find nearest pharmacy, blood bank, wellness center, lab test center, online medicine stores. Also you can track your daily activity, set reminders, and maintain your health profile and much more * Subject to Terms and conditions of Universal Sompo Policy covering the vehicle with RSA cover Al-Powered Virtual Agent ‘= Helps you intimate claim with ease We're committed to offer you best-in-class services. For any query, callus on our toll-free number 1800 22.4030 / 1800 200 4020, or mail us at contactus@universalsompo.com. You can also drop by at one of our branches. For more informs visit our website www.universalsompo.com Please note that your policy is issued as per the information provided by you to us in the praposal form/ e-proposal form as well as the terms and conditions accepted by you. In case of any disagreement, discrepancy, or clarification that you may need, please let us know within 15 days of policy received, We are pleased to share a list of those Garages in your city which have been trusted and rated highly by our customers basis their experience. You may like to consider to utilize their services in the unfortunate event if an accident or damage of your vehicle ‘S.No, Garage Name Garage Address IKANAV MOTORS PRIVATE |118/7 MILESTONE NATIONAL HIGHWAY NO.1 GT ROAD, KARNAL KARNAL KARNAL jumiteD [HARYANA 132001, SAMTAMOTORS PVT.LTD —_ |KHETRAPAL, 119/8 MILESTONE, GT ROAD, KARNAL KARNAL KARNAL HARVANA 132001 LALLY AUTOMOBILES PVT |117/BKM, MILESTONE GT ROAD, MADHUBAN, KARNAL (989632001) KARNAL KARNAL LTD [HARYANA 132001, NEAR NAMASTEY CHOWA, OLD GT RD, KARNAL - 132001. KARNAL KARNAL HARYANA MODERN auToMoniLes [NN 'PLOT NO- 16/1979, KHEDA COLONY, NEAR DOON VALLEY, COLLEE, KARNAL - 132001. [ARPITA MOTORS [KARNAL KARNAL HARYANA 132001 |G T MADANPUR RD, NEAR BANSAL MOTORS, KARNAL - 132001. KARNAL KARNAL HARYANA Jaavi MOTORS: pares PSB AUTOSALES PVTLTD —_|117/8 KM STONE, NH-1.GT ROAD KARNAL KARNAL KARNAL HARYANA 132001 [HOUSE NO.-1508 SHIV COLONY GALI NO.-1 KARNAL SHIV COLONY AMBALA AMBALA SURINDRA MOTORSTASC [ay 130901 1113/12 KM STONE G.T RD. MADHUBAN, KARNAL, HARYANA - 132001 KARNAL KARNAL KANISH MOTORS PVT LTD ee aoe KARNAL MOTORS PVT LTD. |71/3 MILESTONE, G. T. RD, KARNAL 132001. KARNAL KARNAL HARYANA 132001 You can also visit below link to check the Garage list or scan the QR code. UNE httos://universalsompo.com/cashless- ‘Thanks again for choosing Universal Sompo, look forward to a long and healthy relationship. f uh we Gosavi Head Operations Customer Services Ee Bara Scan to download USGI Pulz Sean to check Garage List Be App Regd. No, 134 ‘enna cum Poucy muse usciyweaecjoa93n4o0/000 [INTERMEDIARY MAME "SQUARE INSURANCE BROKERS PRIVATE LIMITED a owcimevoKe 9 yyyza2 Ison name {nun nie mia P10 mnt coveRnore fy (Rado NEAR BHARAT PETROL PUMIPKARNAL [ReGTRATIN DATE feurzsznen Bina Fe =e foe ws pee (eumonsir wrt pen rcctectneccnene: [eet ee Eo oe I ‘POS AGENT DETAILS. ————————__——— AGENT ORLEN— sa rose TORTI — oma —— ‘PARTICULARS OF VEHICLE INSURED REGISTRATION ENGINE BODY | CUBIC [MFG CARRYING SEMEN. CHASSISNUMBER | eyimeR MAKE MODEL yor (cqpactry sean © (capacty co caxco exe HRAG-D-0007 MAGERLFIS00974573 GaaNoors7 MARUTIAEES 9 | ni96 jam 0 | 5 cxxco cen (PEC Nie | PEC Ceter [ ‘NA [ ‘NA IINSURED'S DECLARED VALUE Rs) vemere mane TER | yoxeize | rurcreicaurtecrromic xe irc TOTAL Ty apy CHASSIS | CGRSSORIES | ACCESSORIES KIT KIT) VALUE |/4¢0000.00 0.00 0 | 00 | 0.00 0.00 | 0.00 | 460000.00 SCHEDULE OF PREMIUM (AMOUNTINR) ‘OWN DAMAGE @) [ TIABILITY (B) Sane OentT rr nisinany sy pest ~ \Basic Liabitity 16049.00 Tet D seas eee eee 62085) aston OTHER LIABILITY COVERS (B2) ‘ives Ca Lending ° aa ‘dOnt ped Ni Deed Pan A bar an ‘M4 008) Premio ramon [PaO ae “etal Ova Damage Prenim 218400 NET REMICAL OWN DAMAGE) + OTHER LABEL 59 paste HABIT) 103.0 VERS(B2) IGsT a8%) [39672 GST a2%) 1925 88 AL OWN DAMAGEA)= OTHER LIABILITY COVERS |... TOTAL BASICLIABILTIVB) 525 2) ANCTUDING GSD ascrumixe cst) SERVICE TAX 0.00 [TOTAL PREMIUM aNCLUDING GsT) 120876.00 |coMPULSORY DEDUCTIBLE 00.00) aan NSD NG Cine niy vee Speirs ti pn ofa pveana Tan varie epee Soop tiocon stacey Bayete eronvasfpim wits roc iui tore Pes capes nena cnee esheets gutting eset namanpen ine comme acutn i icrananetraempesenear goes stata ‘Seba ewvmectbreniecrnspeparcos ts hopsissmeng. Peraseg painsg beim ran oner Mama tec mp ererag one arbres et PERMECOLLECTIN SEAMS. alc en Rei PRESSE "DISLAIMER rv gti epee esa tm cern ei iy amet wag tence thong Yvert ogee cane aeaenpn is hen Santo acon ais ape nena eer ety oe cubssunenieap ow at oy ap ete Selizinsss inpisoats anu a consscaguentfapsca istaedeaaussiananisonioamtnsnnciwesasmrenieamneasmesciae vsti that ams ecified incre eX th LUSGHIRDAIREGISTRATIONNO: 138 ew da Dy aa tert A siah ont ne umentnecteceiaencie esa twee pe es gy Up ar NEL Aa a Seni adams emer nape hoa oa pono usb nS ne ba Ean ae cnc a aa ne an Dao wy oe a Universal Sompo General Insurance ‘Suraicha, Hamesha Aapie Saath ‘PROPOSAL FORM CUM TRANSCRIPT LETTER FOR GOODS CARRYING PACKAGE POLICY xc Posen. _quiboosiss Lununy mide mo v.79 pastor rim esueree | exmeeemme) | EWA ‘none sm — com beissct fo oba1 am oF p0270 WNT OF ono tbateranarreot rap ama tneer (ose Sena an ro su ered att TO Sasa, nae NSE occa —— eu/fsT6o33 Cees pereem Gineaseeny ie Mirerevaten ha Manufacturing — 70 vewaziov | ran secu oxseemeuoy | auwer_| vex | Tommy ant oo a on oe PREMIUM DETAILS k ‘hn bance LT OSESUNT OREN A ACERT RETO ND FOS RTD a sen i ‘erase boars an cone besten Pin A, J seen coarion hw J agate longus tess 00 Matra css el ‘iano RebtesSeron isu a SSBamandal)= ‘repo, norsralsryperse ting ovo renewing onsnune Boley scape ay rebate extae sum Teese 4s maybe aloes In ecordance Wi Ne Publsned prospecuset or ables ome Insurer provided mat acobtana by an insurance ager ot commiscion i conmer.on With 3 Poly a fe Insurance {en aur yhimee or is own Ife shal pete dewed fo be aaaptance of a ebate of araniun within themaaning ofthis su secion Wf ae dime ot Such acascance the insurance age salstes te resabedcoriors establishing that hes bara ae nsueree seen emoloyecby he suet «+ Bnybetson maine defutein comping with the prov sins of os secon shal be lise ft = penalty which ay cord oie Nh Tubes rey declare ite insures Persons) sted In oposal Fm wil ade oe olouing ens ad condos 1 ywerere oy score marine srcements mage by ma/us are sue to oe best of my/our owed and beet and Ife nereby agree MTN carson nallfom metasis ote corraz beaveen me/us ana Unwersal Somgo Gere! ncurses Company Une. 4 (MWeatze ceca it tay adaione or saraions are cad og ater te submission oes epoca fom, han He same would be conveyed to he 4+ Wesco salt endeavour vo procure me erenal noice zr pass onthe szme to Unis Sompo General Insurance immestazey Upon the eels of sch «+ Siypetcon whe, knowin 2nd wih inten dtraud one insurance Company octet pesons es 2 proposal fer iasurance containing an fase Intrmatlano conceals fore purpace of msieadrg,infermatonconcing sty fact atta hereto, commis 2 rauulent a which wil end he oly voidebe tthe Companys aol iertion and ecu ne denial of stone: bene STH aMetr|Comprehersie ard For poe tsued inte ame of orporete en (copier FUE, parmership, pve compery eo), STN ix printed arte poly baz the details wove dng poli eruance| Foranyssoacquert changes aadton fief STI rot eters tthe me of pale iesuanee on poly schedule, charges shel been cut rough Senta eee on pene geese anne ne OS { thkcoer isnot opted ajme-az do norhaue eerie dene heen, ot 1 GPksver snot oped ayes nae standolane ck eover Sl #2559) o¢ (© CPkcowric not opted bye se have Persona sider cover for taf 815 tnx or higher “rarer Destin reas sapere o”ejecion or ay other changes with resect to nromation and certerts mations nein above, please {oraz ur toe number ana ester ou sblecions /eanges/lsaptemaneto ie cnten oF hs FanscipeorYaU MaV ASO SeMOUeSI ATTEN ‘vst i conscusqunierselsomp com Tose Ho: 109224050 / 280000450.

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