MotorCommercialVehiclePackagePolicy-ForPassengerCarryingVehiclesupto6

(SeeRule51ofCentralMotorVehiclesRules,1989ofMotorVehicles Act,1988.)

CHOLAMANDALAMMSGENERALINSURANCECOMPANYLTD.
ADDRESS:A G A R T A L A B R A N C H O F F IC E GSTInvoiceNo.:3368486497159
1STFL O O R , ABOVEWS H O W R O O M , NEARR AYM ON DS DATE:1 9/ 1 2/ 20 2 3
M AN TR I BARIR O A D, R M SC H O W M UH IN I PAN:A A B C C 6 6 3 3 K
A G AR T AL A H.O SACCode:9 9 7 1 3 4
CITY:W E ST TR I P U R A STATE:T R I P U R A SACDescription:Motorvehicleinsuranceservices
GSTIN:1 6 A A B C C 6 6 3 3 K 7 Z G
BusinessLocation:AGARTALABRANCHOFFICE CoverNoteNo:-
PolicyNumber:3368/01476551/000/00 CustomerCode:1004858741810001 PolicyType:Package-PassengerCarryingupto6
Name&CommunicationAddress: NameandRegistrationAddress:
ABHIJITDEBBARMA
C/O SENKUMAR DEBBARMA DEBPARA PASCHIM C/O SENKUMAR DEBBARMA DEBPARA PASCHIM
BALARAM,KULAIBAZAR S.O,DHALAI BALARAM,KULAIBAZAR S.O,DHALAI
TRIPURA,PIN-799204Mobile-7085274051 TRIPURA,PIN-799204Mobile-7085274051
AadharNo.:- PANNo.:-
PeriodofInsurance:from19/12/202315:22hourstomidnighton18/12/2024 BusinessorProfession:Individual GeographicalArea:NoExtension
CertificateNumber:3368/01476551/000/00 IssueDate:19/12/2023
PARTICULARSOFTHEVEHICLEINSURED
DateofRegistration:17/01/2023 PlaceofRegistration:AMBASSA RegistrationMark:TR-04-A-3881
Make:PIAGGIO Model:APEECITY-FXMAX Variant:FXMAX VehicleColour:- YearofMfg:2022
TypeofBody:AUTO FuelUsed:ELECTRICAL EngineNo:2211S000858 ChassisNo:MBX0009NF1L245256
Cubic K.Watts Gross Vehicle GVWasperR Public/Private Registration Contract
Capacity:1 :5.4 Weight(GVW):- C:- Carrier:PUBLIC Mark(Trailer):- No:PNB000000000000000
LicensedPassengerCarryingCapacity:3 Driver1 Cleaner:0 Conductor:0 TotalSeatingCapacityIncludingDriver:4 ChassisNo.(Trailer):-
IDV(InsuredDeclaredValue)
ValueofChassis(Rs):306367 ValueofBody(Rs):0 ForVehicle(Rs):306367 ForTrailer(Rs):0 Non-ElectricalAccessories(Rs):0
Electrical/ElectronicAccessories(Rs):0 ValueofCNG/LPGKit(Rs):0 TotalValue(Rs):306367
A.OWNDAMAGE B.LIABILITY
SI No.ofPerson IMT Premium(Rs) SI No.ofPerson IMT Premium(Rs)
BasicOD 306,367.00 3,860.00 BasicTP 3 4,015.00
IMT23 3,860.00 23 579.00 PaidDriver 1 40 50.00
TOTAL 4,439.00 TOTAL 4,065.00
Less: TOTALPREMIUM(B) 4,065.00
BonusDiscount(20%) 887.80 C.PERSONALACCIDENTCOVERS
SubTotal:(discounts) 888.00 TOTALPREMIUM(C) .00
OwnDamagePremium 3,551.00
ExperienceBasedDiscount(55%) 1,953.16 TOTAL(A+B+C+E) 5,663.00
TOTAL(A) 1,598.00 TOTALCONSIDERATION 5,663.00
D.ADD-ONCOVERS(BENEFITS) CGST(9%) 509.50
BenefitN SGST(9%) 509.50
OptionNo. IGST(0%) 0.00
o.
ADD-ONCOVERSPREMIUM 0.00 AMOUNTCOLLECTED 7,882.00
Add-OnCoversDiscount .00
TOTALADD-ON-COVERSPREMIUM(D) 0.00
E.OTHERCHARGES(NONPREMIUM)
Cholavalueaddedservices 0.00
TOTALOTHERCHARGES(NONPREMIUM)(E) 0.00

LIMITATIONSASTOUSE:The Policy covers use of the vehicle for any purpose other than: a)Organised Racing. b)Use while drawing a Trailer,except the towing(other than for reward) of any one disabled mechanically propelled vehicle. c)Pace Making. d) Reliability Trial. e)SpeedTesting.

DRIVER CLAUSE:Any person including insured provided that a person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the Person holding an effective learner's license may also drive
thevehiclewhennotusedforthetransportofpassengersatthetimeoftheaccidentandthatsuchapersonsatisfiestherequirementsofRule3oftheC entralMotorVehiclesRules1989.
LIMITSOFLIABILITY:Under Section II-1 (1) of the Policy - Death or bodly injury such amount as is necessary to meet the requirements of the Motor Vehicle Act, 1988. Under Section II - 1 (ii) of the Policy - Damage to Third Party Property -Rs.750000P.A. Cover for the Owner
cumDriver Under Section III (CSI)-Rs..00Deduction Under Section 1: Rs.500 Additional compulsory deductibles under Section 1 Rs.0.00
AdditionalImposeddeductiblesunderSection1Rs.0
SubjecttoI.M.T.Endt.Nos.andMemorandum:23,22,40,7.
CoverageUnderthispolicyissubjecttorealisationofpremiumcheque(s). Incaseofdishonorofcheque(s).Noseparateintimationwillbegivenandthe policystandscancelledfrominception.
ProductPlan:
Applicablebenefits:-
Thepolicywordingswithdetailedterms,conditions,warrantiesexclusionsandthelistofOmbudsmandetailsareavailableonourwebsitewww.cholainsurance.com.
DateandSignatureoftheproposal19/12/2023.
Warranties:-
Thispolicyisprecededbybreak-ininsuranceandhenceitisexpresslyagreedandunderstoodthattherewillbenoliabilityforanylossordamagethathasoccurredp riortothedateofcommencementmentionedintheschedule
WarrantedthatNCBunderthisPolicyisbasedonrepresentationregardingNCBandabsenceofclaimunderthepreviousPolicy.Iftheinformationbefoundincorrectorfalseinanyaspect,thisPolicyshallbevoidabinitioandnobenefitshallbep ayablebythecompany.
ThispolicyhasbeenissuedupondeclarationbytheAssuredthatavalidPollutionUnderControl(PUC)Certificateisheldonthedateofcommencemen tofthePolicy
ltisherebywarrantedthecoverageunderthisPolicycommencesonlyfromtheRiskStarttimeandDateasmentionedinthePolicyschedule.NoLiabilityshallattachunderthisPolicyinrespectofanyAccident/LosspriortothetimeanddateofcommencementofPeriodof insurance

NoClaimBonuswillonlybeallowedprovidedthepolicyisrenewedwithin90daysoftheexpirydateoftheprevious policy.
CVASNEW:
AsperGR36A-PAforOwnerdriverreferstotheOwneroftheinsuredvehicleholdinganeffectivedrvinglicence.
NomineeDetails:
FinancierName&Address:PUNJABNATIONALBANK,AMBASSA,AMBASSA

Intermediary Name: CIFCL-AGARTALA-NORTHEASTCode: POSPName:

201413991021 POSPPANNo.:
ContactNo:9864639241 POSPAadhaarNo.:
Note:TheMotorPolicySchedulecumCertificateofInsuranceisanimportantdocumentissuedbasedonyourdeclaration.Werequest youto verifythedetails andensurethat everythingisin order. Incaseofanydiscrepancies,pleasecontactuswithin15daysfromthedateofissuanceof
policy.
ForCholamandalamMSGeneralInsuranceCompanyLtd.
Place:CHENNAI Date:19/12/2023 Receipt No: ReceiptDate:
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Digitally signed by:

KANCHIPURAM
SRIDHAR HARISH
ConsolidatedStampDutyPaidVideG.ORtNo,Commercial Taxesand Registration (j1) Department, Tamil Nadu dated DulyConstitutedAttorney(s)

I/Weherebycertifythatthepolicytowhichthiscertificaterelatesaswellasthiscertificateofinsuranceareissuedin accordancewith the p rovisionsof ChapterX and ChapterXI ofthe Motor Vehicles Act, 1988.
IMPORTANTNOTICE:Theinsuredisnotindemnifiedifthevehiclesisusedordrivenotherwisethaninaccordancewiththisschedule.AnypaymentmadebythecompanybyreasonofwidertermsappearingintheCertificateinordertocomplywiththeMotorVehicleAct,1988, is
recoverablefromtheinsured.Seetheclauseheaded"AVOIDANCEOFCERTAINTERMSANDRIGHTOFRECOVERY"
ForInformation/Claims:ContactTollFreeHelplineat18002085544:sms"CHOLA"to56677ForCAREcontact18001035354;
E-mail:customercare@cholams.murugappa.com:www.cholainsurance.com
Note:UINforthisproductandtherelatedaddoncoversavailedunderthispolicyareasmentionedintheattachedsheet,whichformspartofthePolicySchedule.

Whethertaxispayableunderreversechargebasis-No.
CholamandalamMSGeneralInsuranceCompanyLtd.
Regd.&Head Office:DareHouse,2ndFloor,No.2,N.S.CBoseRoad,Chennai-600001,IndiaCIN:
U66030TN2001PLC047977 | IRDAI Reg. No. 123
 Motor Commercial
VehicleProduct Package Policy - For
:
Name PassengerCarryingVehicles
upto6
IRDAN123RP0005V03100001
UIN :
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