This Document is Digitally Signed

The Oriental Insurance Company Limited Signer: SUNITAGUPTA

Date: Mon, Sep 4, 2023 19:47:28 IST
Location: NOIDA
Reason: Signing Policy for OICL

MOTOR INSURANCE CERTIFICATE CUM POLICY SCHEDULE

STANDALONE OWN DAMAGE(OD)-PRIVATE CAR POLICY - ZONE B
UIN: IRDAN556RP0001V01201920
Road Side Assistance included in this policy - Toll free No.18003091209 *Conditions Apply

Policy No : 211200/31/2024/159866 Prev Policy No : -

Cover Note No : - Cover Note Dt :

Insured's Code : 172093584 Issue Office Code : 211200

Insured's Name : MANDAR CHANDRAKANT LOKHANDE Issue Office Name : DO II NEW DELHI (GSTIN:
(GSTIN: 0) 07AAACT0627R1Z1)

Address : 149 Samarth Nagar Aurangabad Address : 16/20, WEA, FIRST FLOOR,NEAR SHASTRI
PARK,
PADAM SINGH ROAD, KAROL BAGH
AURANGABAD
NEW DELHI
MAHARASHTRA 431001
NEW DELHI DELHI 110005
Tel /Fax /Email : / / 9325534581 / mandarlokhande@gmail.com Tel /Fax /Email : 011-41052050, 41062050, 8851779656 /
011-41052050 /
211200@orientalinsurance.co.in
Lead\Breakin No : 0

Local Servicing Office Code : 211200

Local Servicing Office Details : DO 2 NEW DELHI,16/20, WEA, FIRST FLOOR,NEAR SHASTRI PARK,,PADAM SINGH ROAD,
KAROL BAGH,NEW DELHI,,,011-41052050, 41062050,
Agent/Broker Details
Dev.Off.Code :

Agent/Broker :: LC0000000660 M/S POLICYBAZAAR INSURANCE BROKERS PRIVATE LIMITED

Address : Plot No. 119, Sector-44, Gurgaon,, Gurgaon, Haryana, 12200,Tel - 1800-258-
5970,GURGAON,HARYANA,122002
Tel /Fax /Email : 1800-258-5970/1800-258-5970//
Period of Insurance : FROM 00:00 ON 05/09/2023 TO MIDNIGHT OF 04/09/2024

Collection No & Dt : 3 2005168339 - 04/09/2023 GST INVOICE NO :0722398232 UIN :0

Gross Premium : 68,200 GST : 12,276 Stamp Duty : .5 Total : 80,476

Geographical Area : IND Area Extension :

Particulars of Insured Vehicle:

Registration Mark Engine No. & Type Of Body Cubic Year Of Seating Capacity
& Place Chassis No. Make - Model Capacity Manf. (including Driver)

MH 20 GE 3709 K15CN9057130 MARUTI-XL6 Zeta MT OTHERS 1462 2022 5 + 1

Petrol
Aurangabad MA3CNC72SNG302
915

Limitations as to use: C.P.A Cover Owner Driver(CSI):Rs 0

1 The policy covers use of the vehicle for any purpose other than hire or reward ,tuition,organized racing,pace making,reliability
trial,speed testing,carriage of goods(other than samples or personal luggage) or use for any purpose in connection with Motor Trade.

Limit of Liability: As per policy terms/conditions

Place : NEW DELHI

Date : 04/09/2023
Page 1 of 3
 This Document is Digitally Signed

The Oriental Insurance Company Limited Signer: SUNITAGUPTA

Date: Mon, Sep 4, 2023 19:47:28 IST
Location: NOIDA
Reason: Signing Policy for OICL

Attached to and forming part of policy number 211200/31/2024/159866

8851779656,8851779656,211200@orientalinsurance.co.in

Details of TP insurance
Name of Insurer & Address Policy No Period of Insurance
The New India Assurance Co. Ltd. 98000031220911968966 04/09/2022 TO MIDNIGHT OF 04/09/2025

If the TP Insurance declaration provided above by the Insured is found incorrect/or the policy does not exist/ lapsed/Cancelled due to any
reason, then subject policy becomes Null and Void from the date TP coverage has ceased to exist.
*This insurance excludes any loss/liability arising out of Third Party or personal accident.

*This insurance excludes all pre-existing damages

Insured's Declared Value

For the Vehicle For Trailers Non Electrical Electrical Value of CNG Total Value
Accessories Accessories LPG Kit

11,87,654 0 0 0 11,87,654

SCHEDULE OF PREMIUM

BASIC OD COVER 21,943.00 TOTAL PREMIUM 68,200.00

BASIC OD TOTAL 21,943.00 ADD :IGST 12276.00
ADD :Add on cover Key Replacement 300.00 STAMP DUTY 0.50
ADD :Add on cover Consumables 37756.00 TOTAL AMOUNT 80,476.00
ADD :ADD-ON COVER NIL DEPRECIATION 4,057.00
POLICY
LESS :Discount 18,652.00
LESS :Motor Add on Cover 811.00
Discount(Nil.Depreciation)
OD TOTAL 7,593.00
LESS :NO CLAIM BONUS-GR27 658.00
MOTOR TOTAL OD 6,935.00

Please note the coverage under this policy is restricted to Own Damage section only and no other liability in connection with the
vehicle

* NCB discount - 20 %

Deductibles under Section-I :

Subject to IMT Endorsement Printed herein/attached to : IMT-20 , IMT-22

Details of IMT Endorsements are also available on the Company¿s Web Portal www.orientalinsurance.org.in

Hypothecation Agreement with: STATE BANK OF INDIA

Hire Purchase/Lessor Agreement with: -

In the event of a claim under the policy exceeding Rs.1lac or a claim for refund of premium exceeding Rs1lac,the insured will comply with
the provisions of the AML policy of the Company.The AML policy is available in all our operating Offices as well as company's website.
The insurance under this policy is subject to conditions, clauses, warranties, exclusions, IMTs and OIC endorsements mentioned herein
above which are available on Company's website: www.orientalinsurance.org.in or on demand from the policy issuing office.

Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and the policy shall be void
abinitio (from inception).
Claim is not admissible if Driving License is found fake or is not valid whether or not in the knowledge of the insured.

Place : NEW DELHI

Date : 04/09/2023
Page 2 of 3
 This Document is Digitally Signed

The Oriental Insurance Company Limited Signer: SUNITAGUPTA

Date: Mon, Sep 4, 2023 19:47:28 IST
Location: NOIDA
Reason: Signing Policy for OICL

Attached to and forming part of policy number 211200/31/2024/159866

I/We hereby certify that the policy to which the certificate relates as well as this certificate of insurance are issued in accordance with the provision of
Chapter X and Chapter XI of Motor Vehicles Act, 1988.
In witness whereof the undersigned being authorised by and on behalf of the company has/have herein to set his/their hands at DO II NEW DELHI
(GSTIN: 07AAACT0627R1Z1) on 04-SEP-23
IMPORTANT NOTICE
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 the Certificate in order to comply with the MVAct, 1988 is
recoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY".

Entered By : POLICY BAZAR

Examined By : POLICY BAZAR

Digitally Signed
Policy Printed By : PRTL IP : By
Policy Printed On : 04-SEP-23 19:47:42 Authorised Signatory

In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485.
CIN: U66010DL1947GOI007158 All the Amounts mentioned in this policy are in Indian Rupees
IRDA Regn. No. 556-Now you can buy and renew selected policies online at www.orientalinsurance.org.in
and through other digital platforms Whatsapp (Send "Hi" to 9560711200)

Place : NEW DELHI

Date : 04/09/2023
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