HDFCERGOGeneralInsuranceCompanyLimited

CertificateofInsurancecumPolicySchedule
MotorInsurance-PassengerCarringLiabilityonly

2320101024995800000

VehicleDetails PolicyDetails
Make SCOOTER INDA PolicyNo. 2313101394743200000
Model-Variant VIKRAM 3 WELLER Period From15/02,202400:01hrs
RegistrationNo UP14CT4826 ofInsuran To14/02,2025Midnight
ce
EngineNo. 474390 IssuanceDate 14/02/2024
MR. SUKH RAJI ChassisNo. 0882EC InvoiceNo. 101024995800000
VILL PASONDA SAHIBABAD CubicCapacity510WattsY00Seats(Incl.ofsidecar)7
GHAZIABAD UP 999999 earofManufacture 2011 PAN
RTO SAHIBABAD No.EIAN SAHIBABAD

o.
PaymentDetails:FundTransferNo.LP2103884139,Date:05/09/2023,BankName:BizDirect
EmailID:coolkhan00000@gmail.com

Insured'sDeclaredValue(IDV)(`)
Vehicle SideCar ElectricalAccessories NonElectricalAccessories CNG/LPGKit TotalIDV
0 0 0 0 0 0
PremiumDetails(`)
LiabilityPremium (`)
BasicThirdPartyLiability: 9883
SubTotal-Addition 9883
NetLiabilityPremium 9883
IntegratedTax18% 1778
TotalPremium 11661
GeographicalArea India
CompulsoryPAcoverforownerdriverhasnotbeenprovidedtotheinsuredbasishis/herdeclarationofnotholdinganeffectivedrivinglicenseOrhavingAlternatePA/StandaloneCPApolicywithminimumsu
minsuredofRs15Lakhs.

NomineeforOwnerdriver Appointee
EndtNo. ListofEndorsements_Description EffectiveDate EndDate Premium

LIMITATIONS AS TO USE:ThePolicy covers useof thevehiclefor any purpose other than: a)Hire orRewardb) Organizedracingc)Speedtesting.PersonsorClassofPersonsentitledtodrive:Any personincludingtheinsured,
providedthatapersondrivingholds aneffectivedrivinglicenseatthetimeoftheaccidentandis not disqualifie
dfromholdingorobtainingsuchalicense.Providedalsothatthepersonholdinganeffectivelearner`slicensemayalsodrivethevehicleandthatsuchapersonsatisfiestherequirementsofRule3oftheCentralMotorVehiclesRules,198
9.LimitsofLiability1.UnderSectionII-1(i)ofthepolicy
-Deathoforbodilyinjury-SuchamountasisnecessarytomeettherequirementsoftheMotorVehiclesAct,1988.2.UnderSectionII-1(ii)ofthepolicy-DamagetoThirdPartyProperty- `1000003.
P.A.CoverunderSectionIIIforOwner-Driver(CSI):`0Terms,Conditions&Exclusions:AspertheIndianMotorTariff.Apersonalcopyofthesameisavailablefreeofcostonrequest&thesameisalsoavailableatourwebsite.

WarrantedthattheAssurednamedherein/ownerofthevehicleinsuredholdsavalidPollutionUnderControl(PUC)Certificateonthedateofcommenc ementofthePolicy.IfthePUCisnotfoundvalidonthedateofcommencementofthePolicy,Thecompanyre
servestherighttotakeappropriateactionincaseofanydiscrepancyinPUCcertificate.
I/WeherebycertifythatthepolicytowhichthecertificaterelatesaswellasthecertificateofinsuranceareissuedinaccordancewiththeprovisionofchapterX,XIofM.V.Act1988.Thestampdutyof0.50paidbyDemandDraft,videReceipt/Challanno.CSD/36/2
019/2289/19dated27-05-2019asprescribedinGovernmentofMaharashtraOrderNo.Mudrank?2004/4125/CR690/M-
1,datedthe31/12/2004.GoodsANDServiceTaxRegistrationNo:27AABCL5045N1Z8.IMPORTANTNOTICE:TheInsuredisnotindemnifiedifthevehicleisusedordrivenotherwisethaninaccordancewiththisSchedule.AnypaymentmadebytheCom
panybyreasonofwidertermsappearingintheCertificateinordertocomplywiththeMotorVehicleAct,1988isrecoverablefromtheInsured.Seetheclauseheaded"AVOIDANCEOFCERTAINTERMSANDRIGHTOFRECOVERY.
"Disclaimer:ThePolicyshallbevoidfrominceptionifthepremiuminfullisnotrealisedbythecompany.Intheeventofmisrepresentation,fraudornon-
disclosureofmaterialfact,theCompanyreservestherighttocancelthePolicy.Pleasenotethattheinsuredvehiclewaspre-
inspectedandareportwaspreparedaccordingly.TheexistingdamagestothevehicleasmentionedinthereportshallnotbepaidbytheCompany.Thep olicyisissuedbasistheinformationprovide
dbyyou,whichisavailablewiththecompany.Incaseofdiscrepancyornonrecordingofrelevantinformationinthepolicy,theinsuredisrequestedtobringthesametothenoticeofthecompanywithin15days.Iunderstandthattheriskshallcommen cefromthestart
date28/03/2021asspecifiedinthePeriodofInsurancesectionoftheTwoWheelerLiabilityPolicy.GoodsandServiceTaxforthisinvoiceisnotpayableunderreversechargebasis.

Branch:LEELABUSINESSPARK,6THFLR,ANDHERI-KURLARD,MUMBAI,400059.PhoneNo.:+91-22-66383600

GoodsANDServiceTaxRegistrationNo:27AABCL5045N1Z8 HSNCode 997134

AgentCode: 200218255690AgentName : INVICTUSINSURANCEBROKEING ForHDFCERGOGeneralInsuranceCompanyLtd
SERVICESPVTLTD(TP)

ScanthecodeforInstantPolicyInfo,Register/TrackClaim,RenewalandModificationsinpolicy.

"Fordetailedpolicytermsandconditionspleasevisitourwebsitehttps://www.hdfcergo.com/download/policy-wordings."

HDFCERGOGeneralInsuranceCompanyLimited.IRDAIRegNo.146CIN:U66030MH2007PLC 177117.Registered&CorporateOffice:1stFloor,HDFCHouse,165/166BackbayReclamation,H.T.ParekhMarg,Churchg
ate,Mumbai-400020.
UIN:HDE-MT-P16-26-V01-16-
17.CustomerServiceAddress:D301,3rdFloor,EasternBusinessDistrict(Magn
etMall),LBSMarg,Bhandup(West),Mumbai-
400078.CustomerServiceNo:+9122-62346234/+91-