ICICI Lombard General Insurance Co. Ltd.

TWO WHEELER PACKAGE POLICY

UIN: IRDAN115RP0015V05201415
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)

3005/RF-19170276/00/000 Policy Type

Policy No Proposal No. & Date P26886657, 02 May 2024
Renew
04 May 2024 12:00AM to 03 May 2025 11:59PM
Policy Issued On 02 May 2024 4:03PM Period of Own Damage Cover
Tenure 1 Year
Period of Liability Cover Tenure 1 Year
Insured Name MR. HARSH MAHESHWARI Previous Policy No. P0024200002/4115/508473
B-1738, BLOCK-B SHASTRI NAGAR , , DELHI ,
Insured Add. Previous Insurer MAGMA HDI General Insurance Co. Ltd.
DELHI-110052 GSTIN: NA
Nominee Name Age Relation
PAN CMEPM3691R GSTIN: 07AAACI7904G1ZP
Servicing Office of Insurer: Fourth Floor, Parsavnath Capital Tower , Bhai Veer Singh Marg, New Delhi New Delhi 110001, NEW DELHI , DELHI-110001 State Code : 07
INSURED MOTOR VEHICLE DETAILS INSURED DECLARED VALUE (IDV) (in Rs.)
Make Royal Enfield Motors India Ltd. Vehicle IDV 77099
CLASSIC 350- CLASSIC 350-CLASSIC 350 ABS-GUN
Model-Variant Non-Elec. Accessories 0
GREY
Registration No.-RTO DL 8S CP 5024- DELHI Elec. Accessories 0
Manufacturing Year-Body Type 2019- BIKE Total IDV 77099
Engine No.-Chassis No. U3S5C2KA353191- ME3U3S5C2KA379101 :
Cubic Capacity-Seating capacity 346 - 2
Hypothecation/Lease* No
Fuel Type-Invoice Date PETROL- 03 Mar 2019
Schedule of Premium (Amount in Rs.)
Own Damage Premium (A)
Basic Premium Amount (Rs.) Discounts Amount (Rs.)
Vehicle 1235 Voluntary Deductibles (0) (IMT - 22A) 0
Electrical Accessories (IMT - 24) 0 Anti Theft Device (IMT - 10) 0
Non Electrical Accessories 0 AA Membership(IMT - 8) 0
Sub Total (Basic Premium) 1235 No Claim Bonus (0%) 0
Sub Total (Discounts) 0 Handicap Discount (IMT-12) 0
Add On Coverages 0
Geographical Area Extension (IMT - 1) 0
IMT 33 0
Sub Total Addition 1235
Net Own Damage Premium (A) 1235
Liability Premium (B)
Basic Premium Amount (Rs.)
Basic Third Party Liability (including TPPD ) 1366 PA Cover for Owner Driver of Rs. 0 0
Geographical Area Extension 0 PA Cover for Paid Driver 0
PA Cover ( 0 Per Person) for 0 Persons 0
Sub Total (PA Cover) 0
Net Liability Premium (B) 1366
Total Premium (A + B) 2601
SGST(9.00%) 235
CGST(9.00%) 235
Gross Premium Paid 3071
Note: 1.Policy issuance is subject to realization of cheque
2.The Stamp duty ‘0.5 paid vide deface no. CSD6920232872 dated 14/06/2023. Note: This challan number is not applicable for Jammu & Kashmir policies.
3.The policy is subject to compulsory deductible of Rs.100 (IMT-22)
4.Geographical Area- India

*Subject to IMT Endt. Nos.& Memorandum:,22

Insured Declared Value :The schedule of age-wise insured declared(IDV) as shown in the below table is applicable for the purpose of Total loss including Theft/Constructive Total Loss(TL/CTL) claims only on basis of
loss date falling in the respective year. A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and/or repair of the vehicle subject to terms and conditions of the policy exceeds 75% of the IDV.
Tenure 04 May 2024 to 03 May 2025 - - - -
Total IDV 77099 0 0 0 0
Limitations as to use: The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of goods (other than samples or personal luggage) (3) Organized racing (4)Pace making (5)
Speed testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Driver's Clause: Any person including the insured: Provided that a person driving holds an effective driving license at the time of the accident and cois not disqualified from holding or obtaining such a
license,Provided also that the person holding an 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.
Limits of Liability Clause: Under Section II-1(i) of the policy-Death of or bodily 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 is Rs.1.0 lakhs lakhs PA Cover Under Section III for Owner-Driver is Rs. 0lakhs.
Disclaimer: The Compulsory Personal Accident cover has not been opted in this policy as the Owner driver has a separate existing Personal Accident cover against Death and Permanent Disability (Total and Partial)
for Sum Insured of at least Rs.15 lakhs.
No Claim Bonus: No Claim Bonus is subject to no claim on the previous policy. Benefits under the policy stands forfeited if claim is/was made in previous policy
Grievance Clause: For resolution of any query or grievance, you may contact us on our toll free no. 18002666, or visit any of our branch offices. You can also wrote to us at customersupport@icicilombard.com. For
detailed grievance redressal mechanism please visit the 'Grievance Redressal' on our website www.icicilombard.com.
Hypothecation Details: ----NA----
MISP Code : AB-MRE000080 MISP Name : UNITED AUTOMOBILES DP Name : PAWAN KALRA DP Code : AB-DPRE000067-2669
Important Notice: The insured is not indemnified, if the vehicle is used or driven otherwise than in accordance with the schedule. Any payment made by the company by reasons of wider terms appearing in the
certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS & RIGHT OF RECOVERY" For legal interpretation, English version
will hold good.
I/we hereby certify that the policy to which this certificate relates as well as this certificate of insurance are issued in accordance with the provisions of Chapter X and Chapter XI of Motor Vehicle Act, 1988
SAC 997134 Description of Service : Motor Insurance Place of Supply : DELHI(State Code-07) 18052415459
For & On Behalf of ICICI Lombard General Insurance Co. Ltd.

Authorized Signatory
Broker Name & Add : Aditya Birla Insurance Brokers Limited , Regd. Office: Indian Rayon Compound, Veraval - 362 266. Corporate Office: One World Centre, Tower-1, 7th floor, Jupiter Mill Compound, 841,
Senapati Bapat Marg, Elphinstone Road, Mumbai 400 013. Tel. No.: +91 22 43568585. Fax: +91-22-4356 8511 License Number: 146 CIN: U99999GJ2001PLC062239 Broker Code : 10000001926
Receipt No. : 18052415459 Payment Mode : APD
For Renewal/Claims assistance - please contact Insurance.Co./Broker through : UNITED AUTOMOBILES at 072-90037103