Customer Copy

AVERY DENNISON (INDIA) PVT LTD

VECHICLE CONSPICUITY ONLINE MIS CERTIFICATE
COMPLIANCE TO AUTOMOTIVE INDUSTRY STANDARD -089,090&037

TO: Paste Hologram here Hologram No.: 00004596

The Regional Transport Office Certificate NO : AVERYRRT0894257
TN04 CHENNAI (EAST) RTO(TN-4) Fitment Date : 16-05-2024
Vehicle Details
Registration No : TN04L4596 Registration Year:2003
Chassis No : 30530 Engine NO : 13908
Vehicle Make: PIAGGIO Vehicle Model : Ape Auto

Vehicle Owner Details Manufacture & Distributor Details

Company Name/Owner Name : PERIYASAMY Manufacturer Name : AVERY DENNISON (INDIA)PRIVATE LIMITED
Contact Number : 9840369688 Distributor Name : Bolster Solutions
Owner Address / Register Address : MFG Address: Distributor Address:
CH, Narshingpur Industrial Area
Six Kilometer Stone No 15/5A, Vishahan Enclave,
Delhi Jaipur Highway,Gurgaon Gandhi Nagar Colony,
Delhi / India. Erode-638009,

Conspicuity Tapes 20MM Rear Marking Plates Details Certificate Details

Fitment Details
20MM - RED : 1.25 Mtrs Class 3 : Red Retro Reflective and Yellow Retro Reflective - Type Approved Number: A95224 &E13 104R
Alternative Strips
20MM WHITE : 1.25 Mtrs Class 4 : Red Retro Reflective border and Yellow Retro COP Number :
Reflective Centre SHL/16/2019-2020/3000008304/COP/3099
Conspicuity Tapes 50MM Previous Certificate Details Test Report Number :SHL/16/2007-2008/2528/1584
Fitment Details
50MM-RED : 0.00 Mtrs Old Certificate No. : NA REAR MARK :SHL/16/2016-2017/9203/1186
50MM-WHITE : 0.00 Mtrs Old Certificate date : NA Certified By : The Automotive Research Association
of India (ARAI)
50MM-YELLOW : 0.00 Mtrs Old Certificate RTO :NA

The Maximun Retail Price for the products specified in this Certificate is 20mm: Rs. 30/feet | 50mm: Rs.46/feet | C3: Rs.650/piece | C4: Rs.750/piece
Rs.250 only.
Fitment Images
Front Back Side-1 Side-2

This is to certify that we have authorised Distributor / Dealer for the sale AIS-089,090,&037 Compliant AVERY Brand Retro reflective Tapes
Supplied by us as per CMVR 104-1989
We hereby certify that we have supplied/installed ICAT/ARAI Approved Retro Reflective Tapes as per CMRV rule 104 specified under CMVR
GSR 784 (E) Authorized Distributor Seal & Signature

Authorized Dealer Signature Customer Signature

[Note: HOLOGRAM MANDATORY WITHOUT HOLOGRAM CERTIFICATE NOT VALID]

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