1. 421016 - Address:- V C T V MAIN ROAD, SATHY ROAD, ERODE-ERODE TAMIL NADU 638003 Tel 0424-4271787
Date Of
Regn / Delivery
CERTIFICATE CUM POLICY SCHEDULE
MOTORISED-TWO WHEELERS PACKAGE POLICY - ZONE B
Insured's Code/ Name: 8815397 Mr.V RAMESH
S/O VENKATACHALAM,NO
8/79,NETTAVELAMPALAYAM,ANANGOOR,THIRUCHENGODE TK -NAMAKKAL
TAMIL NADU 637001
GST:0
TN 34 T 3131 OE4GD2492212 BIKE 160 16-09-13 1 + 1
PETROL
SCHEDULE OF PREMIUM
2013
A. OWN DAMAGE B. LIABILITY
* NCB discount - 20 % Previous Policy : 015265440800 - Previous Insurer : TATA AIG General Insurance Company Nominee for
Owner/Driver : VENKATACHALAM- Age : 57 - Relationship : Father - Appointee Name : NA - Appointee Relationship : Select
The above Total OD Premium is inclusive of all applicable Loading/Discounts viz (Automobile Association, Voluntary Excess, Anti-Theft, Handicap Person, Driver Tuition, Fibre Glass,
CNG/LPG Unit, Geographical Extn, Imported Vehicle etc wherever applicable)
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 is 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.
Limitations as to Use
Use only for social, domestic and pleasure purposes and for the insured's business or profession. The Policy does not cover use for hire or reward, tuition, racing, pace making, reliability
trial, speed testing, carriage of goods(other than samples or personal luggage) in connection with any trade or business or use for any purpose in connection with Motor Trade
For and on behalf of
Cubic Capacity /
Year of Manf
BASIC TP COVER
ADD :GR36A-PA FOR OWNER DRIVER
TP TOTAL
462.00
50.00
512.00
SHRIRAM GENERAL INSURANCE COMPANY LTD.
IRDA Regn No - 137
:
Executive: NA0000000960 : Contact No:
MD634KE45D2G03072
RTO Tiruchengode
OD TOTAL
TOTAL PREMIUM
ADD :SERVICE TAX
FINAL PREMIUM
732.00
1,244.00
154.00
1,398.00
Deductibles under Section-I : Compulsory Deductible Rs.100
Subject to IMT Endorsement Printed herein/attached to : IMT-22
P.A. Cover under Section III for Owner - Driver (CSI) : Rs. 100000
Place : ERODE Date : 17/09/2014
We will contact you through phone,e-mail, letters, registered AD, sms, etc for renewal before/after the expiry date of
your policy. If you do not want us to contact you, kindly send an e-mail for the same on dnd@shriramgi.com
All the Amounts mentioned in this policy are in Indian Rupees
Authorised Signatory
Note :-Claim intimation after 48 hours will be
considered as delayed intimation.
Service Tax Reg. No. AAKCS2509KST001 Page 1 of 1
CIN No. U66010RJ2006PLC029979
Policy No 421016/31/15/004024 Prev Policy No -
Period of Insurance : From 12:19 on 17/09/2014 To Midnight of 16/09/2015
SI for Named
Persons
Seat Cap
(Incl Driver)
IDV For the Total Value
Vehicle
IDV For side
car
Non Electrical
Accessories
Electrical
Accessories
65,000 65,000
Hypothecation Agreement with:
Hire Purchase/Lease Agreement with:
TVS-APACHE RTR
160
Agent Details
-
-
Collection No & Dt CD A/c AA0000165860
Issue Office:
Geographical Area INDIA
Address: :
Cvr Note No. - Issue date
Gross Premium: 1,244 S Tax: 154 Total: 1,398
Registration
Mark & Place
Engine No
Chassis No
Make - Model Type of Body /
Fuel Type
CNG KIT SI
Limit of Liability :
Under Section II-1(i) in respect of any one accident: as per Motor Vehicles Act, 1988.
Under Section II-1(ii) in respect of any one claim or series of claims arising out of one event is Rs. 100000
The insurance under this policy is subject to conditions, clauses, warranties, endorsements as per forms attached.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). 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 ERODE on 17-SEP-14
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 isrecoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY".
POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION.
Preinspection Report: Not Applicable
Note: In case of new vehicle, Insured have to submit registration documents within a period of 15 days from the date of issue of Registration Certificate of Vehicle.