POLICY SCHEDULE
Policy issuing office and Correspondence address for communication Block No -4, 07th Floor, DLF Towers, 15, Shivaji Marg, New Delhi-
by policyholder for claim, service request, notice, summons, etc. 110015 Tel No:01166278000,

INSURED DETAILS POLICY DETAILS

Insured Name MR LAKHI Current Policy No OG-19-1155-4001-00003027

Insured Address S/O DADHRAM TRACTOR MARKET, RA- Expiring Policy No

SULPUR, HARYANA, RASULPUR-121102 Product Standard Fire and Special Perils Policy
Partner ID 119210358 Policy Issued on 26-MAY-18
GSTIN / UIN NA Period of Insurance 21-MAY-18 to 20-MAY-19
STATE CODE/NAME 06 - Haryana Coinsurance Details N/A
Bank Details Various Financial Institutes as listed in Annexure
II Policy Status Issued
Bank Reference No. 2328285010265
Bank Emp. Code

Description Sum Insured (Rs)

Sum Insured (Only Fire) 5,00,000.00

Premium Details Amount (Currency) Premium Details Amount (Currency)

Net Fire Premium (A) 900.00 Integrated GST (18%) 171
Net Add On Cover (B) 50.00 Final Premium (A+B+C+D+E) 1,121.00
Terrorism Surcharge (C) 0.00

Premium Collection Details RS. 1121 BY FLOAT NO : 10045514 / Canara Bank

Contact No : 0-9989029506/0-0
Email - [email protected]

Risk covered Standard Fire & Special Perils and Addons as detailed under Annexure I

Add on Cover Earthquake Without Plinth and Foundation

Exclusions Standard Fire and Special Perils wordings, clauses and warranties as attached

Subject to clauses Agreed Bank Clause

Designation of Property Clause

Annexure1-Terrorism Damage Exclusion Warranty

Warranties Basement Warranty

Construction (Applicable Other THAN FOR OPEN STORAGE)

Excess (not applicable to dwellings with individual owners):

If total sum insured of all fire policies at one location is -
Special conditions / Higher a) up to INR 10 Cr - 5% of claim amount subject to a minimum of INR 10,000.
Deductibles (if applicable) b) Above INR 10 Cr and up to INR 100 Cr - 5% of claim amount subject to a minimum of INR 25,000.
c) Above INR 100 cr and up to INR 1500 Cr - 5% of claim amount subject to a minimum of INR 5 lakhs.
This excess supersedes the General Exclusion 1 of policy wordings shall apply per event per insured.

88103720/-/10045514/2328/-
NOTE: If Premium paid through Cheque, the Policy is void ab-initio in case of dishonor of Cheque.
This policy is subject to the standard policy wordings, warranties and conditions applicable for this product in addition to any specific warranty or condition attached.

In Case of any claim, please contact our 24 Hour Call Centre at 1800-22-5858, 1800-102-5858, 1800-209-5959 Toll Free / 30305858 (Chargeable, add area code before this number in case of mobile
call) or email us at [email protected]
Regd Office: GE Plaza, Airport Road, Yerwada Pune-411006 (India) Latest Schedule-28-May-2018:11:50:46 AM Generated by vinaykumar kant
 


POLICY SCHEDULE
Policy issuing office and Correspondence address for communication Block No -4, 07th Floor, DLF Towers, 15, Shivaji Marg, New Delhi-
by policyholder for claim, service request, notice, summons, etc. 110015 Tel No:01166278000,

INSURED DETAILS POLICY DETAILS

Insured Name MR LAKHI Current Policy No OG-19-1155-4001-00003027

In witness whereof undersigned being authorized by and on behalf of the company has/have herein to set his/her their
name...........................................................(Date) at............................................................ (Place)................................
null
For & On Behalf of Bajaj Allianz General Insurance Company Ltd.
Stamp
Duty
Rs. 0.5

Authorized Signatory
Printed , Signed and Executed at null Consolidated Stamp Duty of Rs.0.5/- paid towards
Pune Insurance Stamps vide Challan No.
MH001488162201819M Defaced No.
0000969824201819 /Order no. CSD/33/2018/1747/18
dated 21-MAY-18 timing 15:30:01 of General Stamp
Office,Mumbai,India.
Regd Office : GE Plaza,Airport Road, Yerwada Pune-411006 (India), A Company incorporated under Indian Companies Act, 1956 and licensed by Insurance Regulatory and Development
Authority of India [IRDA] vide Reg No.113, Corporate Identification Number U66010PN2000PLC015329.
BAGIC GST No : 07AABCB5730G1ZZ | Principal Location : Block No-4, 7th Floor, DLF Towers, 15, Shivaji Marg, -, New Delhi - 110015 PH:011-66278000 | Services Accounting Code : 997137 -
Other property insurance services. No reverse charge is payable on these services. | Invoice No. : 98042258/1

In Case of any claim, please contact our 24 Hour Call Centre at 1800-22-5858, 1800-102-5858, 1800-209-5959 Toll Free / 30305858 (Chargeable, add area code before this number in case of mobile
call) or email us at [email protected]
Regd Office: GE Plaza, Airport Road, Yerwada Pune-411006 (India) Latest Schedule-28-May-2018:11:50:46 AM Generated by vinaykumar kant
 


Policy issuing office and Correspondence address for communication Block No -4, 07th Floor, DLF Towers, 15, Shivaji Marg, New Delhi-
by policyholder for claim, service request, notice, summons, etc. 110015 Tel No:01166278000,

INSURED DETAILS POLICY DETAILS

Insured Name MR LAKHI Current Policy No OG-19-1155-4001-00003027

Standard Fire And Special Perils Policy

Annexure I

Policy No OG-19-1155-4001-00003027
Policy Period 21-MAY-18 to 20-MAY-19

Location Description: SHOP-COMMERCIAL BUILDING

Location Address : TRACTOR MARKET, RASULPUR,ROAD PALWAL
FARIDABAD HARYANA 121102
Occupation Description : Shops-Others

Sr.No. BlockDescription Plinth & Super P&M FFF Stocks SIP Disc For Deleting
Found.SI(Rs.) St.Bid.SI (Rs.) (Rs.) (Rs.) (Rs.) Others TSI
(Rs.) (Rs.) STFI RSMD
(in mile)
1 Shops-Others 0.00 5,00,000.00 0.00 0.00 0.00 0.00 0.00 5,00,000.00 0.00 0

Addon Covers Details(Location Level):

Sr.No Addon Cover Code Addon Cover Description Addon Cover SI
1 EQ Earthquake Without Plinth and Foundation 5,00,000.00

For and on behalf of

Bajaj Allianz General Insurance Company Ltd

Authorized Signatory
In Case of any claim, please contact our 24 Hour Call Centre at 1800-22-5858, 1800-102-5858, 1800-209-5959 Toll Free / 30305858 (Chargeable, add area code before this number in case of mobile
call) or email us at [email protected]
BAGIC GST No : 07AABCB5730G1ZZ | Principal Location : Block No-4, 7th Floor, DLF Towers, 15, Shivaji Marg, -, New Delhi - 110015 PH:011-66278000 | Services Accounting Code : 997137 - Other
property insurance services. No reverse charge is payable on these services. | Invoice No. : 98042258/1
Regd Office: GE Plaza, Airport Road, Yerwada Pune-411006 (India) Latest Schedule-28-May-2018:11:50:46 AM

Generated by vinaykumar kant

 


Policy issuing office and Correspondence address for communication Block No -4, 07th Floor, DLF Towers, 15, Shivaji Marg, New Delhi-
by policyholder for claim, service request, notice, summons, etc. 110015 Tel No:01166278000,

INSURED DETAILS POLICY DETAILS

Insured Name MR LAKHI Current Policy No OG-19-1155-4001-00003027

Standard Fire And Special Perils Policy

Annexure ||

Policy No. : OG-19-1155-4001-00003027

Location : SHOP-COMMERCIAL BUILDING
Address : TRACTOR MARKET, RASULPUR,ROAD PALWAL
FARIDABAD HARYANA 121102
Block Desc : Shops-Others
Item Code Item Details Item Description
I002 COMMERCIAL BUILDING Super Structure(Building)
This Policy Covers The Respective Rights And Interests Of following Banks/Financial Institutions:-
Sr.No. Financial Institute Name
1 CANARA BANK PALWAL

For and on behalf of

Bajaj Allianz General Insurance Company Ltd.

Authorized Signatory
In Case of any claim, please contact our 24 Hour Call Centre at 1800-22-5858, 1800-102-5858, 1800-209-5959 Toll Free / 30305858 (Chargeable, add area code before this number in case of mobile
call) or email us at [email protected]
BAGIC GST No : 07AABCB5730G1ZZ | Principal Location : Block No-4, 7th Floor, DLF Towers, 15, Shivaji Marg, -, New Delhi - 110015 PH:011-66278000 | Services Accounting Code : 997137 - Other
property insurance services. No reverse charge is payable on these services. | Invoice No. : 98042258/1
Regd Office: GE Plaza, Airport Road, Yerwada Pune-411006 (India) Latest Schedule-28-May-2018:11:50:46 AM
 


Policy issuing office and Correspondence address for communication Block No -4, 07th Floor, DLF Towers, 15, Shivaji Marg, New Delhi-
by policyholder for claim, service request, notice, summons, etc. 110015 Tel No:01166278000,

INSURED DETAILS POLICY DETAILS

Insured Name MR LAKHI Current Policy No OG-19-1155-4001-00003027

Standard Fire And Special Perils Policy

Annexure III

This Following Addon Covers/Clauses/Warrantiesare attached to and form that of policy No : OG-19-1155-4001-00003027

Addon-cover

EarthQuake : Extension cover shall be granted only if the entire property in one Complex / Compound/ location covered under the policy is extended to cover
this risk and sum insured for this extension is identical to the sum insured against the risk covered under main policy except for the value of the plinth and foundation
of the building(s). If option to delete STFI peril is not exercised "In consideration of the payment by the Insured to the Company of the sum of ____________ addition-
al premium, it is hereby agreed and declared that notwithstanding anything stated in the printed exclusions of this policy to the contrary, this Insurance is extended to
cover loss or damage (including loss or damage by fire) to any of the property Insured by this policy occasioned by or through or in consequence of earthquake includ-
ing flood or overflow of the sea, lakes, reservoirs and rivers and/or Landslide /Rockslide resulting therefrom. Provided always that all the conditions of this policy shall
apply (except in so far as they may be hereby expressly varied) and that any reference therein to loss or damage by fire shall be deemed to apply also to loss or damage
directly caused by any of the perils which this insurance extends to include by virtue of this endorsement." Special conditions 1) Excess clause 5% of each and every
claim subject to a minimum of Rs.10,000/. 2) Extension cover shall be granted only if the entire property in one complex / compound /location covered under the
policy is extended to cover this risk and the Sum Insured for this extension is identical to the Sum Insured against the risk covered under main policy except for the
value of the plinth and foundations of the building(s).. 3) Onus of proof In the event of the Insured making any claim for loss or damage under this policy he must (if so
required by the Company) prove that the loss or damage was occasioned by or through or in consequence of earthquake."

CLAUSE

Agreed Bank Clause : "`It is hereby declared and agreed:- i. That upon any monies becoming payable under this policy the same shall be paid by the
Company to the Bank and such part of any monies so paid as may relate to the interests of other parties insured hereunder shall be received by the Bank as Agents for
such other parties. ii. That the receipts of the Bank shall be complete discharge of the Company therefore and shall be binding on all the parties insured hereun-
der.N.B: The Bank shall mean the first named Financial Institution/ Bank named in the policy.iii. That if and whenever any notice shall be required to be given or
other communication shall be required to be made by the Company to the insured or any of them in any manner arising under or in connection with this policy such no-
tice or other communication shall be deemed to have been sufficiently given or made if given or made to the Bank.iv. That any adjustment, settlement, compromise
or reference to arbitration in connection with any dispute between the Company and the insured or any of them arising under or in connection with this policy if made
by the Bank shall be valid and binding on all parties insured hereunder but not so as to impair rights of the Bank to recover the full amount of any claim it may have on
other parties insured hereunder. v. That this insurance so far only as it relates to the interest of the Bank therein shall not cease to attach to any of the insured prop-
erty by reason of operation of condition 3 of the Policy except where a breach of the condition has been committed by the Bank or its duly authorised agents or servants
and this insurance shall not be invalidated by any act or omission on the part of any other party insured hereunder whereby the risk is increased or by anything being
done to upon or any building hereby insured or any building in which the goods insured under the policy are stored without the knowledge of the Bank provided always
that the Bank shall notify the Company of any change of ownership or alterations or increase of hazards not permitted by this insurance as soon as the same shall come
to its knowledge and shall on demand pay to the Company necessary additional premium from the time when such increase of risks first took place andvi. It is fur-
ther agreed that whenever the Company shall pay the Bank any sum in respect of loss or damage under this policy and shall claim that as to the Mortgagor or owner no
liability therefore existed, the Company shall become legally subrogated to all the rights of the Bank to the extent of such payments but not so as to impair the right of
the Bank to recover the full amount of any claim it may have on such Mortgagor or Owner or any other party or parties insured hereunder or from any securities or
funds available.N.B: In cases where the name of any Central Government or State Government owned and / or sponsored Industrial Financing or Rehabilitation Finan-
cing Corporations and /or Unit Trust of India or General Insurance Corporation of India and/or its subsidiaries or LIC of India/ any Financial Institution is included in
the title of the Fire Policy as mortgages, the above Agreed Bank Clause may be incorporated in the Policy substituting the name of such institution in place of the word
'Bank' in the said clause.

Designation of Property Clause : For the purpose of determining, where necessary, the item under which any property is insured, the insurers agree to
accept the designation under which the property has been entered in the insured's books.

Annexure1-Terrorism Damage Exclusion Warranty : This Policy excludes loss, damage, cost or expense of whatsoever nature directly or indir-
ectly caused by, resulting from or in connection with any act of terrorism regardless of any other cause or event contributing concurrently or in any other sequence to
the loss. For the purpose of this exclusion, an act of terrorism means an act or series of acts, including but not limited to the use of force or violence and/or the threat
thereof, of any person or group(s) of persons, whether acting alone or on behalf of or in connection with any organisation(s) or government(s), or unlawful associations,
recognized under Unlawful Activities (Prevention) Amendment Act, 2008 or any other related and applicable national or state legislation formulated to combat unlaw-
ful and terrorist activities in the nation for the time being in force, committed for political, religious, ideological or similar purposes including the intention to influence
any government and/or to put the public or any section of the public in fear for such purposes. This exclusion also includes loss, damage, cost or expense of whatsoever
nature directly or indirectly caused by, resulting from or in connection with any action taken in controlling, preventing, suppressing or in any way relating to the above.

WARRANTY

Basement Warranty : It is hereby agreed and understood that policy shall not cover any loss or damage to stocks/contents stored in the basement.

Construction (Applicable Other THAN FOR OPEN STORAGE) : Warranted that the building covered under the policy/ in which the contents
covered under this policy is present is not kutcha construction as described below. Kutcha construction: Building (s) having walls and / or roofs of wooden planks /
thatched leaves and / or grass/ hay of any kind / bamboo/ plastic cloth/ asphalt cloth/ canvas/ tarpaulin and the like.

For and on behalf of

Bajaj Allianz General Insurance Company Ltd.

Authorized Signatory
In Case of any claim, please contact our 24 Hour Call Centre at 1800-22-5858, 1800-102-5858, 1800-209-5959 Toll Free / 30305858 (Chargeable, add area code before this number in case of mobile
call) or email us at [email protected]
BAGIC GST No : 07AABCB5730G1ZZ | Principal Location : Block No-4, 7th Floor, DLF Towers, 15, Shivaji Marg, -, New Delhi - 110015 PH:011-66278000 | Services Accounting Code : 997137 - Other
property insurance services. No reverse charge is payable on these services. | Invoice No. : 98042258/1
Regd Office: GE Plaza, Airport Road, Yerwada Pune-411006 (India) Latest Schedule-28-May-2018:11:50:46 AM