MR Ashwin Valwan

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CERTIFICATE OF INSURANCE

Marine Inland Policy

Certificate Number: CERT/2001/247977098/00/000/195 UIN: IRDAN115RP0011V01200102 Marine 01


We hereby certify that we have issued Marine Inland Policy No. 2001/247977098/00/000 dated May 20, 2022 at MUMBAI to CARGO TRANSIT AND VARIOUS
CLIENTS, MUMBAI DIVISION , MUMBAI INDIA MAHARASHTRA MUMBAI PIN - 400001 on goods as detailed below. This certificate is subject to the terms
and conditions mentioned in the Policy.
Name of the Insured CARGO TRANSIT AND FARIDABAD-HARYANA
From
VARIOUS CLIENTS
Consignee Name MR ASHWIN VALWAN, To BANGALORE-KARNATAKA
Subject Matter Insured/Packing Details HOUSEHOLD GOODS Remarks IF ANY CLAIM AND QUERY
CONT 9769102034
Total Packages KUBER LOGISTICS MOVERS
AND PACKERS
Weight ITC B (BASIC COVER Total Sum Insured for Cargo (`) 100000.00
)ACCIDENT FIRE RISK
COVERED CAUSED DURING
TRANSIT IN TRUCK
Mode of Conveyance Road Marine Premium (`)
Invoice No. 1094 SRCC Premium (`)
Invoice Date. May 31, 2022 Stamp Duty (`)
LR/RR/AWB No. 1094 Total Premium excluding tax*
LR/RR/AWB No. May 31, 2022 *Please refer relevant invoices issued under
the policy/Endorsement for taxation purpose.
Basis of Valuation INVOICE + 10%
Warranted that in the event of the goods hereby insured arriving at destination in a damaged condition, the consignee shall obtain a Carrier's Survey as per the
terms of the Lorry Receipt and/or other contract of affreightment and shall lodge an immediate claim against the carriers concerned. Loss or damage certificate to
be obtained from the carriers and immediate notice in writing should be given to us.
Shipment Remarks
GSTIN Reg. No HSN/SAC code Counter-Signed by the Authorised Signatory of the Insured
27AAACI7904G1ZN 9971 / GENERAL INSURANCE SERVICES Date: May 31, 2022 9:31:35 PM Place: Mumbai

For ICICI LOMBARD GENERAL INSURANCE CO. LTD.

Grievance Clause: For resolution of any query or grievance, Insured may contact the respective branch office of the company or may call at 1800 2666 or may
write an e-mail at [email protected]. In case the insured is not satisfied with the response of the office, insured may contact the Grievance
Officer of the company at [email protected]. In the event of unsatisfactory response from the Grievance Officer, he/she may, subject to vested
jurisdiction, approach the Insurance Ombudsman for the redressed of grievance. Details of Insurance Ombudsman offices are available at IRDA website:
www.irdaindia.org, or on the website of General Insurance
Council: www.generalinsurancecouncil.org.in or on the company's website at www.icicilombard.com.

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