2/05/24, 1:15 PM Broker - Policy Details

Prev. Policy No:

39010231236201022848

Insured Business/Profession Address of The Insured TP Valid From TP Valid To

Ms RADHA W/O RAVI LODHA GRAM AWAN TEH RAGHOGARH Guna 05-02-2024 Midnight of
LODHA Self Employed MADHYA PRADESH 473226 , Mobile No XXXXXX2297 12:26:06 04-02-2029
Vehicle Regn No. Engine No. Chassis No. Make & Model Year of Mfg Cubic CapacityGSTIN No. (Customer)
Hero MotoCorp HF
New HA11ECP4M02824 MBLHAW285P4M02556 DELUXE DRSC FI 2023 100 N/A
Declared Value Side Car IDV Non-Electrical Accessories Electrical Accessories IDV CNG/LPG/Bi- Total IDV
(IDV) of Vehicle IDV Fuel IDV
63929.00 NA 0.00 0.00 0.00 63929
Place of Regn. Body Type HP/Lease/Hire-Purchase Branch Office of Seating Capacity Premium
Agreement With HP/Lease/Hire-Purchase
IDFC FIRST BANK LTD.,
Guna Solo HPA GUNA 2 5578.00
Section A B. Liability Premium Computation (Section II) in Rs.
Basic OD Premium : 428.00 Basic Third Party Liability : 3851.00
Non-Electrical-Fitting Premium : 0.00 TPPD Discount : 0.00
Electronic & Electrical Accessories : 0.00 Total : 3851.00
Bi-Fuel Kit : 0.00 CNG/LPG/Bi-Fuel Kit : 0.00
Geographical Extension : 0.00 Geographical Extension : 0.00
ND Plus Cover : 153.00 Add
Less : Compulsory PA Cover (Owner Driver) : 295.00
Handicapped Discount : 0.00 Optional PA Cover(Un Named Passenger) : 0.00
For Anti-Theft Discount : 0.00 Optional PA Cover(Un Named Driver) : 0.00
NCB : 0.00 Legal Liability Cover (Paid Drivers, Cleaners) : 0.00
Total Own Damage Premium(A) : 581.00 Legal Liability Cover (Per Licensed Passenger) : 0.00
Total Liablity Premium (B) : 4146.00
Total Premium (A + B) : 4727.00
For any other extra : 0.00
IGST @ 18.00% : 851.00
Gross Premium : 5578.00
1.RegistrationNo.:58||2.LicenceNo.:1424542||3.CNNNo.:U10200WB1906GOI001713||4.GST No.:07AAACN9967E1Z5 ||UIN No.-IRDAN05
8RP0005V01201819
OD Policy 05-02-2024 To 04-02- 05-02-2025 To 04-02- 05-02-2026 To 04-02- 05-02-2027 To 04-02- 05-02-2028 To 04-02-
Period 2025 2026 2027 2028 2029
IDV 63929 NIL NIL NIL NIL
CPA Rs. 15 lakhs. NIL NIL NIL NIL
DRIVER: Any person including insured: Provided that a person driving holds an effective driving licence at the time of the
accident and is not disqualified from Holding or obtaining such a licence.Provided also that the person holding an effective
Learner's Licence may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor
Vehicle Rules, 1989.
LIMIT OF LIABILITY: Limit of the amount of the Company's liability under the Section II-I(i) in respect of any one accident as per
M.V. Act 1988. Limit of the amount of the Company's liability under Secion II-I(ii) in respect of any one claim or series of claims
arising out of one event : Upto Rs - 100000/
I/We certify that the policy to which the certificate relates as well the certificate of insurance are issued in accordance with the
provisions of Chapter X & XI of M.V. Act 1988
Broker Hero Insurance Broking India Pvt. Ltd. The policy is subject to a compulsory
Received Vide excess of Rs. 100/- & Depreciation is
Premium of Rs. 5578.00 Cash/Cheque No. CASH applicable as per policy terms &
RAVI conditions* (Please turn overleaf for
Dated Nominee Name LODHA details)
Consolidted Stamp Duty Paid
Drawn on Nominee Age 25
Acknowledgement Endorsements: IMT - 22,5
05-02-2024 Nominee Relation Husband
Dt
On behalf of NATIONAL INSURANCE
Registration No: 649 Tel No: 1800-102-4376 COMPANY LIMITED
05-Feb-2024
FOR RENEWALS CONTACT: POS: BRIJESH SAHU, AUTPS3141H
Date & Signature of Ph.No- 942-5134560
proposer

Dealer's Stamp & Signature Duly Constituted Attorney

# : Received with Thanks Rs 5578.00 from Ms RADHA LODHA as premium against the money receipt no 024231234573493
Regd. & Head Office : Premises No.18-0374, Plot No. CBD-81, New Town, Kolkata-700156 Service Tax Registration Number - AAACN996EST099
For further information about motor insurance policy please also visit http://irda.gov.in >> Grievances >> Policyholder Handbooks

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