HDFC ERGO General Insurance Company Limited

Certificate of Insurance cum Policy Schedule - Endorsed Copy 2302204999561100001

Private Car Policy - Bundled

2302204999561100001

Vehicle Details Policy Details

MRS SHEELA SHIVHARE Make MORRIS GARAGES Policy No. 2302 2049 9956 1100 001
929/A-2 HARE KRISHNA VIHAR COLONY NIPANIA JHALARIA Model HECTOR-2.0 SHARP PLUS DIESEL Period of From 27 Oct, 2022 00:01 hrs
INDORE INDORE INDORE Registration No NEW Insurance To 26 Oct, 2025 23:59
MADHYA PRADESH - 452001 Tel. 99XXXXXXX1
RTO INDORE Issuance Date 09/01/2023
Chassis No. MZ7BD1D2J5H091878 Invoice No. 204999561100001
Cubic Capacity /Watts 1956 Seats 6 Customer Id 100762615691
Year of Manufacture 2022 Body Type SUV
Engine No. 463445924209541 EIA No. Not provided
Odometer reading:
Email ID : [email protected]
Policy Year Policy Period For the Vehicle (`) Trailer (`) Non Electrical Acc. (`) Electrical Acc. (`) CNG/LPG Kit (`) Total IDV (`)
Year 1 From 27/10/2022 To 26/10/2023 1994810 0 0 0 0 1994810
Own Damage Policy Period Liability Policy Period
From Date & Time 27/10/2022 00:01 hrs To Date & Time 26/10/2023 Midnight From Date & Time 27/10/2022 00:01 hrs To Date & Time 26/10/2025 Midnight
Premium Details (`)
Own Damage Premium(a) (`) Liability Premium(b) (`)
Basic Own Damage 66627 Basic Third Party Liability 24596
Total Basic Premium 66627 LL to Paid Driver (IMT-28) 150
Less: others 45972 PA Cover for Owner Driver of 1500000 ( CPA Cover Policy Period From Date 27/10/2022 325
To Date 26/10/2025 )
Total - Less 45972 PA Cover for Un-Named Persons of 100000 Each (for 6 Persons) (IMT-16) 900
Add on Coverages Net Liability Premium (b) 25971
Zero Depreciation (IRDAN125A0021V01201415) 2593 Total Package Premium (a+b) 54455
Emergency Assistance (IRDAN125A0016V01201314) 350 Tax as Applicable 9802
Engine and Gear box Protection (IRDAN125A0004V01201213) 997
No Claim Bonus Protection (IRDA/F/HDFC/MotorAdd-ons/09-10/2) 997
Cost of Consumables (IRDAN125A0003V01201213) 997
Return to Invoice (IRDAN125A0013V01201213) 1396
Emergency Assistance Wider (IRDAN125A0016V01201314) 499
Total - Add on 7829
Net Own Damage Premium (a) 28484 Total Premium 64257
Geographical Area India Compulsory Deductible (IMT-22) 2,000 Voluntary Deductible 0
Nominee for
Compulsory Owner
PA cover for driver
owner driver has not been providedRohit
to theShivhare, Son
insured basis his/her declaration of not holding an effectiveAppointee
driving license Or having Alternate PA / Stand alone CPA policy with minimum sum
Hypothecated(IMT-7) with:HDFC BANK LIMITED,Indore
Endorsement Premium Details (`)
Premium Amount : 0 CGST 9% : 0 SGST 9% : 0 IGST 18% : 0 Kerala Cess 1% : 0 Total Tax : 0 Total Premium : 0
Endt NO List of Endorsements_Description Effective Date Premium
001 Change in Registration Number Engine Chassis no 27/10/2022 0
LIMITATIONS AS TO USE: The Policy covers use of the vehicle for any purpose other than: a) Hire or Reward b) Carriage of goods (other than samples or personal luggage) c) Organized racing d) Pace making
e ) Speed testing f) Reliability Trials g ) Any purpose in connection with Motor Trade. Persons or Class of Persons entitled to drive: 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. Limits of Liability 1. Under Section II-1 (i) of the policy - Death of or bodily injury - Such amount as is
necessary to meet the requirements of the Motor Vehicles Act, 1988. 2. Under Section II - 1(ii) of the policy -Damage to Third Party Property- ` 750000 3. P. A. Cover under Section III for Owner - Driver(CSI): `
1500000 Terms, Conditions & Exclusions: As per the Indian Motor Tariff. A personal copy of the same is available free of cost on request and the same is also available at our website.

I / We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X, XI of M. V.Act 1988.The stamp duty of Rs. 0.50
paid b y Demand Draft, vide Receipt/Challan no. LOA/CSD/547/2022/5450/22 dated 22/12/2022 a s prescribed in Government of Maharashtra Order No. Mudrank ÿ¿ 2017/CR.97/M-1, dated the 09th January
2018. I / We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are not required to
prepare an invoice in terms of the provisions of the said sub-rule. 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 Motor Vehicle Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN
TERMS AND RIGHT OF RECOVERY". Disclaimer: The Policy shall be void from inception if the premium in full i s not realised by the company. In the event of misrepresentation, fraud or non-disclosure of
material fact, the Company reserves the right to cancel the Policy. Please note that the insured vehicle was pre-inspected and a report was prepared accordingly. The existing damages to the vehicle as mentioned
in the report shall not be paid by the Company. The policy is issued basis the information provided by you, which is available with the company. In case of discrepancy or non recording of relevant information in the
policy, the insured is requested to bring the same to the notice of the company within 15 days. GST for this invoice is not payable under reverse charge basis.
In the event of non-renewal and/or discontinuation of own Damage Cover with us, coverage available under Section II - Liability to Third Parties will be strictly as per Standard Form of Liability Only Policy

Branch :d m tower, flat no. 205-206 2nd floor, new palaysia road indore

For Claim/Policy related queries call us at +91- 22 6234 6234/+91- 120 6234 6234 or Visit Help Section on www.hdfcergo.com for policy copy/tax certificate/make changes/register & track claim.
Goods & Services Tax Registration No: 23AABCL5045N1ZG HSN Code 997134

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0008V01201819. Customer Service Address: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
165/166 Backbay Reclamation, H.T.Parekh Marg, Churchgate, Mumbai - 400 020. Customer Service No : +91 22-62346234/+91-120 6234 6234 | www.hdfcergo.com
HDFC ERGO General Insurance Company Limited
Certificate of Insurance cum Policy Schedule - Endorsed Copy 2302204999561100001

Private Car Policy - Bundled

2302204999561100001

Agent Name : HDFC BANK LTD For HDFC ERGO General Insurance Company Ltd
Agent Code : 201587086428 Tel No. : 91-22-61606161
E-mail : [email protected]

Duly Constituted Attorney

Scan the code for Instant Policy Info, Register/Track Claim, Renewal and Modifications in policy.

"For detailed policy terms and conditions please visit our website https://www.hdfcergo.com/download/policy-wordings."

HDFC ERGO General Insurance Company Limited. IRDAI Reg No.146 UIN :IRDAN125RP0008V01201819. Customer Service Address: D 301, 3rd Floor,
CIN : U66030MH2007PLC177117. Registered & Corporate Office: 1st Floor, HDFC House, Eastern Business District (Magnet Mall), LBS Marg, Bhandup (West), Mumbai - 400 078.
165/166 Backbay Reclamation, H.T.Parekh Marg, Churchgate, Mumbai - 400 020. Customer Service No : +91 22-62346234/+91-120 6234 6234 | www.hdfcergo.com