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    TN - 55 - Av - 9686

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    TN - 55 - Av - 9686

    Uploaded by

    ksrananthan
    6 views2 pages

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    TN - 55 - AV - 9686

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    6 views2 pages

    TN - 55 - Av - 9686

    Uploaded by

    ksrananthan

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    © All Rights Reserved
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    of 2

    UNITED INDIA INSURANCE COMPANY LIMITED

    ENDORSEMENT SCHEDULE
    M ISCELLANEOUS PACKAGE POLICY

    Policy Number 0905033123P101928389 Dept. Motor


    Previous Policy
    Number
    Policy Expiry
    Endorsement No. 1 Policy Start Date 14/12/2023 25/05/2024
    Date
    Endorsement Effective
    14/12/2023
    Date
    Insured's Name MR GANESAN V Issuing Office BO PUDUKKOTTAI
    Address S/O MR VETHIYAPPAN NO: 3/59 B Office Address
    KEELAPANAIYUR KILAPURAM SUNDARAM MASILA MALIGAI ,T.S.NO: 5476-79
    KEELAPANAIYUR PO THIRUMAYAM TK OLD THIRUMAYAM ROAD NEAR ANNA STATUE,
    PUDUKKOTTAI PUDUKKOTTAI
    PUDUKKOTTAI
    PUDUKKOTTAI 622001
    622201 TAMIL NADU
    TAMIL NADU
    Telephone (4322) 228822
    Registration Number TN - 55 - AV - 9686
    Endorsement Type Transfer of Insurance

    Financier Branch
    SUNDARAM FINANCE LTD AVM Complex, 1st Floor, TS No.3211,

    At the request of the Insured, it is hereby declared and agreed that the following items under the, within mentioned policy, has been
    changed/allotted

    IMT 3 Transfer of Insurance

    It is hereby understood and agreed that as from 14/12/2023 the interest in the policy is transferred to and vested in GANESAN V of
    ........... carrying on or engaged in the business or profession of None who shall be deemed to be the insured and whose proposal and
    declaration dated 14/12/2023 shall be deemed to be incorporated in and to be the basis of this contract.
    Provided always that for the purpose of the No claim Bonus, no period during which the interest in this policy has been vested in any
    previous Insured shall accrue to the benefit of new insured GANESAN V as per this endorsement.
    Subject otherwise to the terms exceptions conditions and limitations of this policy.

    Dev.Officer / Agent PRAGATHAMBAL G

    Endorsement Premium : 0.00


    Endorsement CGST(9%) : 0.00
    Endorsement SGST(9%) : 0.00
    Endorsement UTGST(0%) : 0.00
    Endorsement IGST(0%) : 0.00
    Endorsement Stamp Duty : 0.00
    Total Endorsement Premium : 0.00
    For and on behalf of
    United India Insurance Co. Ltd.

    Date : 14/12/2023 4:52:27 PM ( Duly Constituted Attorney(s) )

    1/2
    UNITED INDIA INSURANCE COMPANY LIMITED
    CERTIFICATE OF INSURANCE
    Miscellaneous and Special Type Of Vehicles - Package Policy
    (FORM 51 OF CENTRAL MOTOR VEHICLE RULES 1989)
    Policy No/Endorsement No 0905033123P101928389 / 1 Certificate Number 0905033123P101928389
    Customer Id 23275275851 Issuing Office Address Code 090503
    Name of the SUNDARAM MASILA MALIGAI ,T.S.NO: 5476-79
    MR GANESAN V
    Insured OLD THIRUMAYAM ROAD NEAR ANNA STATUE, PUDUKKOTTAI
    S/O MR VETHIYAPPAN NO: 3/59 B KEELAPANAIYUR 622001
    KILAPURAM KEELAPANAIYUR PO THIRUMAYAM TK
    PUDUKKOTTAI Telephone (4322) 228822
    Address of the
    Insured
    622201
    PUDUKKOTTAI
    TAMIL NADU
    Business/OccupationNone Mobile No.- 9043738194
    Effective date of commencement of Insurance for the purpose of Act Insured's Declared Value 1500000
    from 16:40 Hrs on 14/12/2023

    Date of Expiry of the Insurance Midnight on 25/05/2024

    Particulars of Vehicle Insured


    Registration No.
    Year of HP/Cubic
    Trailer Engine No. Chassis No. Make/Model Type of Body GVW
    Vehicle Mfg Capacity
    (if any)
    3DX /
    TN 55 AV 9686 H00114158 HAR3DXSSP01895192 Backehoe MODULAR 2016 4800 7460
    loader
    Registration Public / Private
    Geographical Area
    Authority Financier Branch
    TN55 PUDUKOTTAI SUNDARAM FINANCE AVM Complex, 1st Floor, TS
    INDIA
    - 622001 LTD No.3211,
    Amount in words:
    Persons or classes of persons entitled to drive
    Any person including Insured provided that a person hold an effective driving licence at the time of 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
    such a person satisfies the requirements of Rule 3 of Central Motor Vehicle Rule, 1989.
    Note:- The policy does not cover liability for death, bodily injury or damage as excluded insection 150 (2) (ii) and (iii); (b) and (c) of the
    Motor Vehicles Act, 1988.
    Limitations as to use Endorsement Premium: 0.00
    The policy covers use only under a permit within the meaning of CGST(9%) : 0.00
    Motor Vehicles Act, 1988 or such a carriage falling under Subsection SGST(9%) : 0.00
    3 of Section 66 of the Motor Vehicles Act, 1988. UTGST(0%) : 0.00
    The policy does not cover use for: IGST(0%) : 0.00
    a) Organized Racing Stamp Duty:
    b) Pace Making Total(Rounded Off): 0.00
    c) Reliability Trials Receipt Number : 10209050323105019958
    d) Speed Testing Receipt Date: 14/12/2023
    DebitNote Number:
    Document Date:
    Limits of Liability Agency/Broker Code: AGN0005849
    Under Section II-I (i) Death or bodily injury in respect of any one PRAGATHAMBAL G
    accident; As per Motor Vehicles Act 1988 Direct Business:
    Under Section II-I (ii) Damage to third party property in respect of Development Officer Code:
    any one claim or series of claims arising out of one event: 750000
    /-

    Subject to IMT Endorsement No.s, terms and conditions printed herein / attached hereto 3,7,22,28
    I/We hereby certify that the policy to which the certificate relates as well as For and On behalf of
    the certificate of insurance are issued in accordance with provisions of United India Insurance Co. Ltd.
    Chapter X & XI of M.V Act, 1988.
    Date of Issue: 14/12/2023

    Duly Constituted Attorney

    Printed By - SRI45110 @ 14/12/2023 4:52:27 PM


    Underwritten By - SRI45110 ( BO UW CUM CASHIER )

    2/2

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