CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED

Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai ‐ 600 001.
Toll free: 1800 208 5544, T: +91﴾0﴿ 44 4044 5400, F: +91﴾0﴿ 44 4044 5550
E‐mail: [email protected]; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977 3361/02760391/000/00

Motor Two ‐ Wheelers Package Policy ‐ Schedule cum Certificate of Insurance

[UIN: IRDAN123RP0002V02200203]

Certificate Number: 3361/02760391/000/00

Policy Number: 3361/02760391/000/00
Registration Address: Room no.2 , Jhillu Mistry Chaw l , Ketkipada, Dahisar East
Name & Communication Address: Mr. Bhagwat Janardhan Badgire Mumbai Maharashtra
Room no.2 , Jhillu Mistry Chaw l , Ketkipada, Dahisar East Mobile‐ 8169156640,Landline‐ ‐
Mumbai Maharashtra Period of Insurance:
Mobile: 8169156640|Landline: ‐|Mail: [email protected] From : 00:01hrs on 20/Jun/2024 To: 23:59hrs on 19/Jun/2025

PAN No: GSTIN:

EIA No: Geographical A r e a: India

Business / Profession: Corporate
PARTICULARS OF VEHICLE INSURED
Date of Registration 30/05/2018 Place of Registration MUMBAI NORTH Registration Number MH47AE9810
Make TVS Model APACHE RTR 160 4V ‐ DISC Variant APACHE RTR 160 4V ‐ DISC
Year of Mfg 2018 Type of Body Two wheeler Fuel Used PETROL
Cubic Capacity 160 Engine No 101738 Chassis No C01815
Licensed passenger Carrying Capacity 2 Driver 0 Cleaner ‐
Total Seating Capacity
Conductor ‐ K.Watt 0 2
Including Driver
IDV ﴾Insured's Declared Value﴿
Value of Chassis ﴾Rs﴿ 0.00 Value of Body ﴾Rs﴿ 0.00 For Vehicle ﴾Rs﴿ 36732
For Trailer ﴾Rs﴿ 0.00 Non‐Electrical Accessories ﴾Rs﴿ 0.00 Electrical/Electronic Accessories ﴾Rs﴿ 0.00
Value of CNG/LPG Kit ﴾Rs﴿ 0.00 Total Value ﴾Rs﴿ 36732
PREMIUM
A.OWN DAMAGE B.LIABILITY
Sum Insured
IMT Premium﴾Rs﴿
﴾Rs.﴿ No.of
Basic OD 36732 679.00 Sum Insured IMT Premium﴾Rs﴿
Person
Electrical or Electronic Accessories 00 24 0
Non Electrical or Electronic Basic TP 1366.00
00 0
Accessories
CNG Kit‐TP 0 25 .00
CNG Kit‐OD 00 25 0
TOTAL 679.00 TOTAL 1366.00

Geographical Extension‐OD 1 0 Geographical Extension‐ TP 1 .00

Sub Total:﴾additions﴿ 0
TOTAL PREMIUM﴾B﴿ 1366.00
Less: 0
C.PERSONAL ACCIDENT COVERS
Anti‐Theft Device‐OD 10 0
Bonus Discount﴾ 0.00 %﴿ 0.00 PA Cover 0.00
Sub Total:﴾discounts﴿ 0.00 TOTAL PREMIUM﴾C﴿ 0.00
Total 679.00
TOTAL ﴾A+B+C+D﴿ 1468.00
Own Damage Premium 679.00
Detariff Discount 577.00 TOTAL PACKAGE PREMIUM 1468.00
GST Discount ﴾ %﴿ 0.00 CGST ﴾0%﴿﴾Rs.﴿ 0.00
TOTAL﴾A﴿ 102.00
SGST ﴾0%﴿﴾Rs.﴿ 0.00
D.ADD‐ON COVERS﴾BENEFITS﴿ Benefit No Option No. Premium﴾Rs
Full Depreciation Waiver 0.00 IGST ﴾0%﴿﴾Rs.﴿ 0.00
CVAS New 0
TOTAL AMOUNT
Road‐Side Assistance Premium 0.00 1733.00
COLLECTED
Engine/Hydrostatic Protection
0.00
Premium
Return to Invoice Premium 0.00
TOTAL OTHER SERVICE
0.00
CHARGES﴾NON PREMIUM﴿
POS ‐ Waiver of Depreciation for
0.00
Partial Loss claims
Break In Loading 0.00
ADD‐ON COVERS PREMIUM 0.00
TOTAL ADD‐ON‐COVERS
0.00
PREMIUM﴾D﴿
Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS C H O L A to 56677 | Visit w w w . c h o l a i n s u r a n c e . c o m | Email [email protected]
Disclaimer: The company may contact you for matters related to your policy or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.
CHOLAMANDALAM MS GENERAL INSURANCE COMPANY LIMITED
Registered Office: 2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road, Chennai ‐ 600 001.
Toll free: 1800 208 5544, T: +91﴾0﴿ 44 4044 5400, F: +91﴾0﴿ 44 4044 5550
E‐mail: [email protected]; website: cholainsurance.com
IRDAI Regn. No.123 PAN AABCC6633K CIN: U66030TN2001PLC047977 3361/02760391/000/00

Motor Two ‐ Wheelers Package Policy ‐ Schedule cum Certificate of Insurance

[UIN: IRDAN123RP0002V02200203]

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﴿ in
connection with any trade or business or use for any purpose in connection with motor trade c﴿ Organized racing d﴿ Pace making e﴿ Speed Testing f﴿ Reliability Trial g﴿ Tuition h﴿
Use only with side car if attached
DRIVER CLAUSE: Any person including 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: Under Section II ‐ 1﴾i﴿ of the Policy ‐ Death or bodily injury such amount as is necessary to meet the requirements of the Motor Vehicle Act, 1988. Under
Section II ‐ 1﴾ii﴿ of the Policy ‐ Damage to Third Party Property ‐ Rs.1,00,000.00 P.A. Cover for the Owner cum Driver Under Section III ﴾CSI﴿‐ Rs.0.00
Deduction Under Section 1: Rs.100
Additional compulsory deductibles under Section 1 Rs.0
Additional Imposed deductibles under Section 1 Rs.0
Subject to I.M.T. Endt. Nos. and Memorandum: 22,7 .
Coverage under this policy is subject to realisation of premium cheque﴾s﴿. Incase of dishonor of cheque﴾s﴿, no separate intimation will be given and the policy stands cancelled
from inception.
Applicable benefits:
Please visit our website for Policy terms and conditions
Date and Signature of the proposal 17/06/2024.
Warranties: Warranted that NCB under this Policy is based on representation regarding NCB and absence of claim under the previous Policy.If the information be found incorrect
or false in any aspect,this Policy shall be void ab initio and no benefit shall be payable by the company.It is hereby warranted the coverage under this Policy commences only from
the Risk Start time and Date as mentioned in the Policy schedule.No Liability shall attach under this Policy in respect of any Accident/Loss prior to the time and date of
commencement of Period of insurance
It is Warranted that the vehicle should possess a valid POLLUTION UNDER CONTROL certificate during the policy period, failing which assessment of own damage claims will be
repudiated.
S l . N o . Name of the Nominee Relationship Age of the Nominee %age of share Name of the Guardian Guardian relationship with Nominee

No Claim Bonus is applicable at the end of the policy period.

NOTE: The Motor Policy Schedule cum Certificate of Insurance is an important document issued based on your declaration. We request you to verify the details and ensure that
everything is in order. In case of any discrepancies, please contact us within 15 days from the date of issuance of policy.
Financier Name & Address:
Intermediary Name: POLICYBAZAAR INSURANCE BROKERS PRIVATE LIMTED
Code: 2009936529320001 Contact No: 1800‐258‐5970
For Cholamandalam MS General Insurance Company Ltd.

Place: Chennai Date:17/06/2024

Duly Constituted Attorney﴾s﴿

Business Location: Chennai Head Office
2nd Floor "DARE HOUSE", 2, N.S.C. Bose Road,
Chennai ‐ 600 001
GST Invoice No: 3361/02760391/000/00 | GSTIN: 33AABCC6633K1ZQ | SAC Code:997134 | SAC Description: Motor vehicle insurance services
Consolidated Stamp Duty Paid to Commercial Taxes and Registration ﴾j1﴿ Department, Tamil Nadu
I/We hereby certify that the policy to which this certificate relates as well as this certificate of insurance are issued in accordance with the provisions of Chapter X and Chapter XI of
the Motor Vehicles Act, 1988.
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".
For legal interpretation, English Version will hold good.
Whether tax is payable under reverse change basis ‐ No
Note: UIN for the related add‐on covers availed under this policy are as mentioned in the attached sheet, which forms part of the policy schedule.
Sl.No. Add on cover Name IRDA BAP UIN UIN

Refer website for policy wordings and detailed Terms & Conditions, Exclusions and the Ombudsman list.
Call Toll Free: 1800 208 5544 | SMS C H O L A to 56677 | Visit w w w . c h o l a i n s u r a n c e . c o m | Email [email protected]
Disclaimer: The company may contact you for matters related to your policy or to provide details of products & services offered. To opt out from the facility, please register
under Do Not Call section on our website.