RenewalBusinessDocument-TRACKON-1-1663614

Policy No : 545445JHP000049870000 Date: 31/01/2024

Name : Mona Yadav
Your Policy Details
Address : HOUSE NO. 255
JEVAN NAGAR : 545445JHP000049870000
HARYANA - 121004 Policy No
HARYANA
Policy Period : 02/02/2024 to 01/02/2025

Premium Paid : ` 55,542.00

Dear Bidya Kumar Yadav,

We thank you for reposing your faith in us by renewing your vehicle insurance policy. Your policy has been renewed as per your
advice and incorporates changes (if any) requested by you.

We are enclosing Policy schedule cum certificate of insurance of your vehicle. You are requested to visit our website
www.tataaig.com for policy wording.

We assure you of our best services at all times. Happy driving!

Warm regards,

Signature Not Verified

Digitally signed by DS TATA AIG GENERAL INSURAN
Date: 20240731135724
Reason: Production
Location: Mumbai

Tata AIG General Insurance Company Limited.

Registered office: Peninsula Business Park, Tower A, 15th Floor,G.K Marg,Lower Parel , Mumbai-400013
24*7 Tollfree Number:1800 266 7780 Fax:0226693 8170 Email:[email protected] website:www.tataaig.com
IRDA of India Registration No : 108 CIN:U85110MH2000PLC128425, PAN : AABCT3518Q, UIN: IRDAN108RP0050V02201819 Page 1 of 4
 Certificate of Insurance and Policy Schedule form 51 of the Central Motor Vehicle Rules,1989
Agent/Broker Name :- TATA MOTORS INSURANCE BROKING AND ADVISORY SERVICES LTD
Agent/Broker License Code :- 375 Agent/Broker:Contact No :- 1800266007 (Mobile or Landline)
Certificate & Policy No 545445JHP000049870000 Policy Type Auto Secure Commercial Vehicle Package Policy Goods Carrying Vehicle
Period of Insurance From 00:00 Hours on 02/02/2024 Date of Expiry To expiry of 01/02/2025
Insured Name & Address: Premium (Incl. of all applicable taxes) ` 55,542.00
Mona Yadav Insured Business/Profession OTHER
Jevan Nagar Geographical Area India
House No. 255 Registration Authority Balasore OD-01
Haryana- 121004
Haryana
HPA/HYP/Lease to TATA MOTORS FINANCE SOLUTIONS

Lessor GSTIN Number

Registration Mfg. Gross Vehicle Cubic Public/ Private
Make & Model Body Type Enigne No. Chassis No.
No. Year Weight Capacity/KW Carrier
Goods Carrying MB1CTDYC4F
WB784493 TATA LPK 2518 - TRUCK 2015 25000 0 27168
Vehicle PC38135

IDV of Externally Total Insured Registered seating

IDV of Vehicle (`) IDV of trailers Bi-Fuel/CNG/ IDV of non-built-in Accessories (`) Built Body Type Declared Values capacity including
(`) LPG Kit (`) Electrical Non-Electrical driver
(`) (`)
11,34,000.00 0.00 0 0.00 0.00 0.00 11,34,000.00 3
SCHEDULE OF PREMIUM
A. Own Damage B. Liabiliity
Premium on Vehicle and non electrical accessories ` 8,441.28 Basic ` 43,950.00
Add :Cover for lamps,tyres,tubes (IMT 23) ` 1,266.19 Add : Legal Liability to paid driver as per (IMT 28) ` 50.00
Less : 50% for NCB ` 4,853.73 Add:Compulsory PA Cover for OwnerDriver Rs. 1500000 ` 450.00
A. TOTAL OWN DAMAGE PREMIUM ` 4,853.74 Net Basic Liability Premium(B) ` 44,450.00
C. TOTAL ADDON PREMIUM ` 0.00 COMPREHENSIVE PREMIUM (A+B+C) ` 49303.74
NET PREMIUM ` 49304
Total GST Amount ` 6,238.00
TOTAL PREMIUM ` 55,542.00
Drivers Clause :Kindly refer to Annexure X attached herewith the policy or Website URL for details.
Limitation to be use :Kindly refer to Annexure X attached herewith the policy or Website URL for details.

Warranty for Goods Carrying Vehicles : Warranted that at no time the Gross Laden Weight of the vehicle exceeds the Gross Vehicle weight mentioned in the
Schedule of the policy.
Limits of Liability: I/we hereby certify that the Policy to which this Certificate relates as well as
Under Section II-1 (i) of the policy (Death of or bodily injury) : Such amount as is this Certificate of Insurance are issued in accordance with provisions of
necessary to meet the requirements of the Motor Vehicles Act, 1988 Chapter X and XI of Motor Vehicles Act,1988. In witness where of this Policy
Under Section II-1 (ii) of the policy (Damage to Third Party Property ): ` 750,000.00 has been signed at Mumbai on 31/07/2024 dated

Under Section III: P.A. to owner Driver CSI: 15,00,000.00 Receipt(s): Date:
Stamp Duty of Rs.0.25/ - is paid as provided under Article 47-B of
Indian Stamp Act, 1899 and included in Consolidated StampDuty
Nominee : Bidya Kumar Yadav Relationship: Spouse Paid to the Government of Maharashtra Treasury vide Order ofAddl.
Controller Of Stamps, Mumbai at General Stamp Office, Fort,
Mumbai
- 400001., vide this Order No. LOA/ENF1/CSD/13/2024/2289Validity

UIN NUMBERS : ,IRDAN108RP0003V02200001/A0013V01201213(TA 06) Period Dt. 01/02/2024 To Dt.01/02/2025

This policy does not cover pre-existing damages as per Inspection photographs and GSTIN: 27AABCT3518Q1ZW-MAHARASHTRA SAC: 997134
Report

Deductible under Section-I: ` 1500.00, - (Compulsory Deductible : ` 1500.00, Voluntary

Deductible: ` 0.00 ,Imposed Excess: ` 0.00) Franchisee:

No Claim Bonus: The insured is entitled for a No Claim Bonus (NCB) on the own
damage section of the policy, if no claim is made or pending during the preceding year(s),
as follows: The preceding year - 20%,preceding two consecutive years - 25%, preceding
three consecutive years - 35%, preceding four consecutive years - 45%, preceding five
consecutive years - 50% of NCB on OD Premium. NCB will only be allowed provided the
policy is renewed within 90 days of the expiry date of the previous policy.

Tata AIG General Insurance Company Limited.

Registered office: Peninsula Business Park, Tower A, 15th Floor,G.K Marg,Lower Parel , Mumbai-400013
24*7 Tollfree Number:1800 266 7780 Fax:0226693 8170 Email:[email protected] website:www.tataaig.com
IRDA of India Registration No : 108 CIN:U85110MH2000PLC128425, UIN: IRDAN108RP0050V02201819 Page 2 of 4
Subject to: A) IMT Endorsement No.: 21 , 28 , 23 , 40 , 07 Place of Supply : HARYANA Supply Code : 21
B) TATA AIG Auto Secure endorsement No.(TA): 06
Policy Servicing Office: 15TH FLOOR, TOWER A,, PENINSULA BUSINESS PARK, GK MARG,, LOWER PAREL, MUMBAI, MAHARASHTRA, 400013,, 022-66382333

IN CASE OF AN ACCIDENT TO YOUR VEHICLE PLEASE INTIMATE US IMMEDIATELY FOR SPOT SURVEY FAILING WHICH CLAIM COULD BE PREJUDICED.

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 Vehicles Act, 1988 is recoverable from the Insured. See the clause headed “AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY”.

Note:This Schedule, Policy terms and conditions available on company website and Endorsements mentioned herein above shall read together and word or expression to which a specific meaning has been
attached in any part of this Policy or of the Schedule shall bear the same meaning wherever it may appear. Any amendments/modifications/alterations made on this system generated policy document is not valid
and Company shall not be liable for any liability whatsoever arising from such changes. Any changes required to be made in the policy once issued, would be valid and effective, only after written request is made to
the Company and Company accepts the requested amendments/modifications/alterations and records the same through separate endorsement to be issued by the Company.
You are advised to go through the policy schedule cum certificate of insurance which is issued based on your declaration and if any error/ discrepancy is found in respect of vehicle details, No Claim Bonus or any
other material information, it should be brought to our notice within 15 days of receipt of this policy for necessary correction along with the supporting documents, otherwise it will be deemed correct. You may visit
company website at www.tataaig.com for detailed benefits, terms & conditions & exclusions of the policy. You may also reach us at our 24*7 helpline 1800 266 7780 in case you desire to have a printed copyof
policy wording. Our grievance redressal procedure and details about ombudsman is also available in our policy wording.
Please note that any misrepresentation, non disclosure or withholding of material facts will lead to cancellation of policy ab initio with for feiture of premium and non consideration of claim, if any. We will specifically
seek confirmation on No Claim Bonus availed by you from your previous insurer. In case we receive confirmation that you had lodged claim with them then we will forfeit all the benefits under section I i.e. own damage
section of policy.

For Policy wordings, please scan the below QR code :

Tata AIG General Insurance Company Limited.

Registered office: Peninsula Business Park, Tower A, 15th Floor,G.K Marg,Lower Parel , Mumbai-400013
24*7 Tollfree Number:1800 266 7780 Fax:0226693 8170 Email:[email protected] website:www.tataaig.com
IRDA of India Registration No : 108 CIN:U85110MH2000PLC128425, UIN: IRDAN108RP0050V02201819 Page 3 of 4
 Auto Secure Commercial Vehicle Package Policy – Goods Carrying Vehicle

Drivers Clause

Persons or Classes of Persons entitled to drive:

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 when not used
for the transport of goods at the time of the accident and that such a person satisfies the requirements of Rule 3 of the Central Motor
Vehicles Rules 1989

Limitations as to use

The Policy covers use only under a permit within the meaning of the Motor Vehicle Act, 1988 or such a carriage falling under Sub-section
3 of Section 66 of the Motor Vehicle’s Act 1988.

5) The Policy does not cover use for

a) Organised racing
b) Pace Making
c) Reliability Trials
d) Speed Testing

Tata AIG General Insurance Company Limited.

Registered office: Peninsula Business Park, Tower A, 15th Floor,G.K Marg,Lower Parel , Mumbai-400013
24*7 Tollfree Number:1800 266 7780 Fax:0226693 8170 Email:[email protected] website:www.tataaig.com
IRDA of India Registration No : 108 CIN:U85110MH2000PLC128425, PAN : AABCT3518Q, UIN: IRDAN108RP0050V02201819 Page 4 of 4