Bajaj Allianz General Insurance Company Ltd .

GE Plaza, Airport Road, Yerwada, Pune - 411006

CERTIFICATE CUM POLICY SCHEDULE
Policy Issuing Office C- 31, 1st Floor Sai Complex Gandhi nagar, Moradabad-244001
Policy Number OG-08-1101-1801-00025331 Product Carrying Vehicles Package Policy
Period Of Insurance From 00:00 02-JAN-2014 To 01-JAN-2015 Midnight Zone C
Insured Name NASEEM AKHTAR URF MOHD NASEEM Trn Id -3320365

Insured Address KHAWAS KHAN SARAY HOJBHADHESRA

SAMBHAL -244302{UTTAR PRADESH} Policy Issued On 04-JAN-2014
Intermediary Sub Imd Code
Hypothecated with-.CHOLAMANDALAM INV&FIN CO.LTD Cover Note No-

Registration Sub Type Make Model CC Mfg. Year Seat Cap. Chassis no. Engine no.
Number

UP21AN-3633 TRUCK TATA 2513 TRUCK 25000 KG 2011 07 IN ALL 11037 30976

Vehicle IDV Elec Acc. Non-Elec Trailer CNG/LPG UNIT TOTAL SUM INSURED

1250000 0 0 0 0 1250000

SCHEDULE OF PREMIUM
Own Damage Liability
Total Own Damage Premium : 25131.0 Basic Third Party Premium 14974.00
Electronic Accessory : 0 00.00
Discount on Third Party Property Damage ( - )
Non Elec Acc: 0
Bi-Fuel (CNG/LPG) Premium : 0 Bi-Fuel (CNG/LPG) Liability Premium 00.00
Discounts: (0)% 0 Geographical Area Extn. : 00.00
Anti theft 0 PA Cover for owner driver 200000 150.00
Auto Association membership 0 LL to Driver / Cleaner 50.00
Voluntary Deductible (Rs. /-): 0 LL to Employee 00.00
No Claim Bonus (25)% 6283.0 Unnamed PA Cover 00.00
Loading : (0)% 0
Total own damage premium: 18848.00 Total liability premium: 15124.00
Total premium 33972.00
Special Discount 0
Net Premium
Service Tax Edu Cess 12.36% 4199.00

FINAL PREMIUM 38171.00

LIMIT OF LIABILITY:
Under Section II-(i) of the policy -> Death of or bodily injury: Such amount as is necessary to meet there requirement of the motor
vehicle act 1988.
Under Section II-1(ii) of the policy -> Damage to Third Party Property: Rs.750000/-
LIMITATION AS TO USE : The Policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than
samples or personal luggage), Organised racing, Pace making, Speed testing, Reliability trials, Any purpose in connection with Motor Trade.
DRIVER : Any person including the 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 Vehicles Rules, 1989.
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".

*** If premium paid through cheque, the policy is void ab-initio in case of dishonour of cheque
This certificate of insurance is issued in accordance with the provision of Chapter X and Chapter XI of M.V. Act,
For & on the behalf of
Bajaj Allianz General Insurance Company Ltd.

Authorized Signatory

In case of any claim, please contact our 24 Hour Call centre at 1800-22-5858, 1800-102-5858,1800-209-5959(Toll Free) /
30305858 (chargeable, add area code before this number in case of mobile call)or email us at
'info@bajajallianz.co.in'.Kindly contact our nearest / local office(s) for No Claim Bonus Confirmations.

Regd. Office : GE Plaza, Airport Road, Yerwada, Pune 411006 Service Tax Reg. No. AABCB5730G-ST-001