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POLIGY SCHEDULE National lnsurance Company Limited
Middleton Street, Post Box No. 9229, Ko:kata - 700 021
cy Issuing
Complex. Nea Bhawan Lal Bung Road Navrangpura, l, Gujarat Ptn:

Tele : 079 26407384 (D) 26407032 (c)

Policy No: 1200/1 1/16J31 0000151 9 Dept :Firc Standard Fare and Speciat Per:ls Polic
insuaed's N S PARSHWANATH DUESTUFF Dev. officer: 41023
INDUSTRIES
Agent Code: 4075130892
Address PLOT NO. '115617. PHASE-2. G DC ESTATE, Agent Name; NIRENKUIV]AR NIRANJANBHAI PATEL,
VATVA AHI\,IEDABAD 382445. ]NDIA
D st Ahmedabad, cujaral
Agent Contact No: 9909004824
Pin Code i382445

Policy Period : 00 00
hours on 30/09/2016 to midn ght of 29109/2017
Receipt date d.No: 2grcSrZA16 (
30120081160000019849 )
Net PTemium: <5656 . ( RUPEES FIVE THOUSAND SIX HUNDRED FIFTY SIX oNLY

Mode of Payment: Cleq-e

Co-insurance Details: N;C 301200: 100%

Risks Covered Risk/Rate Block Basic Rate RSMD Excl STFI Excl Disc/Lo Claim Net Rate Sum lnsured Prem:un
Code No. No. (Perlvlillel (PerMille) (PerlVIi ad{od ) Exp(%) (%0)
e) ad(%)
(Perlvlille) (%o)
(<) ({)
Burd nq Stock(s) 044 /OB 156II
115617 1.688
I.EId6 0.000 0 UUIU o ooo U.UU
0000 U,UUU
!J 0.00 L.UO/J U 0
iconlen(s) l. 1.688 0.000 o.0ooo o0o0 o.0o 1.6875 so 00.000 8,438

The Risk Covered is/are as under :-

Srl sk Description of Risk Rate Applicable
hemical lManufacturlng (others), Pharmaceulicals, 16875
Tolletry products

Desciiptictn of Risk : ON STOCK OF E.D, AS LISTED

Add-On Desc.iption Raie Applled Sum lnsured
(<) (<l
Ea.thquake (Fke and Shock)' .1 50,00 000 500.0t
ToiaiAddon Premium : 5o0.oc

The property is situated at i- PLOT NO. 1/5617, PHASE-2, GIDC ESTATE, VATVA, AHMEDABAD-382445, tNDtA - 382445
The Sum(s) Insured is/are as under:-
Sum lnsured Escl EscalationPremiLrm
Si Description of Property
i{} (%t (t)
l Stock and Stock ln Process
,1 I II .,r',t:i::::::.
ON STOCK & SSP OF E.D., PACKING MATERIALS 5o,oo,ooo o ,ii.do,:.: ': l
INCLUOING GOODS HELD ON TRUST &/OR IN
POSSESSTON
ln witness whereof the undersigned being authorised by and on behalf ] 4 " 2v\
For and on behall of
of the company has/have herein to set his/their hands. National lnsurance Company Limited
CIN No: U10200W81906GO10017'13, IRDA Reqn. Noi 58 Duly Constituted Attorney (s)
PBA-TBS-07/10/2016 10:51:44-9-1 30120010000114 -6.9.0.0
Customer Care Toll Free Number : 18002007710; Grievance CellToll Free Number: 18003454033

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POL]CY SCHEDULE National lnsurance Company t_imited
rrrPa y Lr Leq
Middleton Street. Post Box No. 9229, Kotkata -
3, Mid( 7OO 071

. {rL
Policy Premium: 8,938
Net Premium : 5,656
Add SeryiCe Ta1 (i4,00)%:
792
Swachh bharat Cess {0.5)%:
Krishi Kalyan Cess (0.5)%:
6504

Total Sum lnsured(tn Figures) : tS0,00,000

TotalSum lnsured Non-AOG Excess(%) 5 Min Excess for Non-AOG perils: l100OO
(in words): Rup;es Fifty Lakh Onty .. AOG Excess(%) Min Excess foiAOG Pdits: i1O0OO

STFI Rate Charged.: .18?5 Per Mi[e EQ Rate Charged: .l Per lVille

The lnsurance under this Policy is subject to : l.Agreed Bank

warranties & clauses (as per forms attached) & is j
extended to cover risks of (as per forms attached) :
Policies having sum lnsured up to < 10 cr per location - 5% of claim amount subject
to a min imum of -10.000/,

Description of Risk : ON STOCK & SSp OF E.D. AS LTSTED

ATTAC.JIED TO}{j FORM N_ pl\RT-i)E p O LteI NO. L
T
M2ooi 1lI 6/3100-00 1 51 L
Sr. No. Description of Clauses
-
1 Subject to Earthquake {Fire and Shock) Ctause As Attached

NAIVIE OF BANruFINANCER :

Srl No. Finarcier Name Branch Name

l Kotak lrahindra Bank Ltd _NtL_

Remarks/Special Conditions :
visit us at www.nationalinsuranceindia.com for informalion on Products, services
anct c.ievance Redressal.

att. a ''
\\
ln-witness whereof the undersigned being authorised by and on behalf
For anddn behalf of
of the company has/have herein to set his/their hands. National lnsunce Company Limited
CIN No: U10200W81906cOt00.17j3, tRDA Regn. No:58 Duly constituted Attorney (s)

Ef $;rfi 3;'J113'i31,6'i3l'ili,.,{;';l fl ffioo%B'rgqil.o,*3;'ig Toll Free Number : 18003454033

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