National Insurance Company Limited

Div.No 10, Flat No.101-106, N-1 BMC House,Cannaught Place,

New Delhi. Tel: 011-41523362 011-41523363 Fax : 011-23326384
Service Tax Registration No. AAACN9967EST099

Certifacate Cum Policy Schedule

Policy No: OG-18-1150-1801-00000225 Package Policy [Issued at 06-NOV-2017 2PM]
THE INSURED: Name: ROHIT VISHWAKARMA
Address: I -358 Govind Puram Ghaziabad
Occupation Service
Period of Insurance From: 06-NOV-2017 00:02 (Hrs) To 05-NOV-2018 Midnight

Vehical Identification No (VIN) Date and Proposel No:

The vehical Maruti 800
UP-14-1773 06-NOV-2017 / DY1303356062
Geographical Area Engine- Chassis No. Type of Body CC Mfg Year Seating Capacity Registration Mark& Place
Registration
INDIA DDMBKH16989/59568 Solo 800 2001 5 Ghaziabad

INSURED'S DECLARED VALUE

Vehical Rs. Non-Elect accessories Rs. Elec Accessories Rs. CNG/LPG UNIT Rs. Total Value Rs.
20000 0 0 CNG 5000

Schedule of Premium
Note:- Premium: Rs. 884.00
Service Tax: Rs. 90.39
1. If the Premium is paid by cheque, the issue of Policy Krishi Kalyan Cess Rs. 43.00
is subjected to the realization of cheque . Swachh Bharat Cess Rs. 43.00
2. Consolidated stamp duty paid to state exchequer Total Premium Rs.1060.39
Compulsory Deduction

Limitation as to use : Use only for social domestic and pleasure purposes and for the Insured Business, The Policy dose not cover the use for : (!) Hire or reward(2)
Carriage of Goods (other then samples and personal luggage) (3) Organized racing (4) Pace making (5) Speed Testing (6) Reliability Trails )
Any Purpose inconnection with motor Trade

Deriver Clause : Any personincluding the insured: provided that a Person driving holds as effectieve driving licence at the time of the

and is not disqualifing from holding or obtaning such a licence.Provided also that the person holding an effectieve learner licence may also
drivindg the vehical & that such a person satisfies the requirement rule 3 of the central motor vehical Rule,1989
Limits of Liability Clause: Under section II-1(1)of the policy-death of the bodily injury.such amount as in necessary to meet there requirement

of the moter vehical act 1988.under section II (2) of the policy-damage to third party Property is Rs.7.5 Lakhs P.A. cover under section III for owner

No claim bonus: The insured is entitled for a no claim Bonus (NCB) on the owner damage section of the policy,if no clame is made or pending During the preceding years
as per the: The preceding year20%,preceding two consecutive year/25%,preciding three concutieve year/35%,preceding four concuctieve year /45% Preceding five
consecutieve year/50% of NCB on OD Premium . No claim bonus only be allowed provided the Policy is renewed with in 90 days of the expery date of previes policy

Lease/HP/Hypothecation: PUNJAB NATIONAL BANK

Nominee Details for compulsary PA : Rohit Vishwakarma
Subject to I.M.T Endt. Nos.&memorandem 7 10 15 22 28
The Insured is not indemnified if the vehical is use or driven I /we here by certify that the policy to which this certificate related as well as this certificate of
otherwise then in accordance with this schedule. Any payment Insurance are issued in accordance with the provision of chapter x and chapter xi of MV act 1988,
Made by the compnay by reasons of wider terms appering
in the certificate in order to comply with the moters vehical

act, 1988 is revoverable frm the insured.see the clause headed For National Insurance compney

AVODIANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY

For legal interpretation, English version will hold good.

Authorized Signa
This Policy is sourced and serviced through:
MARUTI INSURANCE BROKING PRIVATE LIMITED
DIRECT BROKER LICENCE NO: IRDA/DB475/10,intermediate code :910322. mail id: mibpl@maruti.co.on,contect No. 011-46781104