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MAGMA HOUSE, 24 Park Street , Kolkata -700016


(www.magma-hdi.co.in)

Date : 19/07/2013

To,
PRAN SINGH

S/O HAJARI LALVILL PAIYAAI TEH LATERI


464001,
VIDISHA,
MADHYA PRADESH.

Agent/ Intermediary Name and Code:LANDMARK INSURANCE BROKERS PVT LTD BRC0000011

Dear Mr. PRAN SINGH


(Customer ID: 20000124990)

We extend our warm welcome to you as an esteemed customer of Magma HDI General Insurance Co Ltd.

At the outset, we wish to thank you for choosing Magma HDI as your preferred insurer and subscribing to MHDI Motor
Policy. Your policy No is P0014200013/4107/169561.

We hope that this is beginning of a long term relationship, because we aim to provide services of highest quality
constantly to our customers so that we continue to be the preferred insurance provider year on year.

In case of any queries, please call us on 1-800 - 3002 - 3202 or write to us at customercare@magma-hdi.co.in and we
shall get back to you at the earliest.

Assuring you of our best services at all times.

Best Regards

For Magma HDI General Insurance Co Ltd.

Authorised Signatory

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MAGMA HOUSE, 24 PARK STREET , KOLKATA -700016

COMMERCIAL VEHICLE PACKAGE MISCELLANEOUS GROUP OF VEHICLES POLICY


CERTIFICATE OF INSURANCE CUM SCHEDULE
IMPORTANT - 1) The Validity of this Certificate of Insurance cum Schedule is subject to realisation of the premium cheque.
2) No Claim Bonus will only be allowed provided the Policy is renewed within 90 days of the expiry date of the previous policy.
Policy Servicing Office MAGMA FINCORP LTD T-5, III FLOOR, CITY CENTER ABOVE VISHAL MEGA MART ZONE I, M.P. NAGAR, BHOPAL (M.P.) 462011 BHOPAL- 462011
BHOPAL - 462011 MADHYA PRADESH
PH: FAX:
Policy No P0014200013/4107/169561 Period Of
From 17:15 Hrs of 02/07/2013
Geographical Area India Insurance
Insured PRAN SINGH To Midnight of 01/07/2014
Address S/O HAJARI LAL VILL PAIYAAI TEH LATERI Agent No BRC0000011
464001 VIDISHA MADHYA PRADESH
Business / Profession None Covernote No
Contact Number 9977554450 Covernote Date
PG/IR No. Zone Zone-C
Carrying on or engaged in the business or occupation of and no other for the purposes of this Insurance
INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION
Year of Public/Private Licensed Carrying
Registration Mark & No. Engine No. Chassis No. Make/Model/Type of Body CC/HP/GVW
Manufacture Carrier capacity including Driver
TAFE/MF 1035 DI
NEW 2013 46866 832703 0 1
TRACTOR/TRACTOR
IDV (INSURED'S DECLARED VALUE)
Non Electrical Accessories Electrical/electronic
IDV of Vehicle Trailers Bi-Fuel kit(LPG/CNG) Other accessories Total Value
Accessories
437000 0 0 0 0/0 0 437,000.00
A-OWN DAMAGE B-LIABILITY
Own Damage Premium on vehicle and accessories Third Party Premium
Basic Cover Basic Cover
Basic - OD 3,120.18 Basic - TP 1,750.00
TOTAL OWN-DAMAGE PREMIUM 3,120.00 PA Benefits
Compulsory pa to owner-driver - 2 lacs 100.00
Under WC act-Driver/cleaner/employees-IMT 28 50.00
TOTAL LIABILITY PREMIUM 1,900.00
TOTAL POLICY PREMIUM 5,020.00
Service Tax(Including education cess & higher education cess) 620.47
TOTAL 5,640.00
Hire Purchase/ Lease /Hypothecated with HDFC BANK LTD.
LIMITATIONS AS TO USE - THE POLICY COVERS USE ONLY UNDER A PERMIT WITHIN THE MEANING OF THE MOTOR VEHICLES ACT, 1988 OR SUCH A CARRIAGE FALLING UNDER
SUB-SECTION 3 OF SECTION 66 OF THE MOTOR VEHICLE'S ACT 1988.
The Policy does not cover use for a) Organised racing, b) Pace Making, c) Reliability Trials, d) Speed Testing, e) Use whilst drawing a trailer except the
towing (other than for reward) of any one disabled Mechanically propelled vehicle (only for Passenger Carrying Vehicles).
Persons or classes of
Any person including Insured:
persons entitled to drive:
Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining
such a license.
Non-transport Vehicles
Provided also that the person holding an effective learner's license may also drive the vehicle when not used for the transport of passengers at
the time of the accident and that such a person satisfies the requirements of Rule 3 of The Central Motor Vehicles Rules, 1989.
LIMITS OF LIABILITY
Under Compulsory excess in respect of Under In respect of any Under Damage to Third Party Property Rs. Under PA Owner – Driver as per
Section I each and every claim under Sec Section II-I one accident -- As Section II-I 750000/- in respect of any one claim Section premium computation table
I of motor policy : Rs. 2185/- (i) per Motor Vehicle (ii) or series of claims arising out of one III:
Act event.
Subject to I.M.T Endorsement Nos. IMT 7,IMT 21,IMT 28,IMT 48
NOMINATION DETAILS
Name Of the Nominee Date of Birth of Nominee Age of Nominee Address of Nominee Relationship Percentage
HAJARILAL 10/04/1960 53 FATHER 100
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 M.V. Act, 1988.
For Magma HDI General Insurance Co. Ltd.
In case of Claims, please contact us at 1-800 - 3002 - 3202

Date of Issue : 19/07/2013


Place : Kolkata

Consolidated Stamps Duty on the issue of General Insurance Policies paid vide G.O. No 1598- F.T. dated
27/9/2012 Authorised Signatory
Service Tax Registration no : AAGCM1685CSD001
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 be good.

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RECEIPT

Receipt Number PIS/200013/14/100072288


Receipt Date 19/07/2013
Business Channel

Received with thanks from PRAN SINGH

(Customer ID : 20000124990) a total sum of Rupees Five Thousand Six Hundred Forty Only

Instrument Type Instrument No. Date Bank Name Branch Name Amount
CASH N.A. N.A. N.A. N.A. 5,640.00

Total Amount Rs.5,640.00

Note:

* The insurance cover for the risk shall be as per the terms and conditions of the Insurance Policy as detailed in Policy Document.

* Receipt is Subject to realisation of cheque(s)

For & on behalf of

Magma HDI General Insurance Company Ltd.

Authorised Signatory