RAHEJA QBE GENERAL INSURANCE COMPANY LIMITED

Ground Floor, P&G Plaza, Cardinal Gracious Road, Chakala, Andheri (East), Mumbai 400099
Telephone: 91 22 4171 5050, Fax: +91 22 4171 4920, Toll Free No. 1800-102-7723
Website: www.rahejaqbe.com Email: info@rahejaqbe.com
Corporate Identity Number: U66030MH2007PLC173129, IRDA Reg. No. 141

HELD COVER LETTER

Date – 06th February 2020

No: HC/HYD/D3062/WCA/2020/R01
Policy No. 015W000330800000

To,
Aries Power Systems (India) Private Limited
8-2-269/W/7, Plot No. 7, Banjara Hills,
Road No. 2, Hyderabad, Telangana 500034

Dear Madam/Sir,

Subject: Confirmation of Cover for “Workmen’s Compensation Insurance Policy”

Thank you for expressing your confidence in Raheja QBE General Insurance Company Ltd.

We are glad to confirm receipt of the premium of INR 10,589/- vide cheque number 242806, dated
05th February 2020, drawn on ICICI Bank, towards Workmen’s Compensation Insurance Policy for
“Aries Power Systems (India) Private Limited".

The agreed terms and conditions are as per annexure attached.

We request you to kindly note that inception of risk cover is subject only to realization of cheque/funds
and receipt of full premium and applicable taxes, as well as complete compliance of terms and
conditions of cover, by the policy holder. The policy shall stand cancelled ab initio in the event of non-
realization of the premium.

We look forward to an enriching business relationship.

Thanking you,

For RAHEJA QBE GENERAL INSURANCE CO. LTD.

FARZAN PESI Digitally signed by FARZAN
PESI KHANSAHEB

KHANSAHEB Date: 2020.02.06 15:01:21

+05'30'

Authorized Signatory
Kba
This document is digitally signed; hence counter signature is not required.
 Annexure

Insured Aries Power Systems (India) Private Limited

8-2-269/W/7, Plot No. 7, Banjara Hills,

Address
Road No. 2, Hyderabad, Telangana 500034

GSTIN 36AAHCA8072C1ZS

Perkin Laboratories.
Location of employment
Plot No.94, TSIIC, Medchal Industrial Area, Medchal-501401, Telangana.

Nature of Work Civil Construction

Territory /Jurisdiction India/India

Policy Period 06th February 2020 To 05th February 2021

Estimated Total Wages INR 21,00,000/-

Number of Employees 10

• As per Workmen’s Compensation Act, Fatal Accidents Act and Common Law
• Medical Expenses Extension – INR 100,000/- per person
• Average Clause
Coverage • Sanction Limitation and Exclusion Clause
• Contractors / subcontractors are covered under policy
• The policy excludes blasting, tunneling, mining, use of explosives, any aircraft
or related risk , any vessels or related risk , any off shore risks.

• Submission of Completed & Signed Proposal Form

Subjectivity • Declaration of “No known or reported claims”, prior to binding.
• List of employees to be provided at the time of binding of cover

Premium INR 8,974/- + GST @ 18%