You are on page 1of 1

Servicing Office

IFFCO TOKIO GEN INS CO. LTD 2ND FLOOR,NO.31,ABOVE CONAGRA FOODS, LANE OPP: DBR DIAGNOSTICS, S.D.ROAD, SECUNDERABAD ANDHRA PRA 500003 INDIA Phone #: 040 27718944 ASHA K DURGA Agent Name: 81000144 Agent #: 9866309227 Agent Mobile #: Policy #: 1-T3DHMP P400 Policy #: Date of Issuance 09/09/2011 16:29:36 Period of Insurance From: 07/09/2011 00:00:00 To: Midnight On 06/09/2012 00:00:00 Geographical Area: Within India Only Engine No. W0H3171991 Chassis No. MBX0000DFMH106724 Seating Capacity 3


Regd. Office: IFFCO Sadan C1 Distt. Centre, Saket, New Delhi - 110017 COMMERCIAL VEHICLE CERTIFICATE OF INSURANCE cum SCHEDULE
Insured's Name: BATHURAJU SWAMI Address: S/O: BAGAIHA # 8-44 VENKATAPUR TUPRAN Pin Code MEDAK ANDHRA PRA INDIA Phone #: 9705993851 Cover Note # Insured Motor Vehicle Details & Premium Calculation Type of Body Registration Mark & Year of Manuf. No. APE PASSENGER Make of Vehicle AP23X2620 2010 ICVCLASS C.1B 3WHEELED VEHICLE Registration Authority Vehicle Trailer Non Electrical Access. 128360.00 0.00 0.00 A. Own Damage (Rs.) Basic OD Premium Basic Trailers OD Premium (0) Electrical /Electronics Accessories (IMT24) Bi Fuel Kit (IMT 25) Fiber Glass Fuel Tank Add: Geographical Area Extension (IMT 1) Overturning Extensions( IMT 47) Hire Reward/Commercial Usage (IMT 44) IMT 23 Driving/Tuitions Foreign Vehicle Loading (IMT 19)


CC 395

Coverage Package

IDV in Rs. 128360


Elec./Elect. Acc. 0.00 1632.74 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Bi-Fuel Kit 0

Total Value Net Premium Rs. 128360.00 3893.53 B. Third Party (Rs.) 2360.00 0.00 0.00

Basic TP Premium Basic Trailers TP Premium (IMT 30) Bi Fuel Kit (IMT 25)

Add: Geographical Area Extension (IMT 1) PA Owner Driver Legal Liability to Driver (IMT 28) LL to Non Fare Paying PAX (IMT 37) (0) LL To PAX on Ambulance/Hearses (IMT 46) LL to Employee (IMT29) (0) PA to Passenger (IMT 16) Less: Third Party Property Damage (IMT 20) Limit of Liability Under Section II-I (ii)

0.00 100.00 25.00 0.00 0.00 0.00 0.00

Less: Anti Theft Device (IMT 10) Handicap Discount (IMT 12) Vehicle User (IMT 13) No Claim Discount Any Other Loading/Discount Net (A) Co-Insurance Details Co-Insurer 1 Co-Insurer 2

0.00 0.00 ( 20% ) ( -20% ) -326.55 -261.23 1044.96 Agent No./Share No Co-Insurer No Co-Insurer

0.00 0.00

Any Other Loading Discount Net (B) Total Premium Service Tax Premium Paid Rs.

2485.00 3529.96 363.59 3893.53

Printed herein / attached hereto

Under Hire Purchase /Hypothecated/Lease Agreement with THE AP MAHESH CO-OP URBAN BANK Subject to IMT Endorsement Nos. , 28

Limitation as to use: Passenger Carrying Vehicles - Class C:: Use only in Connection with insured's business. Use only for carriage of passengers in accordance with the permit (Contract Carriage or Stage Carriage) instead within the meaning of the Motor Vehicles Act
The Policy does not Cover: (1) Use for Organised racing, pace making, reliability trail or speed testing. (2) Use whilst drawing a trailer except the towing (other than reward) of any one disabled mechanically propelled vehicle. (3) Use for the Conveyance of passenger for hire or reward by any person to whom the Motor Vehicle is hired. Private Car type vehicles let out on private hire and driven by hirer or any driver with hire permission.(4) Use for the conveyance of passenger for hire or reward, other than the guests of hotel. Private Car type vehicles owned by hotels and hired by them to their guests. Driver Clause: Any person including insured: provided that the person driving holds and effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the person holding an effective learner's license may also drive the vehicle and that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989. The preceding year 20 % Preceding two consecutive year 25% Preceding three consecutive year 35% Preceding four consecutive year 45% Preceding five consecutive year 50% Notwithstanding anything to the contrary contained in the policy, it is hereby agreed, understood and warranted that the No Claim Bonus allowed under this policy is subject to the fact that the Own Damage claim experience for your insured vehicle or your earlier vehicle (in case of transfer of No Claim Bonus from the earlier vehicle) in the Previous year policy (s) was Nil. Accordingly you give the consent and accept that the No Claim Bonus allowed under this current policy for insured vehicle is based on the above Nil claim history. However if we find that the basis of availing the "No Claim Bonus" under the Current policy is incorrect; then we will impose suitable damages at the time of claim under Own Damage section of the policy, which may at our discretion include forfeiture of all benefits under the Own Damage section of the policy. In case you find that the No Claim Bonus under the present policy is not correct, then you may please deposit the amount for NCB to us within 10 (Ten) days from the date of the issuance of the policy for the continuation of benefits under the Own Damage section of the policy. No claim bonus will only be allowed, provided the policy is renewed within 90 days of the expiry date of the previous policy. Limit of Liability Deductible under Section I Under Section II-I(i) Such amount as is necessary to meet the requirements of the Motor Vehicles Act, 1988 Passenger Carrying Vehicle Under Section II-I(ii) As per premium computation table Under Section III PA Owner- Driver as per premium computation table Not Exceeding 7500 Kg. GVW 500/- : Rs. 500/Inspection Status: InspectionDate InspectionRefNum: Taxis and Three Wheelers rated as Commercial Vehicles (Exceeding 1500 cc) : Rs. 1000/InspectingAgency:

Receipt Particulars Cash / Cheque No. Premium Bank Detail

CASH 3893.53

S.Tax.No. AAACI7573HST001 Dated

For IFFCO-TOKIO General Insurance Co. Ltd

Authorised Signatory

1) "Policy Issuing Office: Delhi", 2) "Consolidated Stamp Duty deposited as per the order of Government of National Capital Territory of Delhi" FOR CLAIMS CALL 1800 103 5499(Toll Free),0124-4285499 or SMS"CLAIM" to 56161