For all your insurance needs & query call us at our Toll free No.

: 1800-209-8888(Accessible from your mobile also), you can also E-mail us at: customersupport@iddlombard.com

Certificate cum Policy No : 3005/2010043736/B/0000002316 Policy I s s u i n g Office Period of I ns u r a n c e I n s u r e d Nam e I n s u r e d Address Zenith house, Opp Race Course, Bangalore. Fr om 00:00 03/04/2013 To 02/04/2014 m id n ig h t ARUN RTO Location I n t e r m e d i a r y Code Pol icy I s su e d On S/o Jaya, Opp Tsp , Indira Nagar, Opp Tsp, T.B.Dam-583225 HOSPET, KARNATAKA, P r im ar y Vertical Nam e BAJAJ DISCOVER 125 Contact No. 91-9731488528 (Mobile No.) Reg istra tio n Company Model Type of body CC Number BAJAJ DTS KA-35-K-6549 BAJAJ Solo 125 125 SCHEDULE OF PREMIUM Own Damage(A) Two Wheeler Prerrium : Additional Covers Discounts Total Own Damage Pr em ium
T ot a l Pac k age Pr em ium ( A+ B) ' Net Premium Service Tax(Incl Edu.Cess And Higher Edu.Cess) T ot a l Pr emi um For No claim Bonus (NCB), Coverages and exclusion of policy Please refer to the policy wordings attached with this schedule, in case of you have not received your kindly write to us at the below mentioned mailing address. Co m pu ls or y Deduc ti b les : Rs. 50
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KARANATAKA HOSPET 202111920830

29-Mar-2013 12:50 PM

First Registration Date : Mfg Year 2005 Seat Chassis Num ber Cap 2 DSGBCJ71487

03/01/2005 Engine Number DSGBCJ71470

Liability(B) 20238.00 310.00 50.00 366.00 1323.00

957.00 Insured declared Value (ID'/): 0.00 0.00 957.00 ._

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Basic Third Party Liability PA Cover For Owner-Driver (Of Rs. 100000 ) Total Liabilit y Prem ium

1323.00 67.00

1390.00_

IGeographicalArea India

... All Premium figures are in Rupees

Li mi t s Of Li abi lit y : (a)Under Section I I - 1 ( i) of the policy->Death of or bodily injury: Such amount as is necessary to meet there requirements of the Motor Vehicles Act,1988.(b)Under Section I I - 1 (ii)of the policy-> Damage to Third Party Property Rs 100000.00; PA Cover for Owner-Driver under section I I I : CSI Rs 100000.00 Voluntary Deductable Rs.0.00

LIMITATIONS AS TO USE: The policy covers use of the vehicle for any purpose other than : Hire or reward, Carriage of goods(other than samples or
personal luggage), Organized racing, Pace making, Speed testing, Reliability trials, Any purpose in connection with Motor Trade.

DRIVER'S CLAUSES: Any person including the insured : Provided that a person driving holds an 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. 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 hold good

Subject to IMT End or s em ent No s . & M emor an dum p r i n t e d her ei n / at t ac he d her eto : Premium Collection Details

22,28

I/W e hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X,XI of M.V.Act 1988.

Agency Code: DB35606 Agent's Mobile No.: 91-8867894926

Agency Name : RELIANCE RETAIL INSURANCE BROKING LTD Agent's Landline No.:-

G r i ev anc e C la us e: For resolution of any query or grievance, Insured may contact the respective branch office of the Company or may call at 1800-209-8888 or may write an email at customersupport@icicilombard.com . In case the insured is not satisfied with the response of the office , insured may contact the Grievance Officer of the Company at grievanceofficer@icicilombard.com. In the event of unsatisfactory response from the Grievance Officer, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of Insurance Ombudsman offices are available at IRDA website: www.irdaindia.org, or on the website of General Insurance Council: or on the Company's website at www.icicilombard.com.