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Reliance Two Wheeler Vehicle Certificate cum Liability Policy Schedule

Name of Insured : Mrs RAM GOUD ARE
Address :S/O VEERAIAH,
LIG103, APHB COLONY,
BOHONGIR ,NALGONDA,
TELANGANA.
Contact Details :
Mob.No.: 9700363769
Email ID : NA

Policy/Certificate No.
:1801442348000552
Proposal/Covernote No. : NA
Period of Insurance
: From 00:00 Hrs on 04/07/2016 to 03/06/2017 Hrs on
23:59:00
NCB Retention
: No
Business / Occupation : NA
Hypothecated with: NA Location : NA
Zone : B Geographical Area : India

Particulars of vehicle Insured:

Reg. No. & Place

Make / Model / Variant

AP- 24 AA- 7132 &

RTA BHONGIR

HERO HONDA /
PASSION PLUS

Type of
body

Engine / Chassis No.

HA10EB9HH04949 /
MBLHA10EG9HH02013

Cubic
Capacity

Year of Seating capacity of side car (If Net Premium

IDV (Insured
MFG
any Including driver)
Rs.
Declared Value) Rs.

97.0

2009

928.00

0.00

Limitations As To Use :
The Policy covers use for any purpose other than: a. Hire or Reward, b. Carriage of goods (other than samples or personal luggage), c. Organized racing, d. Pace making, e. Speed testing, f. Reliability trials, g. Any purpose in connection
with Motor Trade
Persons or Classes of Persons entitled to drive :
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.
Limits of Liability :
a. Under Section II-1(i) of the Policy-Death of or bodily injury to any person so far as it is necessary to meet the requirements of the Motor Vehicle Act, 1988. b. Under Section II (1)(ii) of the Policy-Damage to property other than property
belonging to the insured or held in trust or in the custody of control of the insured up to the limits specified Rs. 1,00,000./-. (iii) PA Cover for owner-driver under Section-III CSI - Rs.1,00,000/Deductible under Section-I :
(i) Compulsory deductible Rs.100/- (ii) Additional compulsory deductible Rs. 0.00/-, (iii) Voluntary deductible Rs. 0.00/
Special Conditions : NA
It is hereby declared and agreed that all pre-existing damages to the vehicle having occurred prior to the commencement of cover are excluded from the scope of the policy. The NCB provided is on Basic OD Premium excluding Add on
where applicable. The policy wording with detailed terms, conditions and exclusions are available on our website www.reliancegeneral.co.in
Consolidated stamp duty paid vide Receipt No. MH000819484201415E dated 04/07/2016. Not applicable for the State of Jammu and Kashmir.
I/We hereby certify that the Policy to which the certificate relates as well as this certificate of insurance are issued in accordance with the provision of Chapter X and Chapter XI of M.V. Act, 1988. Note: In the event of dishonor of cheque,
this policy document automatically stands cancelled from inception irrespective of whether a separate communication is sent or not. No Claim Bonus will only be allowed, provided the policy is renewed within 90 days of the expiry of the
previous policy.

Insured's Declared Value

For the Vehicle (Rs)

For Trailers (Rs)

Elec./Electronic Accessories (Rs)

Non Elec. Accessories (Rs)

Value of CNG/LPG Kit (Rs)

Total IDV (Rs)

0.00

0.00

Electrical Accessories
Sl No.

Make and Model

Serial Number of Accessory

Non Electrical Accessories

Sum Insured

Sl No.

Make and Model/Description

Serial Number of Accessory

Sum Insured

PREMIUM SCHEDULE
OWN DAMAGE
Basic OD (Including Additional Covers if any)

LIABILITY
0.00 Basic Liability

464.00

Basic Liability Premium

Total Own Damage Premium

***All Premium Figures are in Rupees

464.00

0.00 PA Benefits
Compulsory PA covers for owner-Driver of CSI 1,00,000 (IMT-15)

100.00

Total PA Premium

100.00

Legal Liablitiy
Total Legal Liablitiy Premium

0.00

Total Liability Premium

1028.00

Package Premium

1028.00

Add: Service Tax (12% of Net Premium)

120.00

Add: Education Cess (2%of Service Tax)

20.00

Add: Secondary & Higher Education Cess (1% of Service Tax)

FINAL PREMIUM

0.00
1168.00

***All Premium Figures are in Rupees

Service Tax Reg. No. AABCR6747BST001
Category-General Insurance Business Service 00440005
Subject to Reliance GI Add on endrosements printed herein/ attached hereto
The policy has been issued based on the information provided by you and the policy is not valid if any of the information provided is incorrect. Subject otherwise to the terms, conditions and exclusions of the Reliance Motorised Two Wheeler Liability Policy. In Witness whereof
this Policy has been signed at Mumbai on 04/07/2016 in lieu of Cover Note No. NA dated NA
Subject to I.M.T.Endt.Nos. & Memorandum printed/herein/attached hereto.16

In the unfortunate event of a claim, Please call along with your Policy No. on 1800 103 1999 (toll free) or 022 41112600 (Standard STD Rates Apply) and register your claim immediately
within 7 days from the date of loss. For Customer service, Please call along with your Policy No. on 1800 3002 8282 (toll free) or 022 39898282 (local charges apply)|www.reliancegeneral.co.in
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
appealing 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. NOTE: Kindly acknowledge receipt of this policy.
In case you find any variations against your proposal or any discrepancy in the policy, kindly contact us immediately
Reliance General Insurance Co. Ltd. , CIN:U66603MH2000PLC128300
Registered Office: Reliance Centre, 19, Walchand Hirachand Marg, Ballard Estate, Mumbai - 400 001
Policy Issuing Office: 570, Naigaum Cross Road, Next to Royal Industrial Estate, Wadala (W), Mumbai - 400 031
Branch Issuance Office: 3rd Floor, Street No. 3. Main Road, Himayat Nagar, Hyderabad 500029

For Reliance General Insurance Co. Ltd.

Duly Constituted Attorney(s)

An ISO 9001:2008 Certified Company
Intermediary Code/Name:

18A08521 / NANDA VEERESHAM

Intermediary Contact No:

9533006306