The Oriental Insurance Co. Ltd.

Servicing Office of Insurer : Divisional Office Shree Krishna Plaza, 100 Ft. Road Shobhagpura,
Udaipur, Rajasthan (State Code:08) -313011, PH-0294-2980013 Website :
www.orientalinsurance.org.in
PAN : AAACT0627R . GSTIN: 08AAACT0627R3ZX Insurer's IRDA Registration Number: 556
Tollfree Helpline : 1800-11-8485 Email: abhishek.gurjar@orientalinsurance.co.in CIN :
U66010DL1947GO1007158

GOODS CARRYING VEHICLE PACKAGE POLICY-CERTIFICATE CUM POLICY SCHEDULE

(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. 242596/31/2024/TMC/5146 Policy Issued On 10-MAY-2023 (15:05)
Insured Name MR. IMRAN
Own Damage Period 10-MAY-2023(15:05) To 09-MAY-2024(Midnight) Motor Liability Period 10-MAY-2023(15:05) To 09-MAY-2024(Midnight)

Proposal No. & Date : PCVBU9085894, 10-MAY-2023 CPA Cover Period : 10-MAY-2023(15:05) To 09-MAY-2024(Midnight)
Insured Add. : S/O JAHID VILLAGE JAITPUR TAHARPUR KALAN (28) Previous Insurer : NA
TAHARPURKALAN YAMUNANAGAR, YAMUNA NAGAR , HARYANA (State Previous Policy No. : NA
Code:06) -135001

BROKER DETAILS
IRDA Lic. No. 375 CIN No. U50300MH1997PLC149349

Broker Category Composite Broker Validity 13-MAY-20 To 12-MAY-23

Name & Add. : TATA MOTORS INSURANCE BROKING AND ADVISORY SERVICES LTD, 1ST FLOOR, AFL HOUSE, LOK BHARTI COMPLEX, MAROL
MAROSHI ROAD, ANDHERI (EAST), MUMBAI - 400 059
Contact us at: 1800 209 0060 or write to us at: support@tatamotorsinsurancebrokers.com

Make Model Variant Cubic Capacity Manufacturing Year Seating capacity

TATA LPK 2518 CR BSIV
TATA MOTORS TATA LPK 2518 5883 2015 3
HD
Registration No. RTO Invoice Date GVW Chassis No. Engine No.
B5.91803251H634599
HR 58 B 0674 YAMUNANAGAR 30-SEP-2015 25000 MAT448137F3H17090
64
Vehicle Type Vehicle Sub Class Built Type IDV of Chassis IDVof Body Elec. Accessories

A1- Public Carrier-GCV Open Body Fully Built 1,800,000 0 0

Non-Elec. Accessories CNG/LPG Kit IDV of Trailer Total IDV

0 0 0 1,800,000

NOMINEE DETAILS
Name of Nominee Age Relationship with Insured Name of Appointee Relationship with Nominee

JAHID 68 FATHER --N.A-- --N.A--

PAYMENT DETAILS
Premium Paid : 61977 Cheque No. : 000038 Cheque Date: 10-MAY-2023

Bank Name : HDFC BANK LTD Bank City : YAMUNANAGAR

For & On Behalf of The Oriental Insurance Co. Ltd.

Dealer Code : PASCO MOTORS DOSARKA - 100906100

Authorized Signatory
In case of any claim or assistance required please contact our help line at 1800 209 0060 and you may also reach us at
support@tatamotorsinsurancebrokers.com
 The Oriental Insurance Co. Ltd.
Servicing Office of Insurer : Divisional Office Shree Krishna Plaza, 100 Ft. Road Shobhagpura,
Udaipur, Rajasthan (State Code:08) -313011, PH-0294-2980013 Website :
www.orientalinsurance.org.in
PAN : AAACT0627R . GSTIN: 08AAACT0627R3ZX Insurer's IRDA Registration Number: 556
Tollfree Helpline : 1800-11-8485 Email: abhishek.gurjar@orientalinsurance.co.in CIN :
U66010DL1947GO1007158

GOODS CARRYING VEHICLE PACKAGE POLICY-CERTIFICATE CUM POLICY SCHEDULE

(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. 242596/31/2024/TMC/5146 Policy Issued On 10-MAY-2023 (15:05)
Insured Name MR. IMRAN
Own Damage Period 10-MAY-2023(15:05) To 09-MAY-2024(Midnight) Motor Liability Period 10-MAY-2023(15:05) To 09-MAY-2024(Midnight)

Schedule of Premium (Amount in Rs.)

Own Damage Premium (A)
Basic Premium Deductibles
Vehicle 8,154 Voluntary Deductibles (0) (IMT-22A) 0
Additional GVW Loading 878 Anti Theft Device (IMT-10) 0
Trailer 0 AA Membership (IMT-8) 0
Non-Elec. Accessories 0 No Claim Bonus (0%) 0
Elec. Accessories (IMT-24) 0 Sub Total (Deductibles) 0
CNG/LPG Kit (IMT-25) 0
Sub Total (Basic Premium) 9,032
Add On Coverages 0
Geographical Area Extension (IMT-1) 0
IMT -23 1,355
IMT -34 0
Overturn Cover 0
Sub Total-Addition 10,387 Net Own Damage Premium (A) 10,387
Liability Premium (B)
Basic Third Party Liability 43,950 PA Cover For 0 Persons of Rs. 200000 Each (IMT-16) 0
Third Party Liability For Bi-Fuel Kit 0 Legal Liability For Paid Driver (IMT-28) 50
Third Party Liability For Geographical Area Legal Liability For Cleaner / Conductor / Helper (for 1
0 50
Extension persons) (IMTʹϮϵͿ
Third Party Liability For IMT -34 0 Legal Liability For 0 Non Fare Paying Passenger 0
Third Party Liability For Trailer 0 Legal Liability for Employees (for 0 persons) (IMTʹϮϵͿ 0
PA Cover For Owner Driver Of Rs. 1500000 (IMT- 320
15)Cover For Cleaner / Conductor / Helper
PA
0
200000 Each (IMT-17)
PA cover for Paid Driver of Rs 200000 (IMTʹϭϳͿ 0 Net Liability Premium (B) 44370
Note: In case of dishonour of the premium cheque, this document stands
automatically cancelled 'ab-initio
Total Premium (A+B) 54757
> Consolidated stamp duty paid to state exchequer.
> The policy is subject to compulsory deductible of Rs.1500 IMT 21 IGST (12% of Basic TP + 18% of rest of Premium) 7220
> Geographical Area-India
> The insurance company will display terms & conditions on its website
www.orientalinsurance.org.in which can be accessed by you online.
> Gross Premium Paid 61977
*Subject to IMT Endt. Nos.& Memorandum:7,21,23,28
0

Addon Unique Identification Number (UIN) Details Add On Premium

Hypothecation Details: HINDUJA LEYLAND FINANCE LTD - A - A

MISP Name: PASCO MOTORS DOSARKA, MISP PAN No: AAGPP7032H, MISP Code: TMIBASL/MISP/AAGPP7032H

SAC:997134, Description of Service :Motor Vehicle Insurance Services, Place of Supply :HARYANA(State Code:06), Receipt No/Invoice No:TMC24005146
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 Motor
Vehicle Act, 1988

For & On Behalf of The Oriental Insurance Co. Ltd.

Dealer Code : PASCO MOTORS DOSARKA - 100906100

Authorized Signatory
In case of any claim or assistance required please contact our help line at 1800 209 0060 and you may also reach us at
support@tatamotorsinsurancebrokers.com
 The Oriental Insurance Co. Ltd.
Servicing Office of Insurer : Divisional Office Shree Krishna Plaza, 100 Ft. Road Shobhagpura,
Udaipur, Rajasthan (State Code:08) -313011, PH-0294-2980013 Website :
www.orientalinsurance.org.in
PAN : AAACT0627R . GSTIN: 08AAACT0627R3ZX Insurer's IRDA Registration Number: 556
Tollfree Helpline : 1800-11-8485 Email: abhishek.gurjar@orientalinsurance.co.in CIN :
U66010DL1947GO1007158

GOODS CARRYING VEHICLE PACKAGE POLICY-CERTIFICATE CUM POLICY SCHEDULE

(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Policy No. 242596/31/2024/TMC/5146 Policy Issued On 10-MAY-2023 (15:05)
Insured Name MR. IMRAN
Own Damage Period 10-MAY-2023(15:05) To 09-MAY-2024(Midnight) Motor Liability Period 10-MAY-2023(15:05) To 09-MAY-2024(Midnight)

The insured is entitled for a No Claim Bonus (NCB) on the own damage section of the
policy, if no claim is made or pending during the preceding year(s)-20%, preceding two
consecutive years-25%, preceding three consecutive years-35%, preceding four
No Claim Bonus consecutive years-45%, preceding five consecutive years-50% of NCB on OD Premium.
NCB is allowed provided the policy is renewed within 90 days of the expiry date of the
previous policy.

The Policy covers use only under a permit within the meaning of the Motor Vehicle Act, 1988 or
such a carriage falling under Sub-section 3 of Section 66 of the Motor Vehicles Act 1988 The Policy
does not cover: 1. Use whilst drawing a trailer except the towing (other than for reward) of any
Limitations as to
one disabled mechanically propelled vehicle. 2. Use for carrying passengers in the vehicles; except
use employees (other than the driver) not exceeding the number permitted in the registration
document and coming under the purview of Workmen's Compensation Act 1923. 3. Use for a)
Organized racing, b) Pace-making, C) Reliability Trials, d) Speed Testing.

Any person including insured: Provided that a person driving hold an effective driving license at
the time of the accident and is not disqualified from holding or obtaining such a license. Provided
Driver͛s Clause also that the person holding an effective Learners license may also drive the vehicle when not used
for the transport of goods at the time of the accident and that such a person satisfies the
requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.

Under Section II-1(i) of the policy-Death of or bodily injury: Such amount as is necessary to meet
Limits of Liability
the requirements of the Motor Vehicle Act 1988.Under Section II-1 (ii) of the policy-Damage to
Clause third party property is Rs.7.5lakhs PA Cover Under Section III for Owner-Driver is Rs. 1500000.

This Schedule, the attached Policy and Endorsements mentioned herein above shall read together
and word or expression to which a specific meaning has been attached in any part of this policy or
of the Schedule shall bear the same meaning wherever it may appear. Any
amendments/modifications/alterations made on this system generated policy document is not
valid and Company shall not be liable for any liability whatsoever arising from such changes. Any
Note changes required to be made in the policy once issued would be valid and effective, only after
written request is made to the Company and Company accepts the requested
amendments/modifications/alterations and records the same through separate endorsement to
be issued by the company.
In Witness whereoff this policy has been signed at AMBALA on 10-MAY-2023 15:05