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Product Code: 3001 UIN: IRDAN115P0017V01200102

Ref. No. W58284592

Date: Feb 11, 2020
CHARU HOME PRODUCTS P LTD
12, SCHOOL LANE, BARA KHAMBA ROAD,
NEW DELHI
DELHI 110001
Mobile No: 8010699700

Sub: Risk Assumption Letter

Dear Sir/Madam,

Thank you for choosing ICICI Lombard General Insurance Company Limited (ICICI Lombard) as your preferred service
provider.

Please find enclosed Policy No. 3001/144675515/02/000, which has been issued based on the below mentioned details:

Insured & Vehicle Details

Name of Insured CHARU HOME PRODUCTS P LTD
Period of Insurance Feb 16, 2020 to Feb 15, 2021
Vehicle Make / Model TOYOTA / INNOVA VX 7STR
RTO City DELHI-NEW DELHI
Vehicle Registration No. DL12CD1230
Vehicle Registration Date Feb 18, 2013
Engine No. 2KDU210983
Chassis No. MBJ11JV4007382966
Current Year NCB(%) 35%
Previous Policy Details
Previous Policy No. 3001/144675515/01/000
Previous Policy Period 16-02-2019 to 15-02-2020
Previous Year NCB(%) 25%
Claims Made Under Previous Policy 0
Previous Insurer Name ICICI LOMBARD
Previous Policy Type Comprehensive Package
1

The information provided above is based on the information received from you and accordingly, the policy has been
processed. Coverage of risk is subject to realisation of the full premium, post which, insurance coverage under the policy
would commence. In case the premium is not received by us due to cheque dishonour or any other reason, the insurance
cover shall be void ab-initio.

We have issued the policy basis your confirmation that you hold a valid PUC and/or Fitness certificate, as applicable.

If you require any changes in the Certificate of Insurance cum Policy Schedule, you are requested to inform us by writing to
customersupport@[Link] or calling our 24 hour toll free helpline on 1800 2666. Absence of any communication within
a period of 15 days of the date mentioned on this letter, would mean that the issued policy is in order and as per your proposal.

The information provided is merely illustrative and shall not be construed to be an evidence of existence of a contract of
insurance. The Risk Assumption Letter is to be read in conjunction with the policy and shall be considered null and void without
the same.

The Compulsory Personal Accident cover has not been opted in this policy on account that, the vehicle to be insured is not
owned by an individual.
CORP/SUP/OPI/2014/1777

Feb 11, 2020

CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE 0

Private Car Package Policy

Product Code: 3001 UIN: IRDAN115P0017V01200102

Insured Name : CHARU HOME PRODUCTS P LTD Policy No : 3001/144675515/02/000

Address : 12, SCHOOL LANE, BARA KHAMBA ROAD,, NEW Tenure : 1
DELHI, DELHI 110001
Telephone No : - Mobile No: 8010699700 Period of Insurance : Feb 16, 2020 00:00 to
Midnight of Feb 15, 2021
Email Address : E-Policy No :
Nominee Name : - Named Passenger's Nominee: Policy Issued On : Feb 11, 2020
Relationship : - - Covernote No : 144675515
Age : - RTO Location : DELHI-NEW DELHI
GSTIN Number (Customer) : Hypothecated To : -
Servicing Branch Name : New Delhi Invoice Number : 100220278466
:
Servicing Branch Address : Fourth Parsavnath Capital Tower Bhai Veer Singh Marg, New Delhi New Delhi 110001

Registration No. Make Model Type of Body CC/KW Mfg Yr Seating Chassis No. Engine No.
Capacity
DL12CD1230 TOYOTA INNOVA VX 7STR Saloon 2494 2013 7 MBJ11JV4007382966 2KDU210983
Vehicle IDV Trailer Non Electrical Electrical / Electronic Accessories CNG / LPG Unit Total IDV
(`) (`) Accessories (`) (`) (`) (`)
560000 0 0 0 0 560000

Premium Details
OWN DAMAGE(A) (`) LIABILITY(B) (`)
Basic OD Premium 9102 Basic Third Party Liability 7890
Road Side Assistance (RSA-Standard) 199 Total 7890
Sub Total 9301 Add:
Less: Legal Liability to Paid Driver 50
No Claim Bonus 35% 3186 Sub-Total 50
Sub-Total Deductions 3186
Total Own Damage Premium(A) 6115 Total Liability Premium(B) 7940
Total Package Premium(A+B): 14055
% 9
CGST
` 1264.95
% 9
SGST
` 1264.95
Total Tax Payable in ` 2530
Total Premium Payable In ` 16585
Unique Identification Number (UIN) Details 0 0
Road Side Assistance 0 0
IRDAN115A0002V01201213 190

Geographical Area: India Applicable IMT Clauses: 28 , 22

Compulsory Deductible: ` 2000 Voluntary Deductible: ` 0

Features of Add-on Covers:

1. List of services for Road Side Assistance :Arrangement of keys,Arrangement/Supply of fuel,Arrangement of rental vehicle,Towing on breakdown/accident,Battery jump
start,Message Relay,Arrangement of Accommodation,Flat Tyre support,Minor on spot Repairs,Breakdown support over phone

Premium Collection No. 1108876412 Premium Amount ` 16585 Receipt Date 11-02-2020
GSTIN [Link] 07AAACI7904G1ZP HSN/SAC code 9971 / GENERAL INSURANCE SERVICES

Limits of Liability: (a) Under Section II-I(i) of the policy: Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor Vehicles Act 1988. (b)
Under Section II-I(ii) of the policy: Damage to Third Party Property ` 750000/-; PA Cover for Owner-Driver under Section III: CSI ` 0/-. The Compulsory Personal Accident
cover has not been opted in this policy on account that, the vehicle to be insured is not owned by an individual. 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 of personal luggage), Organised racing, Pace Making, Reliability trails or Speed testing,
any purpose in Connection with Motor Trade. Driver's Clause: Any person including the insured: Provided that a person driving holds an effective driving license at the time
of the accident and i s 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 i s 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 i s recoverable from the insured. See the clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY". For
Legal interpretation, English version will hold good. Disclaimer: Please visit [Link] for the policy wordings, for complete details on terms and conditions
governing the coverage and NCB. This document i s to be read with the policy wordings. The policy is valid subject to realization of cheque. We accept premium only via
legally recognized modes. In case of dishonour of premium cheque, the company shall not be liable under the policy and the policy shall be void ab-initio. In case of any
discrepancy with respect to the policy, please revert within 15 days from the policy start date. This policy is underwritten on the basis of the information provided by you and
as detailed in the Risk Assumption Letter shared with you along with the policy. On renewal, the benefits provided under the policy and/or terms and conditions of the policy
including premium rate may be subject to change. Grievance Redressal: For resolution of any query or grievance you may contact us on our toll free no. 1800 2666, or visit
any of our branch offices. You can also write to us at customersupport@[Link]. For detailed grievance redressal mechanism please visit the "Grievance
Redressal" section on our website [Link].
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. In witness whereof, this Policy has been signed at Mumbai on this date of Feb 11, 2020 in lieu of Covernote no. 144675515. The
stamp duty of ` 0.5 paid vide deface no. CSD30720205102020 dated Jan 30, 2020.
Policy Issuing Office: ICICI Lombard General Insurance Company Limited, ICICI LOMBARD HOUSE, 414, Veer Savarkar Marg, Near Siddhi Vinayak Temple, Prabhadevi,
Mumbai 400 025.
Warranted that the insured named herein/owner of the vehicle holds a valid Pollution Under Control (PUC) Certificate and/or valid fitness certificate, as applicable, on the
date of commencement of the Policy and undertakes to renew and maintain a valid and effective PUC and/or fitness Certificate, as applicable, during the subsistence of the
Policy. Further, the Company reserves the right to take appropriate action in case of any discrepancy in the PUC or fitness certificate.
CORP/SUP/OPI/2014/1777

Feb 11, 2020

CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE 0

Private Car Package Policy

Product Code: 3001 UIN: IRDAN115P0017V01200102

Agency Code : 5926770

Agency Name : RACHNA KAKKAR

Agent's Contact No : 9811590840

Contact Person :

Signature Not Verified

Digitally signed by DS ICICI
LOMBARD GENERAL
INSURANCE COMPANY
LIMITED
Date: 2020.02.11 14:43:38 IST
CORP/SUP/OPI/2014/1777

Feb 11, 2020