B A R D
I C I L OM
I C
ICICI Lombard is one of the largest private sector
general insurance company in FY2020.
• Gross written premium of 135.92 Billion
• Over 26.2 Million policies issued to customers
• 1.8 Million claims settled
Pan India Presence
273 Branches 840 Virtual Offices
8,800 Garages 6,536 Hospitals
Data as on March 31, 2020
1015/IP-04205954/000
ICICI Lombard General Insurance Co. Ltd
Date: 04/04/2024
Quotation Number: 1015/IP-04205954/000 Previous Policy Number:
To,
Pankaj Bhasin
Wave city ,GHAZIABAD ,201002
UTTAR PRADESH ,INDIA
Broker/Agent
DEEPA JAIN(IM-483604)
Dear Sir/Madam
Reference: Quotation for ICICI Bharat Griha Raksha Policy
We thank you for the opportunity extended to us to submit the quote for your insurance requirement based on the
details furnished.
Risk Location
Occupancy details
As per Annexure attached
Sum Insured
Terms & conditions and warranties
Policy Period 04/04/2024 To 03/04/2025
Hypothecation details
Total Premium Payable 7,862
Validity of Quote 19/05/2024
Undertaking:
I/We hereby confirm that the particulars of the prospect/risk mentioned in this quotation are those provided me to
ICICI Lombard General Insurance Co (Insurer)for the purpose of the requested risk coverage. I/We herby further
confirm that the derivation of the premium in the quotation is in accordance with the risk coverage required by us from
the Insurer. I/We also understand that the copy of this quotation duly signed by me shall for all purposes be treated as
my/our proposal for insurance and the required insurance policy shall be issued by the insurer on the basis of the
details as mentioned in this quotation.
I hereby give my consent to the Company to verify and obtain my identity/address proof as well as the identity
/address proof of the insured through Central KYC Registry or UIDAI or through any other modes for the purpose of
undertaking KYC
Are you or any of the proposed applicants/beneficial owner a PEP* or a close relative of a PEP*?
[__] Yes [__] No
If yes, please give details:____________________.
Page 1 of 4
1015/IP-04205954/000
*Politically Exposed Persons (PEPs) are individuals who are or have been entrusted with prominent public functions
in a foreign country, e.g., Heads of States/Governments, senior politicians, senior government/judicial/military
officers, senior executives of state-owned corporations, important political party officials, etc.
Client Email ID
PAN or TAN number
Authorized Signatory
Name & Designation
Contact Number
Signature
Annexure 1 Quote Number : 1015/IP-04205954/000
Location 1
Wave city,GHAZIABAD ,201002,UTTAR PRADESH, INDIA,
Occupancy : Dwellings
Secondary Occupancy : Dwellings
Covers Required: Home Building and Carpet area of structure of Home in Rate of Cost of Construction at the
Home Contents square metres : 3000 policy Commencement Date: 10000
Sum Insured Breakup
Sum Insured
Sum Insured
for Sum Insured
for Content - Sum Insured Sum Insured
Residential for Sum Sum Insured
furniture, for Content- for Contents - Total Sum
Building Insured for for Content -
fixtures and Electrical/Ele Valuable Insured
including additional Other
fittings (home ctronic Contents
fitting and structure
furnishing)
fixture
30000000 0 2500000 0 0 0 3,25,00,000
Block Level Add On Covers
Add On Cover Description Sum Insured Premium
Warranties Specific to Location
Warranted that construction type is RCC
Warranted any contents in basement are excluded from the scope of cover
Block level Terms and Conditions
The scope of cover is limited to following description of stocks. "." Any other kind of stocks not mentioned in this list
shall get excluded from the policy.
Terrorism Clause
Earthquake (Fire and Shock)
Page 2 of 4
1015/IP-04205954/000
Policy Level Add On Covers
Add On Cover Description Sum Insured Premium
Policy level Terms and Conditions
No cover for storage or manufacturing of any kind of single use plastics or like, under the scope of this policy.
Nil Excess for dwelling risk with policy holders as house/flat owners
The Policy shall be void-able in the event of mis-representation, mis-description or non - disclosure of any material
particular
Warranted that the claims experience is nil for last 3 years
Local Authorities Clause
Reinstatement Value Policies
Designation of Property Clause
Special Conditions
If the Policy Period is more than one year, We will automatically increase Your Sum Insured during the Policy Period
by 10% per annum on each anniversary of Your Policy without additional premium for a maximum of 100% of the
Sum Insured at the Policy Commencement Date.
Premium Breakup
Block Level Premium table Location 1 Total
Risk Location description GHAZIABAD, 201002
Basic Premium 2,438 2,438
Block Level Add on Cover Premium 0
Earthquake Premium 1,625 1,625
Terrorism Premium 2,600 2,600
Policy Level Add on Cover Premium
Net Premium 6,663
Add Floater Premium 0
Total Premium 6,663
Goods & Service Tax 1,199
Add Stamp Duty 0
Total Premium Payable 7,862
*Premium value mentioned above is inclusive of taxes applicable.
Excess: NIL : Excess
Page 3 of 4
1015/IP-04205954/000
End of Quotation
STATUTARY WARNING
PROHIBITION OF REBATES
Section 41 of the Insurance Act, 1938 as amended by the Insurance Laws (Amendment) Act, 2015
1 No person shall allow or offer to allow, either directly or indirectly as an inducement to any person to
) take out or renew or continue an insurance in respect of any kind of risk relating to lives or property, in
India, any rebate of the whole or part of the commission payable or any rebate of the premium shown
on the policy, nor shall any person taking out or renewing or continuing a Policy accept any rebate,
except such rebate as may be allowed in accordance with the published prospectuses or tables of the
Insurer.
2
Any person making default in complying with the provisions of this section shall be punishable with fine
)
which may extend to ten lac rupees.
ICICI Lombard General Insurance Company Limited
IRDA Regn. No. 115 CIN: U67200MH2000PLC129408
Mailing Address: Registered Office: Toll Free No: 1800-2666
401 & 402, 4th Floor, Interface 11, ICICI Lombard House, 414, Veer Savarkar Marg, Alternate No: +919223622666 (chargeable)
New Linking Road, Malad (West), Near Siddhi Vinayak Temple, Prabhadevi, Email:customersupport@[Link]
Mumbai - 400064 Mumbai - 400025 Website:[Link] Page 4 of 4
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Fire Safety Guidelines for ommercial uil ings
DO s
• learly mar the location of fire e tinguishers manual control points alarm facilities
an no ho to operate them
• no your evacuation plan emergency contact num ers nearest assem ly point
an perform moc rills
• eep every e it passage ay an ischarge free from o structions
• est smo e etectors fire alarms panel an emergency lighting systems at regularly
• eep emergency first ai it maintaine an han y
• f you encounter smo e uring fire emergency stay lo an eep a et cloth covering your nose
DO s
• eave appliances unatten e uring coo ing
• amper smo e etectors fire alarms an or hang anything from sprin ler hea s or pipes
• se lift for evacuation an eep fire oors open
• se na e flame an halogen lamps near com usti les
• ight out hen not traine in firefighting an ignore instruction of security
e site [Link] oll ree o 1800 2666
*Available basis policy T&C.
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