DEVELOPMENT HOUSE, 24 Park Street , Kolkata -700016

In case of any query, assistance or claims, please contact us at 1800 266 3202
UIN: IRDAN149RP0006V02201213

COMMERCIAL VEHICLE PACKAGE MISCELLANEOUS GROUP OF VEHICLES POLICY

CERTIFICATE OF INSURANCE CUM SCHEDULE /TAX INVOICE
Policy Servicing Office 1ST FLOOR, JANARDHAN TOWERS, 133/2, RESIDENCY ROAD, ,BANGALORE -560025 ,KARNATAKA , PH: (1800) 2663202
Policy No P0026300004/4107/100560
Insured Mr PUNITHRAO Y
Period Of Insurance 18:48 Hrs of 28/04/2025
Address S/O YOGESHRAO ,KANUBENAHALLI (V) KANCHIPURA (PO)
To Midnight of 27/04/2026
HOSADURGA (TQ),
Agent No.: NANDINI N-POS0015108-BQWPN0515N-
CHITRADURGA (DIST)
Agent Contact No.: 9901824905
CHITRADURGA
Email ID: nandhu8889@[Link]
KARNATAKA 577533
Covernote No. : CN26300004/4107/103530
Mobile:9108587975
Contact Number 9108587975
Hypothecation with L AND T FINANCE LTD
Email ID:
GST Number Unregistered
INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION
Registration Mark & No. & Trolley Serial Trolley Year of Public/Private SEATING
Engine No. Chassis No. Make/Model/Type of Body CC/HP/GVW
RTA Location ID Chassis No. Manufacture Carrier CAPACITY
NEW / SONALIKA DI 35 RX
2025 3100FLU54B1535665F18 MYASL1553370S3 40/0 1
CHITRADURGA TRACTOR/TRACTOR
IDV (INSURED'S DECLARED VALUE)
Electrical/electronic
IDV of Vehicle Trailers Non Electrical Accessories Bi-Fuel kit(LPG/CNG) Other accessories Total Value
Accessories
732000 0 0 0 0/0 0 732000
OWN DAMAGE(A) LIABILITY(B)
Basic - OD 1,742.16 Basic - TP 7,267.00
Loss/damage to lamps/tyres/mud guards etc. - IMT-23 261.32 PA Owner Driver -SI Rs.1500000 Tenure 1 Year(s) 750.00
Sub Total 2,003.48 PA for Paid Drivers Cleaners and Conductors - IMT 17 240.00
Total Own Damage Premium(A) 2,003.00 Under WC act-Driver/cleaner/employees-IMT 28 50.00
Sub Total 8,307.00

Total Liability Premium(B) 8,307.00

Premium Computation
Total Package Premium(A+B) 10,310.00
CGST @ 9% 927.90
SGST @ 9% 927.90
TOTAL 12,166.00
Disclaimer:The Exclusions in this policy are as specified in the pre inspection report ID :
LIMITATIONS AS TO USE -The Policy covers use only under a permit within the meaning of the Motor Vehicles Act, 1988 or such a carriage falling under Sub-section 3 of Section 66 of the Motor
Vehicle's Act 1988. Use only for agricultural and forestry purpose. The Policy does not cover use for a) Organised racing, b) Pace Making, c) Reliability Trials, d) Speed Testing, e) Use whilst drawing a
trailer except the towing (other than for reward) of any one disabled Mechanically propelled vehicle (only for Passenger Carrying Vehicles).
The Policy does not cover use for a) Organised racing, b) Pace Making, c) Reliability Trials, d) Speed Testing, e) Use whilst drawing a trailer except the towing (other than for reward) of any one
disabled Mechanically propelled vehicle (only for Passenger Carrying Vehicles).
Persons or classes of persons
Any person including Insured:
entitled to drive:
Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license.
Non-transport Vehicles Provided also that the person holding an effective learner's license may also drive the vehicle when not used for the transport of passengers at the time of the accident
and that such a person satisfies the requirements of Rule 3 of The Central Motor Vehicles Rules, 1989.
LIMITS OF LIABILITY
Under Compulsory excess in respect of each and every claim Under In respect of any one Under Damage to Third Party Property Rs. Under PA Owner – Driver as per
Section I under Sec I of motor policy : Rs. 3660/- Imposed : Rs. Section accident -- As per Section 750000/- in respect of any one claim Section III: premium computation
0/- II-I (i) Motor Vehicle Act II-I (ii) or series of claims arising out of one table
event.
Subject to I.M.T Endorsement Nos. IMT 7,IMT 17,IMT 21,IMT 23,IMT 28
NOMINATION DETAILS
Name Of the Nominee Date of Birth of Nominee Age of Nominee Relationship Percentage
YOGESHRAO 01/01/1970 55 Father 100
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 M.V. Act, 1988.
Premium Collection Details :- [ReceiptDate - Amount] : - 28/04/2025 , 12166
Premium Amount in Word's ( ) :- Twelve Thousand One Hundred Sixty-Six Only
For Magma General Insurance Limited
In case of Claims, please contact us at 1800 266 3202

Date of Issue : 28/04/2025

Place : Kolkata

Consolidated Stamp Duty on the issue of General Insurance Policies Paid vide G.O No. 378, dated 06.03.2025
GST Number of Magma - 29AAGCM1685C1ZF
GST Invoice Number - POL2904260005952
GST Invoice Date - 28/04/2025
Accounting Code for Service - 997134, Motor vehicle insurance services

Place of Supply:KARNATAKA ( 29 )
Authorised Signatory
Whether Tax is payable on Reverse Charge - No
UIN : IRDAN149RP0006V02201213
This is a valid Tax invoice in terms of Sub-rule 2 of Rule 54 of CGST Rule 2017. Further, being an Insurance Company, issuing of
e-invoice and QR Code are not applicable on us in terms of Notification No 13 and 14 of 2020 dated 21st March 2020 issued
from Central Board of Indirect Taxes and Customs. I/We hereby declare that though our aggregate turnover in any preceding
financial year from 2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are not
required to prepare an invoice in terms of the provisions of the said sub-rule.
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 be good. Please note that any misrepresentation, non disclosure or withholding of material facts will lead to cancellation of policy ab initio with forfeiture of premium
and non consideration of claim, if any.

As per the GST regulations, the amount of GST will not be refunded if the policy / endorsement is cancelled after 31st October of the next financial year.
For Complete details of coverage , terms, conditions & exclusion please refer the standard policy wording attached with this schedule

IMPORTANT - 1) The Validity of this Certificate of Insurance cum Schedule is subject to realisation of the premium cheque.
2) No Claim Bonus will only be allowed provided the Policy is renewed within 90 days of the expiry date of the previous policy.
3) This document is digitally signed, hence counter signature / stamp is not required.
4) For detailed terms & conditions please refer our website [Link]