<br>

Form 59
[Soe rulos 115 (2)]
Certificate
Pollution Under Control
Authorised By:
Government of West Bengal

Date 28/09/2023
12:20:46 PM
Time
Validity upto 27/09/2024
WB00102650041229
Certificato SL. No. WBO2AR3091
Registration No.
08/Jul/2021
Date of Registration Juno-2021
Month & Yoar of
Manufacturing
Valid Mobile Number
**3004
BHARAT STAGE VI
Emission Norms
Fuel PETROL
PUC Code WB0010265
GSTIN
Fees Rs.100.00
(GST to be paid extra as applicable)
MIL observation No

Vehicle Photo with Registration plate

60 mmx 30 mm
WBO2AR3091

Measured
Pollutant (as Units (as Emission limits Value (upto 2
Sr. No. applicable) applicable)
decimal places)
1 2 3 4 5

Carbon Monoxide (CO) percentage (%) 0.3 0.02

Idling Emissions
Hydrocarbon, (THC/HC) ppm 200.0 70.0
CO percentage (%) 0.2 0.02
High idling RPM RPM 2500 200 2474.0
emissions
Lambda 1±0.03 1.02
Light absorption 1/metre
Smoke Density coefficient

This PUC certificate is system generated through the national register of motor vehicles and does
not require any signature.

Note: 1. Vehicle owners to link their mobile numbers to registered vehicle by logging to https:l/[Link].ín

Authorised Signature with stamp of PUC operalor

60rmm x 20 mm

GOTIN: 19AAHFFC724H1Z9
- 1C0.00
PUC
- 9.00
SCST
-
CGST 9.00
Total - 118.00
<br>

oiRECTO

GOVERNMENT OF WEST BENGAL

Registration Authority : PVD KOLKATA
FORM 23
CERTIFICATE OF REGISTRATION

rAL
Registration No :WB02AR3091 Registration Date :08-07-2021
Description of Vehicle
:

MOTOR CAR Purpose For Printing RC

Dealer's NamelAddress : .,
PREMIER CAR WORLD PVTLTD, 57A, PARK STREET, KOLKATA- 700016, -
: :
Owner Name DIPANKAR MARIK Son/wifeldaughter of HEMANTA KUMAR MARIK
Full Address: (Permanent) :P-16 C IT SCHEME-114A, K MCLAKE,, KOLKATA, WEST BENGAL-700045
Full Address: (Temporary) :P-16 CIT SCHEME -114A, K MC,LAKE,, KOLKATA-WEST BENGAL-700045
Fitness UpTo
:

07-07-2036 Tax UpTo 04-Ju-2026

Owner Serial No :1
Detailed Description
Class of Vehicle 7 Link Vehicle No
Ownershlp
:
INDIVIDUAL Norms :BHARAT STAGE VM
Maker's Name :MARUTI SUZUKI INDIA LTD
Front HSRP No :AA2037374550 Rear HSRP No :AA2037374551
Type of Body
:
RIGID (PASSENGER CAR) Month/Year of Manuf. :6/2021
No of Cylinders 4 Chassis No :MA3NFG81SMF316164
Engine No
:

K12MN4729657 Fuel
Horse Power(BHP) :81.74 Cubic Capacity :1197.0
Maker's Classification IGNIS ZETA AGS Wheel base :2435
Seating Cap(in all) :5 Standing Cap
Sleepar Cap Unladen Wt (kgs) :865
Colour PRME, STARGAZE BLUE Laden/GV Wt (kgs) :1280
Other Criteria :0 Service Type false
AC Fitted Y Vehicle Purchase As :Fully Built

Additional Particulars of all transport vehicles other than motor cabs 1280
By Manuf. :MARUTI SUZUKI INDIA LTD As Regd. :ABC
Description Weight(in kgs)
a) Front:
b) Rear:
c) Other:
) Tandem:
The motor vehicle above described is subject to Hypothecation in favour of : STATE BANK OF INDIA, MIDDLETON ROW BRANCH,,, Kolkata, West Bengal
700016, HT
Purchase Date :05-Ju-2021 Sale Amt :661820
OTT Date Amount/Rcpt No :, WB1D210700000557
:

TaxUpTo :04-Ju-2026 Vehicle is Govt/ Pvt. PRIVATE

Tax Exempted or Not :Not Exempted Date of Approval :2021-07-08 18:28:25.543405
Other State/Transfer/Conversion Details
Previous Owner Previous Registration Number
Old State Entry Date
Transfer Date Conversion Date
This certificate is valid from 08-07-2021 to 07-07-2036

Date:07-Sep-2021 11:33:53
Taxation Particulars I Advance Registration Mark Fee Details

DISCLAIMER-This print-out is only the Registration Certificate related information from [Link] portal. This is not the
original Registration [Link] applicant must collect the original Registration Certificate from issuing office.

Scanned wItn camscanne

<br>

MARUTISUZUKE
INSURANCE BROKING
Dedicated
Customer
This policy is sOurced and serviced by: Support
Maruti Suzuki Insurance Broking Private Limited-
1, Nelson Mandela Road, Vasant Kunj, New Delhi 110 07O 3377011/022/033/044
prefix
4477)
This is not a part of the policy document. Please Detach Here

HDFC ERGO General Insurance ompany Limited :

Regn.
IRDAI No. 146
POLIC
Y

CERTIFICATE CU M SCHED ULE

ORIGNAL FOR RECIPIENTIDUPLICATE FORSUPPLIER

TAX INVOICECERTIACATE CUM POLICY SCHEDULE
Policy Type Stand-alone CPAPolicyfor Owner-Driver Proposal No, & Date C02973167 / 24-May-2023
Policy No. & Type 3317205443698900000 Period of Insurance |03:35:01:PM05-Jul-2023 to midnight on 04-Jul-2024
Policy Issued On 24-May-2023 (00:00)
MR MR DPANKAR MARIK Geographical Area INDIA
Insured Name
Invoice No 2054436989000 Accounting Code of Serice 997134
P-16,C.I.T SCHEME-114A KMC, LAKE..
Insured Address
KOLKATA700045, West Bengal

|Insured State & Code West Bengal-19 Place of Supply West Bengal GSTIN of Customer |GSTUNREGISTERED

Schedule OfPremium (AOunt in Rs)

Stand-alone Compulsory PAcover premium to Owner-Driver(1 Year) 325
Add on Cover (if any)
Net Premium 325
CGST @9%
29
SGST @9% 29
Gross Premium Paid 383

INote:

1. Policy Issuance is the subject to the realisation of cheque.

2. Consolidate stanp duty paid to State Exchequer

3. UIN: IRDANI25RPO010V01201819

Nominee Details Nominee Name KAKOLI MARIK JAge 47 Relation Wife

Payme nt Detail Payment Method Che que No./Trans action No. Bank Name |Amount
Cheque 572294 STATE BANK OF INDIA 383

Benefit Details:
)i00% of CSI for Death, Loss Two Linbs or sight ofboth eyes or one linb and sight of one cye.
of

is% ofCSI for LOSs of one Limb or sight of one eye.

ii)100% for Penanent Total Disablement from injuries other than named above.
imitations as to use:- The Policy covers use thevehicle for any purpose other than: a) Hire or Reward, b) Carriage
of of
goods (other than sanples or personal lugage), c) Organized racing d) Pace making e) Speed testing f) Reliability Trials,
g) Any pupose in connection with Motor Trade.

Driver: 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 aperson satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
- III (CSI) Rs. 1500000
imits of Liability: :Cover for Owner Driver under section
IMPORTANT NOTICE: The nsured is not indennified if thevehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by the Conpany by reason of wider terns appearing in the Certificate in order to conply
with the Motor Vhicle Act, 1988 is recoverable from the Insured. See the clause headed "AVOIDANCE OF CERTAIN TERMSAND RIGHT OF RECOVERY". For Legal interpretation, Engish version will hold good.
For information on ombucs man you may visit website : Thttps/[Link] Onbudsman

For HDFC
ERGO General
Insurance
Company
Limited
We hereby declare that though our aggregate tumover in any preceding financial year from 2017-18 onwards is more than the aggregate tumover notified under sub-rule (4) of
rule 48, we are not required to prepare an invoice in tems of the proisions of the said sub-rule.

Authorized
Signatory

Policy Issuing Ofice:-HDFC House, 1st Floor, 165-166, Backbay Recdamation, HT. Parekh. [Link], Mumbaj -400 020
GSTIN:, CIN No.:U66030MH2007PLC177117
State Name:

This Policy is sourced & erviced by : Maruti Suzuki insurance Broking Private Limited, Direct Broker (General) IRDAI License No.: 428 (Valid Til: O1-02-2o24)
Contact 3377 4477 (prefix o11/022 /033 /044), [Link] Visit : [Link]
For Policy Terms and Conditions Log on tO [Link], [Link]-Gom
<br>

MARUTI SUZUKI
INSURANCE BROKING
Dedicated
Customer
This policy is sourced and serviced by: Support
Maruti Suzuki Insurance Broking Private Limited
1, Nelson Mandela Road, Vasant Kunj, New Delhi - 110 07O 3377 4477/
veThis is not a part of the policy document. Please Detach Here. prefix 011/022/033/044

HDFC ERGO General Insurance Company Limited :

IRDA Regn. No. 146
CERTIF ICATE CUM POLICY SCHED ULE

ORIGINAL FOR RECIPIENT/DUPLICATE FOR SUPPLIER

TAX INVOICEICERTIACATE CUM POLICY SCHEDULE
(FORM51 OF THE CENTRAL MOTORVEHICIES RULES, 1989)
Stand-alone OD Policy( Private Vehice Proposal No. & Date
)

Policy Type SR13778775/24-Mayy2023

Policy No. & Type 2302205444109600000 Period of Insurance 05-Jul-2023 to 04-Jul-2024
Policy Issued On 24-May-2023 (00:00) Vehicle ldentification No. MA3NFG81SMF316164
Insured Name Mr Mr Dipankar Marik |Geographical Area NDIA
Invoice No 2054441096000 |Accounting Code of Service 997134
P-16,C.I.T SCHEME -114A KMC, LAKE
Insured Address
KOLKATA700045, VWest Bengal
West Bengal-19 Place Supply
of
West Bengal lGSTINof Qustomer
Insured State & Code GSTUNREGISTERED
INSURED MOTOR VEHICLEDETAILS INSURED DECLARED VALUE (DV) (in Rs.)
Make Maruti Vehice 463274
Model &
Variant JIGNIS BSMZETA1.2L PETROLAMTMARUTI IGNIS ZETA 1.2LAGS INon Elecrical Accessories
Registration No WB02AR3091 Electrical Accessories 0
Year of Vanufacture |2021 CNG LPGKit 0
Engine- Chassis No K12MN4729657 - MA3NFG81SMF316164 Total |DV 463274
Cubic Capacity |1197
Seating Capacity 5
Type Of Body Saloon
RTOLOcation WB02AR3091 /KOLKATA
Schedule OfPremiun (Amount in Rs.)
OWN DAMAGESECTION (A) Pre-Existing Third Party Policv Details.
Vehicde 6083 Insurance Company Name Go Diait General Insurance Ltd.
Flec Accessories Policy No. DO39565610
Non- Elec. Accessories Risk Inception Date 05-Jul-2021
|Kit (IMT-25) Rsk Bxpiry Date 04-Jul-2024
ExdraPremium towards Inbuilt CNGLPG NA
Basic Premium 6083
MISP- PREMER CARWORLD PVTLTD, BARASAT
Geographical Area Esn. (IMT-1) NA
Lamp, Tyres etc. (IMT 23)
Driving Tuition Loading On OD Premium (60%) NA Notes :( For Standalone OD Policy)
Fiber Glass Tank 1. Policy lssuance is the subject to the realisation of cheque.
Sub-Total Additions 0 2. Consolidate stamp duty paid to State Echequer
Deductibles 3. The Policy is subject to a compulsory Deducible of Rs 1000 (IMT -22)
Voluntary Deductibles (IMT 22A) 0 4. Voluntary excess Rs (0)
Anti-Theft Device (IMT-10) 5. Subject toEndorsements IMT,7 10,
152
6. As per your decdaration to opt out of Compulsory PACover due to no valid Driing Licence with the
AA Membership (IMT-8) ,
Owner-Driver /Atemate PAStand-alone CPApolicy with minimum Sum Insured of 15 Lakhs the PA
|No Claim Bonus 0 CcOver will not be applicable under this policy
Discount for vehicdes designed for handicapped NA 7. The Coverage under this policy is only for Own Damage and no other liability in connection with
Sub- Total Deductibles 152 the vehicle
Add-On Coverages 8. I/We hereby certify that the policy to which the certificate relates as well as the certificate of insurance
are issued in accordance with the provision of chapter X X of M VA 1988." The stamp duty of Rs
ZERO DEPRECIATION 3243
0.50 paid by Demand Draft, vide Receipt/Challan no. NO.LONCSDI47712022/4252 (Validity Period Dt.
Engine & Gear Box Protector 927 29/09/2022 to Dt.31/12/2023) DATE- 29/SEPI2022 as prescribed in Government of Maharashtra
Return To Invoice 1158 Order No. Mudrank 2017/CR.97/M1, dated the 09th January 2018"
Road Side Assistance 60 9. This policy proides the benefit of Roadside Assistance In case of emergency please contact on
-
below number.
Cost Of Consumable Item 695
Net own Damage Premium (A) 12004 Contact No: - 02262346234
|CGST@9% 1080.36
sGST@9% 1080.36
Total OD Premium 14165
Nominee Details :
Nominee Name KAKOLI MARIK Age 47 Relation Wife
Payme nt Method Che que No./Trans action No. Bank Name Amount
Payment Detail
Cheque 572294 STATE BANK OF INDIA 14548
Financier Type Financed Financier Name STATE BANK OF INDIA Financier Branch KOLKATA

Limitations as to use:- The Policy covers use of the vehide for any purp0se other than: a) Hire or Reward, b) Cariage of goods (other than samples or personal luggage), c) Organized racng, d) Pace making, e) Speed
testing, f) Reliability Trials, g) Any purpose in connection with Motor Trade.
Driver: Any person incduding the insured, Provided that a person driing holds an effecive driving license at the time of the accident and is not disqualified from holding or obtaining such a license; Proided also that the
person holding an effecive learner's license may also drive the vehice and that such a person satisfies the requirements of Rule 3 of the Central Mbtor Vehicles Rules, 1989.
Deductibles: Deductible under secion-l : Rs 1000(Compulsory Deductible Rs 1000 Imposed Deducible Rs.0 and Voluntary Deductible Rs 0)
No Claim Bonus: The insured is entitled for a No Claim Bonus (NCB) on the Own Damage section thepolicy if no daim is made or pending during the preceding year (s), as per the following: The preceding year/20%,
of

Preceding Two consecutive years/25%, Preceding Three consecutive years/35%, Preoceding Four consecutive years/45%, Preceding Five consecutive years/50%. No Claim Bonus will only be allowed proided the policy
is renewed within 90 days of the expiry date of the prevous policy
IMPORTANT NOTICE The Insured is not indemnified if the vehicde is used or driven otherwise than in accordance with this Schedule. Any payment made bythe Company by reason of wider terms appearing in the
Certificate in order to complywith the Mbtor Vehice Act, 1988 is recoverable from the Insured. See the dause headed "AVOIDANCE OF CERTAIN TERMSAND RIGHT OF RECOVERY". For Legal interpretation, English
version will hold good.
For information on ombuds man you may visit website : [Link]
UWe hereby certify that the Policy towhich this Certificate relates as well as this Certificate of Insurance are issued in accordance with the proisions of Chapter Xand Chapter of [Link], 1988.
For HDFC ERGO General Insurance Company Limited

We hereby declare that though our aggregate tumover in any preceding financial year from 2017-18 onwards is more than the
aggregate tumover notified under sub-rule (4) of rule 48, we are not required to prepare an inoice in tems of the provsions of the
said sub-rule.
Authorized Signatory
Policy Issuing Office:-1st Aoor, Part of
Right Wing., Shakespeare Sarani, Kolkata (Formerty HDFC General Insurance Limited from September 14. 2016 and L&T General Insurance Company Limited up to September 13.
2016)
GSTIN: 19AABCL5045N125, CIN No.:U66030MH20077PLC17717
State Name: West Bengal
This Policy is sourced & serviced by Maruti Suzuki Insurance Broking Private Limited, Direct Broker (General) IRDAI License No.: 428 (Valid Till: 01-02-2024)
Contact : 3377 4477 (prefix 011 / 022 / 033 / 044), support@[Link] Visit : [Link]
For Policy Terms and Conditions Log on to [Link], [Link]
:
 Commonly used Add-on Covers

ZERO DEPRECIATION CLAIM - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer not withstanding
anything to the contrary, it is hereby understood & agreed that for the purpose of this policy, in the event of partial loss, the depreciation applicable under section 1 ofthis
policy would stand deleted.

Product Name - Zero Depreciation Claim - Private Car

-
UIN No IRDAN125A0021V01201415

Product Name - Zero Depreciation Claim - (PCV and GCV)

UIN No - IRDAN125A0005V01200910

ENGINE GEAR BOX PROTECTOR - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer, it is hereby
&

understood & agreed that for the purpose of this policy, the Company hereby extends the Policy to cover the consequential damage to the internal child parts of the engine
and/or gear box ofthe Insured Vehicle, arising out of
1. Wateringression,
i. Leakage of lubricatingoilAnd/or damageto engine and/orgearboxofthe Insured Vehicle arisingoutofleakage of lubricating oil duetoAccidental means.

Product Name -
Engine and Gear box Protector - Private car
UIN No -
IRDAN125A0004vo1201213

Product Name- Engine and Gear box Protector-Only for PCV Taxi segment
-
UIN NO IRDAN125A0004 Vo1201213

COST OF CONSUMABLE - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer, not withstanding anything to
the contrary contained in the Policy, the Company hereby extends the Policy to cover expenses incurred by the Insured towards Consumable Items, in the event of
damage to the Insured Vehicle and/orto its accessories (if Insured), arising out of any peril as covered under Section 1 of the Policy.
Such Consumable Items may but not limited to include nut, bolt, screw, washers, grease, coolants, lubricants, engine & other oils, clips, acgas, bearings, battery water,
filters, sealants, gaskets.

Name Private car

UIN NO N125A0003M0420424

Product Name - Cost of Consumable Items - Only for PCV Taxi segment
UIN No -IRDAN125A0003V01201213

RETURN TO INVOICE - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer not withstanding anything to the
contrary, it is hereby understood & agreed that for the purpose of this policy, in the event of Total Loss (TL) or a Constructive Total Loss (CTL), the Insurer will pay the
Insured, the difference between the 'claim amount receivable' under the motor package policy and the 'value of vehicle' as per the first sale invoice of new vehicle
along with the first time registration charges and road tax which was incurred on the Insured vehicle.
Subjectotherwise to the terms, exceptions, conditions and limitations of this Policy. Exclusions: This covers

excludes the following

A Incase oftheftstolenvehicle is recovered within 90 days oftheft.

B Finalinvestigation reportin case oftheft claim is not issued by police authorities.
-
Product
IM Name Return to Inv
1RDAN125A0013V01201213

Offering only in Private cars and not in commercial vehicles

EMERGENCY ASSISTANCE WIDER - Lost/Stolen Keys: In case the keys of the insured vehicle are lost or misplaced orstolen we shall arrange for a alternate key set
ubmission of police report.

Product Name - Emergency Assistance Wider ( Pvt car & PCV Taxi/GcV)
UIN No -
IRDAN125A0016V01201314

- This covers for instant/ spot assistance in the event of vehicle breakdown such as tyre puncture/ jump start / fuel delivery
Emergency
and toe Assistance"
towing to the nearest w
Workshon In order to o avail any
ny of the
.
above services, you may contact on the below mentioned details:

Toll Free: - 02262346234

*Applicable only for private car( Package Policy) Vehicle up to 15 years of age
Note: Above is a summary of policy add-on product and not the exact wordings. To view product wordings, please visit: [Link]
 MARUTI SUZUKI
INSURANCE BROKING Dedicated
Customer
This policy is sourced and serviced by: Support
Maruti Suzuki Insurance Broking Private Limited
1, Nelson Mandela Road, Vasant Kunj, New Delhi - 110 070 3377 4477,
prefix 011/022/033/044
This is not a part of the policy document. Please Detach Here.
INSURAN

Original Certificate of Insurance must be carried in your Car

Carry the Original certificate of insurance with the vehicle at all times this is -
mandatory and is an evidence of compliance with Motor Vehicle Act 1988.
Want to change anything in your policy ?
change Get in touch with Maruti Suzuki Insurance Broking at their dedicated customer support - DIAL
3377 4477 (prefix 011/o22 /o33/044) to update your contact details, address, any change
in the vehicle ownership, CNG/LPG fitment status, accessories addition/deletion etc.

? Dedicated
Is your policy falling due for Renewal Customer
Support
Just Call Maruti Suzuki Insurance Broking at 3377 4477 (prefix 011 /022 /033 /044)
and they willdo the rest to deliver your policy at your doorstep. 3377 4477,
pretix 011/022/033/044

What to do if your car meets with an accident ?

Simply inform Maruti Suzuki Insurance Broking at 3377 4477(prefix 01 1 /022 / 033 / 044)
or visit the nearest Maruti Suzuki Dealer. They will assist you with your claim
intimation and will also help you with other formalities. In case you intend to
make a claim on your policy, please ensure that the claim is intimated within
24 hours of accident or on the next working day.
What should you do if there is a third party injury/ death and/or third party property damage ?
Lodge an FIR with the nearest Police station and obtain a copy. Provide
a photocopy of your insurance policy to the affected third party. It is
not necessary to compensate the affected third party on the spot. Inform
Maruti Suzuki Insurance Broking at 3377 4477 (prefix 011 /022 / 033 / 044) for further assistance.
Theft...?
Lodge an FIR at the nearest Police Station and obtain a copy of the FIR. Inform Maruti Suzuki Insurance
Broking at 3377 4477 (prefix 011 /022 / 033 / 044). Maruti Suzuki Insurance Broking will guide you for
proper filing of your claim towards a quick settlement.

Total Loss Claim...?

As a convention, it is called a Total Loss when the damages are so severe that claim assessment (Survey) indicates
that the vehicle is beyond repairs OR it shows that the Insurance Co.'s liability is more than 75% of vehicle's
Insured Declared Value. Just inform Maruti Suzuki Insurance Broking at 3377 4477 (prefix 011 /092 / 033 / 044) and
you will be guided for a quick claim settlement.

Avoid driving through water logged areas

!

It can cause damage to your vehicle both internally and externally. Please do not try to start your car
in case your vehicle stops by getting submerged in flood or while crossing a water logged area. This can
cause severe damage to the engine which is called Consequential Loss and is not covered in your policy.
MUST TO KNOW
This Policy does not cover damage due to consequential loss, Wear & Tear, Mechanical/Electrical Breakdown, Driving
under the influence of Contractual Liability, Driving without valid driving licence, Usage outside
specified geographical area, Nuclear
uclear or War perils. It does not cover Damage to tyres (unless vehicle is also damaged).
A Compulsory deductible based on Vehicle CC as per India Motor Tariff will apply at the time of every claim.
Depreciation on parts as per India Motor tariff will apply at the time of every claim unless opted for zero depreciation
COver.

In case of Zero Depreciation Policy, the benefits of Zero Depreciation would be applicable for specific number of claims
as per the Insurance Company's Terms & Conditions.
AC Gas is fully payable. AIlOils/ Brake Lining/ Glass Sealants/ Oil Air Filters are paid @ 50%. Coolant / Fastener are
not payable.
Visit Maruti Suzuki Insurance Broking at [Link]
Be Responsible, Be Safe : Your Safety is our Concern

Don't Mix Drinking and Driving Always keep your Follow Traffic Signals Pedestrians have Please use Child Seats, Always Wear your
vehicle in good condition first priority on Roads when Children are seated Safety Belts
in front of Airbags
 Indian Union Driving Licence (WR
Issued by GOVERNMENT OF WEST BENGAL

WBO1 20131 001273

Issue Date Validity(NT) Validity (TR)' 11-09-2013

11-09-2013 02-09-2028

Holder's Signature Issue

9
Name: DIPANKAR MARIK
First
N
Date of Birth: 03-09-1968 Blood Group: U Organ Donor:
Son/ Daughter/Wife of: HKMARIK of
Date
Address:
P-16CITSCHEME-114 LAKE GARDENS KOLKATA 700045

DLWB0240945
DL No: WBO1 2013100273
Invalid Carriages (Regn. Numbers)"
Hazardous Validity HilIValidity

Class of Date of Cate

NumlberYSate
2013
LMY NI

Emergency Contact Number LiCensikg Authority

P.V.D, KOLKATA
Customer Copy
Printed On: 09-Jul-2021 10:25:53

GOVERNMENT OF WEST BENGAL

State Transport Department
PVD KOLKATA,West Bengal

RECEIPTIAPPL No: WB1D210700000557WB21070532832516

Vehicle Class: Motor Car
Received From: DIPANKAR MARIK
Receipt Date: 06-Jul-2021
Chassis No: MA3NFG81SMF316164
Vehicle No: WB02AR3091
08-Jul-2021 Sale Amount: 661820/
Regn Date:
Bank Ref No: 6123367698823
Transaction ld: 0732107068870555
Remarks: ONLINE-PAYMENT
Amount Fine/Penalty/[Link] Total
Particular 600
600
New Registration 1500
1500
Hypothecation Addition 100
100
Showroom Inspeclion Fee 20
20
Service/User Charge 20
20
Transaction Fee 36401
36401
ONLY)
MV Tax(05-Jul-2021 to 04-Ju-2026) HUNDRED AND FORTY ONE
(in Rs): 38641/- (THIRTY EIGHT THOUSAND SIX
GRAND TOTAL (https:/[Link]).
slip., no need of signature
Note-- This is computer generated RAKESH SHARMA
PREMIER CAR WORLD PVTLTD

1/1

Scanned witn CamScanne

 MARUTISUZUKE
INSURANCE BROKING
Dedicated
Customer
This policy is sourced and serviced by: Support
Maruti Suzuki Insurance Broking Private Limited
1, Nelson Mandela Road, Vasant Kunj, New Delhi - 110 07O 3377 4477/
prefix 011/02
This is not a part of the policy document. Please Detach Here. 2/033/044

ERGO HDFC ERGO General Insurance Company Limited :

IRDAI Regn. No. 146
CERTIFICATE CUM POLICY SCHED ULE

ORIGNAL FOR RECIPIENT/DUPLICATE FOR SUPPER

TAX INVOICECERTIACATE CUM POLICYSCHEDULE
(FORM51 OF THECENTRALMOTORVEHICLES RULES, 1989)
Policy Type Package Policy Private Vehice
)

Proposal No. & Date R195371053 /02-Jul-2024

Policy No. & Type 2302206590115100000 Period of lnsurance |05-Jul-2024 to 04-Jul-2025
Policy Issued On |02-Jul-2024 (00:00) Vehicle ldentification No. MA3NFG81SMF316164
Insured Name Mr Dipankar Marik Geographical Area |INDIA
Invoice No 2065901151000 Accounting Code of Service |997134
P-16.C..TSCHEME-114A Lake Gardens,
Insured Address
KOLKATA700045, West Bengal
West Bengal-19 Place of Supply West Bengal
Insured State & Code GSTIN of Customer |GSTUNREGISTERED

INSURED MOTOR VEHICLE DETALS INSURED DECLARED VALUE (IDV (in Rs.)
Make Maruti Vehicde 397092
Model &
Variant IGNIS BS-VZETA1.2L PETROL AMTIMARUTI IGNIS ZETA1.2LAGS INon Electrical Accessories
Registration No WB02AR3091 Electrical Accessories 0
Year of anufacture 20% CNGLPGKit 0
- MA3NFG81SMF316164
Engine- Chassis No 4729657 Total |DV 397092
Cubic Capacity 1197
Seating Capacity 5
Type Of Body Saloon
RTOLOcation WB02AR3091/KOLKATA
Sehedule OfPremnium (Amount in Rs,)
OWN DAMAGESECTION (A) UABIUTY SECTION (B)
ehicle 6191 BasicThird Party Liability 3416
Elec. Accessories 0 Third Party Liabilityfor Bi-fuel Kit
INon- Elec. Acoessories |Compulsory PACover Premium to Owner-Driver (1 Year) 325
Kit (IMT-25) PACover for O Person of Rs (0) each (lIMI- 16)
0
Legal Liability (WC) to Driver (IMT-28) 50
Edra Premium towards Inbuilt CNGLPG NA
Geographical Area Extn. (IMT-1) NA
Basic Premium 6191 Legal Liability to Employees (IMT-29)
Geographical Area Etn. (IMT-1) NA Legal Liatbilityto Passenger (IMT 46) 0
Lamp, Tyres etc. (IMT 23) Driving Tuition Loading On TP Premium (60%) NA

|Driving Tuition Loading On OD Premium (60%) NA Net Liability Premium (B) 3791
Total Premium (A+B) 1910
Fiber Glass Tank 0
CGST @9% 1341.90
Sub-Total Additions
sGST @9% 1341.90
Deductibles
Gross Premium Paid 17594
bluntary Deductibles (IMT 22A) 0
Anti-Theft Device (IMT-10) MISP -PREMER CARWORLD PVTLTD, KOLKATA
155
AA Membership (IMT-8)
No Claim Bonus 0 Notes:
Discount for vehicdes designed for handicapped NA
1. Policy lssuance is the subject to the realisation of cheque.
Sub-Total Deductibles 155 2. Consolidate stamp duty paid to State Exchequer
Add-On Coverages 3. The Policy is subject to a compulsory Deductible of Rs 1000 (IMT-22)
4. Vbluntary excess Rs (0)
ZERODEPRECIATION 3574 5. Subject to Endorsements IMT,7 10, 28,
Engine & Gear Box Protector 794 6. UIN: IRDAN125RPO001V02201415
Retum To Invoice 7. I/We hereby certify that the policyto which the certificate relates as well as the certificate of insurance
are issued in accordance with the proision of chapter X X of M VAct 1988." The stamp duty of Rs
lCost Of Consumable ltem 715 0.50 paid by Demand Draft, vide ReceiptChallan no. NO. LOAENF-1/CSDI34/2023/ (Validity Period
Net own Damage Premium (A) 11119 Dt. 28/12/2023 to Dt. 31/12/2026) /6045 DATE- 27/Dec2023 as prescribed in Government of
Maharashtra Order No. Mudrank 2017/CR.97/M1, dated the 09th January 2018"

Nomine e Details : KAKOLI MARIK

Nominee Name Age 47 Relation Wife

Pavment Method Cheque No./Trans action No. Bank Name Amount

Payme nt Detail
Electronic Payment 113357036188 ELECTRONIC PAYMENT 17594
Financie r Type Financed Financier Name STATE BANK OF INDIA Financier Branch KOLKATA

Limitations as to use:- The Policy covers use of the vehicde 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.
Driver:Any person induding the insured, Provided that a person driing holds an effective driing license at the time of the accident and is not disqualified from holding or obtaining such a license; Proided also that the
person holding an effecive learner's license may also drive the vehicle and that such a person satisfies the regquirements of Rule 3 of the Central Motor Vehicdes Rules, 1989.
Limits ofLiability: Under Section I-1 (0) of the policy-Death of or bodily injury- Such amount as is necessary to meet there requirements of the Motor Vehicles Act, 1988. Under Secion I| -1(i) of the Policy- Damage to
Third Paty Property- Rs.7.5 lakhs - (as per IMT 20)in respect of any onedaim or series of daims arising out of one event Cover for Owner- Driver under secion I (CSI) Rs 1500000 - Deductible under section-l: Rs
1000(Compulsory Deductible Rs 1000 Imposed Deductible Rs. 0 and Vbluntary Deductible Rs 0)
No Claim Bonus: : The insured is entitled for a No Claim Bonus (NCB) on the Own Damage secion of the policy if no daim is made or pending during the preceding year (s), as per the following: The preceding
year/20%, Preceding Two consecutive years/25%, Preceding Three consecutive years/35%, Preceding Four consecutive years/45%, Preceding Five consecutive years/50%. No Claim Bonus will only be allowed proided
the policyis renewed within 90 days of the expiry date of the previous policy
IMPORTANT NOTICE The Insured is not indemnified if the vehicde is used or driven otherwise than in acoordance with this Schedule. Any payment made by the Company by reason of wider terns appearing in the
Certificate in order to complywith the Mbtor Vehicle Act, 1988 is recoverable from the Insured. See the dlause headed "AVOIDANCE OF CERTAN TERMSAND RIGHT OF RECOVERY". For Legal interpretation, English
version will hold good.
For information on ombucs man you may visit website : htps://[Link]/Ombudsman
We hereby certify that the Policy to which this Certificate relates as well as this Cetificate of Insurance are issued in acoordance with the provisions of Chapter Xand Chapter X of MV. Act, 1988.
For HDFC ERGO General Insurance Company Limited

We hereby declare that though our aggregate tumover in any preceding financial year from 2017-18 onwards is more than the
aggregate tumover 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-ule.

Authorized Signatory
Policy Issuing Office:-1st Floor, Part of Right Wng, Shakespeare Sarani, Kolkata (Formerly HDFC General Insurance Limited from September 14, 2016 and L&T General lnsurance Company Limited up to September 13,
2016)
GSTIN: 19AABCL5045N1Z5, CIN No.:U66030MH2007PLC177117
State Name:West Bengal
This Policy is sourced & serviced by Maruti Suzuki Insurance Broking Private Limited, Direct Broker (General) IRDAILicense No.: 428 (Valid Till: 01-02-2027)
Contact:3377 4477 (prefix 011 /022 / 033 / 044), support@[Link] Visit : [Link]

For Policy Terms and Conditions Log on to :[Link], [Link]

 Commonly used Add-on Covers

ZERO DEPRECIATION CLAIM - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer not withstanding
anythingto the contrary, it is hereby understood & agreed that for the purpose of this policy, in the event of partial loss, the depreciation applicable under section 1 ofthis
policywould stand deleted.

Product Name - Zero Depreciation Claim Private Car

-
UIN No IRDAN125A0021VO1201415

Product Name - Zero Depreciation Claim - (PCV and GCV)

- .
UIN No IRDAN125A0005V01200910

ENGINE GEAR BOX PROTECTOR - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer, it is hereby
&

understood & agreed that for the purpose of this policy, the Company hereby extends the Policy to cover the consequential damage to the internal child parts of the engine
and/or gear box ofthe Insured Vehicle, arising out of
1. Wateringression,
ii Leakage of lubricatingoilAnd/or damageto engine and/orgearboxofthe Insured Vehicle arisingoutofleakage of lubricating oil duetoAccidental means.

Product Name - Engine

and Gear box Protector - Private car
UIN No -
IRDAN125A0004VO1201213

Product Name- Engine and Gear box Protector- Only for PCV Taxi segment
-
UIN No IRDAN125A0004 Vo1201213

COST OF CONSUMABLE - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer,, not withstanding anything to
the contrary contained in the Policy, the Company hereby extends the Policy to cover expenses incurred by the Insured towards Consumable Items, in the event of
damage to the Insured Vehicle and/orto its accessories (if Insured), arising out of any peril as covered under Section 1 of the Policy.
Such Consumable Items may but not limited to include nut, bolt, screw, washers, grease, coolants, lubricants, engine & other oils, clips, acgas, bearings, battery water,
filters, sealants, gaskets.

Name Private car

UIN NO 125A000204e
Product Name - Cost of Cons
onsumable Items Only for PCV Taxi segment
UIN No -IRDAN125A0003V01201213

RETURN TO INVOICE - In consideration of the payment of additional premium paid by the Insured and realized by the Insurer not withstanding anything to the
contrary, it is hereby understood & agreed that for the purpose of this policy, in the event of Total Loss (TL) or a Constructive Total Loss (CTL), the Insurer will pay the
Insured, the difference between the 'claim amount receivable' under the motor package policy and the 'value of vehicle' as per the first sale invoice of new vehicle
along with the first time registration charges and road tax which was incurred on the Insured vehicle.
Subjectotherwise to the terms, exceptions, conditions and limitations of this Policy. Exclusions: This covers

excludes the following

A Incase oftheftstolenvehicle is recovered within 90days oftheft.

B Finalinvestigation reportincase oftheft claim is not issued by police authorities.
Product
IM Name -Return
- to Inv
IRDAN125A0013v01201213

Offering only in Private cars and not in commercial vehicles

EMERGENCY ASSISTANCE WIDER - Lost/Stolen Keys: In case the keys of the insured vehicle are lostor misplaced orstolen we shall arrange for a alternate key set
submission of police report.

Product Name- Emergency Assistance Wider ( Pvt car & PcV Taxi/GcV)
UIN No -
IRDAN125A0016vo1201314

- This covers for instant/ spot assistance in the event of vehicle breakdown such as tyre puncture/ jump start / fuel delivery
Emergency
and tee to theAssistance*
towing nearest workshop. In orden o avail anyny
of the above services, you may contact on the below mentioned details:

-
Toll Free: 02262346234
*Applicable only for private car( Package Policy) Vehicle up to 15 years of age
Note: Above is a summary of policy add-on product and not the exact wordings. To view product wordings, please visit: [Link]
 MARUTI SUZUKI
INSURANCE BROKING Dedicated
Customer
This policy is sourced and serviced by: Support
Maruti Suzuki Insurance Broking Private Limited
1, Nelson Mandela Road, Vasant Kunj, New Delhi - 110 070 3377 4477,
prefix 011/022/033/044
This is not a part of the policy document. Please Detach Here.
MsuRAN
Original Certificate of Insurance must be carried in your Car
Carry the Original certificate of insurance with the vehicle at all times - this is
mandatory and is an evidence of compliance with Motor Vehicle Act 1988.
Want to change anything in your policy ?
change Get in touch with Maruti Suzuki Insurance Broking at their dedicated customer support - DIAL
3377 4477 (prefix 011/o22 /o33/044) to update your contact details, address, any change
in the vehicle ownership, CNG/LPG fitment status, accessories addition/deletion etc.

? Dedicated
Is your policy falling due for Renewal Customer
Support
Just Call Maruti Suzuki Insurance Broking at 3377 4477 (prefix 011 /022 /033 /044)
and they will do the rest to deliver your policy at your doorstep. 3377011/022/033/044
4477/
pretfiz

What to do if your car meets with an accident ?

Simply inform Maruti Suzuki Insurance Broking at 3377 4477 (prefix 01 1 /022 / 033 / 044)
or visit the nearest Maruti Suzuki Dealer. They will assist you with your claim
intimation and will also help you with other formalities. In case you intend to
make a claim on your policy, please ensure that the claim is intimated within
94 hours of accident or on the next working day.
What should you do if there is a third party injury/ death and/or third party property damage ?
Lodge an FIR with the nearest Police station and obtain a copy. Provide
a photocopy of your insurance policy to the affected third party. It is
not necessary to compensate the affected third party on the spot. Inform
Maruti Suzuki Insurance Broking at 3377 4477 (prefix 011 /022 / 033 / 044) for further assistance.
Theft...?
Lodge an FIR at the nearest Police Station and obtain a copy of the FIR. Inform Maruti Suzuki Insurance
Broking at 3377 4477 (prefix 011 /022 /033 / 044). Maruti Suzuki Insurance Broking will guide you for
proper filing of your claim towards quick settlement.
a

Total Loss Claim...?

Asa convention, it is called a Total Loss when the damages are so severe that claim assessment (Survey) indicates
that the vehicle is beyond repairs OR it shows that the Insurance Co.'s liability is more than 75% of vehicle's
Insured Declared Value. Just inform Maruti Suzuki Insurance Broking at 3377 4477 (prefix 011 /022 / 033 / 044) and
you will be guided for a quick claim settlement.
Avoid driving through water logged areas !
It can cause damage to your vehicle both internally and externally. Please do not try to start your car
in case your vehicle stops by getting submerged in flood or while crossing a water logged area. This can
cause severe damage to the engine which is called Consequential Loss and is not covered in your policy.
MUST TO KNOW
This Policy does not cover damage due to consequential loss, Wear & Tear, Mechanical/Electrical Breakdown, Driving
under the influence of liquor or dr or Contractual Liability,cover
Driving without valid driving licence, Usage outside
specified geographical area, Nuclear War perils. It does not Damage to tyres (unless vehicle is also damaged).
A Compulsory deductible based on Vehicle CC as per India Motor Tariff will apply at the time of every claim.
Depreciation on parts as per India Motor tariff will apply at the time of every claim unless opted for zero depreciation
COver.

In case of Zero Depreciation Policy, the benefits of Zero Depreciation would be applicable for specific number of claims
as per the Insurance Company's Terms & Conditions.
AC Gas is fully payable. AIlOils/ Brake Lining/ Glass Sealants/ Oil Air Filters are paid @ 50%. Coolant / Fastener are
not payable.

Visit Maruti Suzuki Insurance Broking at [Link]

Be Responsible, Be Safe : Your Safety is our Concern

Don't Mix Drinking and Driving Always keep your Follow Traffic Signals Pedestrians have Please use Child Seats. Always Wear your
vehicle in good condition first priority on Roads when Children are seated Safety Belts
in front of Airbags