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CERTIFICATE OF INSURANCE
(MOTORCYCLE / SCOOTER)
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Customer Id :978233630 Policy Number :01110131130260000845
Insured Name :Mr. ARUN SINGH Certificate Number :
Occupation :ARMY Policy Start Date & Time :24/07/13 00:00:00 (hours)
Phone/Mobile/Fax :25451357 7795349796 Policy Expiry Date :23/07/14 midnight
E-mail :ALOK.KUMAR0127@GMAIL.COM Geographical Area : INDIA (B)
Insured Address : Policy Issuing Office
Address
:
HOUSE NO 15 SANDHU NIWAS SUBHANPALYA
CHIKKABANASWADI MAIN ROAD
City : BANGLORE District : BANGALORE
State : Karnataka Pincode : 560033
DO 11 CHENNAI, OFFICE TYPE:DO,BUILDING
NAME:SUDARSAN BUILDING,DOOR NO:OLD NO.14,NEW
NO.27,FLOOR NO: 2,ROAD NAME:WHITES
ROAD,LOCALITY/AREA:ROYAPETTAH
City : CHENNAI District : CHENNAI
State : Tamil Nadu Pincode : 600014
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Business Channel Code:
.
Mobile No:
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60
.
support.onlinepolicies@uiic.co.in
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Business Channel Sub Code:
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Agent Name :
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99999
.
Direct
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VEHICLE DETAILS
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Registreation No:
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Registering Authority & Place
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Registration Date
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KA-03-HH-3499
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East, Indiranagar Bangalore, Karnataka
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22/07/2010
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Engine Number
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Chassis Number
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Vehicle Make & Model
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JC44E0794079
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ME4JC446GA8348002
.
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Year of Manufacture
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Cubic Capacity
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Type of Body
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Vehicle Color
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2010
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109
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Solo With Pillion
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.
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Seating Capacity (Including Sidecar)
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Geographical Extension
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2 In All (Persons)
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No Extension
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PREMIUM
Premium -Rs.472.00 Service Tax @ 12.36% - Rs. 58.00 Total Payable - Rs. 530.00 Stamp Duty - Rs. 1.00
Service Tax Registration Number:AAACU5552CST001
Receipt Number:01110181138000004047 Receipt Date: 23/07/2013 Receipt Amount:- Rs.530.00 Payment Mode: Credit Card
NOTE: Warranted that in case of dishonor of the premium cheque, this document stands cancelled automatically ab-initio.
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LIMITATIONS AS TO USE
The policy covers use of vehicle 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.
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DRIVER:
Any person including 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 a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
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LIMITS OF LIABILITY:
Under Section II-1(i) of the policy Death of or bodily injury Such amount as is necessary to meet the
requirement of the Motor Vehicles Act,1988
Under Section II-1(ii) of the policy Damage to Third Party Property Rs.0
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Policy Subject to IMT Endorsements
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Applicable Add-on covers / Services
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I / We hereby certify that the policy to which the certificate relates as well as this certificate of insurance are issued in accordance
with the provisions of Chapter X and Chapter XI of MV Act, 1988.
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For United India Insurance Company Limited
Print Date: 24/07/2013 00:19:17 hours
DULY CONSTITUTED ATTORNEY(S):
Digitally signed by K
SUBASHINI
Date: 2013.07.24 00:26:31
GMT+05:30
Signature Not Verified

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