MAGMA HOUSE, 24 Park Street, Kolkata - 700016 (WWW - Magma-Hdi - Co.in)

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MAGMA HOUSE, 24 Park Street , Kolkata -700016

(www.magma-hdi.co.in)
Date : 02/08/2013
To,
SAFIQ AHMAD
MAIN MARKETSINGRAULI
486889,
SIDHI,
MADHYA PRADESH.
Agent/ Intermediary Name and Code:LANDMARK INSURANCE BROKERS PVT LTD BRC0000011
Dear Mr. SAFIQ AHMAD

(Customer ID: 20000143248)
We extend our warm welcome to you as an esteemed customer of Magma HDI General Insurance Co Ltd.
At the outset, we wish to thank you for choosing Magma HDI as your preferred insurer and subscribing to MHDI Motor Policy.
Your policy No is P0014200013/4101/178588.
We hope that this is beginning of a long term relationship, because we aim to provide services of highest quality constantly to
our customers so that we continue to be the preferred insurance provider year on year.
In case of any queries, please call us on 1-800 - 3002 - 3202 or write to us at [email protected] and we shall
get back to you at the earliest.
Assuring you of our best services at all times.
Best Regards
For Magma HDI General Insurance Co Ltd.
Authorised Signatory
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MAGMA HOUSE, 24 PARK STREET , KOLKATA -700016
PRIVATE CAR PACKAGE POLICY

CERTIFICATE OF INSURANCE CUM 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.
Policy Servicing Office MAGMA FINCORP LTD T-5, III FLOOR, CITY CENTER ABOVE VISHAL MEGA MART ZONE I, M.P. NAGAR, BHOPAL (M.P.) 462011 BHOPAL- 462011
BHOPAL - 462011 MADHYA PRADESH
PH: FAX:
Policy No P0014200013/4101/178588 Period Of Insurance From 00:00 Hrs of 02/08/2013
Geographical Area India To Midnight of 01/08/2014
Insured SAFIQ AHMAD Agent No BRC0000011
Address MAIN MARKET SINGRAULI
486889 SIDHI MADHYA PRADESH Covernote No
Business / Profession None Covernote Date
Contact Number 9826040739 PG/IR No. Zone Zone-B
Carrying on or engaged in the business or occupation of and no other for the purposes of this Insurance
INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION
Year of Licensed Carrying capacity
Registration Mark & No. Engine No. Chassis No. Make/Model/Type of Body CC/HP/GVW
Manufacture including Driver
MAHINDRA & MAHINDRA/BOLERO
UP 64 P 8786 2011 73305 85351 DI 2WD 7STR BS3 2498 6
REFRESH/SALOON
IDV (INSURED'S DECLARED VALUE)
Non Electrical Accessories Electrical/electronic
IDV of Vehicle Trailers Bi-Fuel kit(LPG/CNG) Other accessories Total Value
Accessories
343800 0 0 0 0/0 0 343,800.00
A-OWN DAMAGE B-LIABILITY
Own Damage Premium on vehicle and accessories Third Party Premium
Basic Cover Basic Cover
Basic - OD 9,194.58 Basic - TP 3,424.00
DISCOUNTS UNDER OWN DAMAGE SECTION PA Benefits
No claim bonus 25% 2,111.15 PA Owner Driver 100.00
Voluntary Excess Discount 750.00 Personal Accident Cover-Unnamed 150.00
TOTAL OWN-DAMAGE PREMIUM 6,333.00 Legal Liability
LL to Paid Driver IMT 28 50.00
TOTAL LIABILITY PREMIUM 3,724.00
TOTAL POLICY PREMIUM 10,057.00
Service Tax(Including education cess & higher education cess) 1,243.05
TOTAL 11,300.00
Hire Purchase/ Lease /Hypothecated with MAHINDRA AND MAHINDRA FINANCIAL SERVICES LTD.
LIMITATIONS AS TO USE - The Policy covers use of the 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)Use in connection with Motor Trade
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).
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
Driver
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
Clause :
Vehicles Rules, 1989.
LIMITS OF LIABILITY
Under Excess in respect of each and every Under In respect of any Under Damage to Third Party Property Rs. Under PA Owner – Driver as per
Section I claim under Sec I of motor policy Section II- one accident -- As Section II-I 750000/- in respect of any one claim Section premium computation table
Compulsory : Rs. 2000/- Voluntary : I (i) per Motor Vehicle (ii) or series of claims arising out of one III:
Rs. 2500/- Total : Rs. 4,500.00/- Act event.
Subject to I.M.T Endorsement Nos. IMT 7,IMT 16,IMT 22,IMT 28
NOMINATION DETAILS
Name Of the Nominee Date of Birth of Nominee Age of Nominee Relationship With Insured Percentage
AHMAD ALI 10/06/1955 58 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.
For Magma HDI General Insurance Co. Ltd.
In case of Claims, please contact us at 1-800 - 3002 - 3202
Date of Issue : 02/08/2013

Place : Kolkata
Consolidated Stamps Duty on the issue of General Insurance Policies paid vide G.O. No 1598- F.T. dated
27/9/2012 Authorised Signatory
Service Tax Registration no : AAGCM1685CSD001
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.
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RECEIPT
Receipt Number PIS/200013/14/100081409

Receipt Date 02/08/2013
Business Channel
Received with thanks from SAFIQ AHMAD
(Customer ID : 20000143248 a total sum of Rupees Eleven Thousand Three Hundred Only
Instrument Type Instrument No. Date Bank Name Branch Name Amount
CASH N.A. N.A. N.A. N.A. 11,300.00
Total Amount Rs. 11,300.00
Note:
* The insurance cover for the risk shall be as per the terms and conditions of the Insurance Policy as detailed in Policy Document.
* Receipt is Subject to realisation of cheque(s)
For & on behalf of
Magma HDI General Insurance Company Ltd.
Authorised Signatory

MAGMA HOUSE, 24 Park Street, Kolkata - 700016 (WWW - Magma-Hdi - Co.in)

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MAGMA HOUSE, 24 Park Street , Kolkata -700016

Dear Mr. SAFIQ AHMAD

Assuring you of our best services at all times.

For Magma HDI General Insurance Co Ltd.

MAGMA HOUSE, 24 PARK STREET , KOLKATA -700016

PRIVATE CAR PACKAGE POLICY

Date of Issue : 02/08/2013

Receipt Number PIS/200013/14/100081409

Received with thanks from SAFIQ AHMAD

Total Amount Rs. 11,300.00

* Receipt is Subject to realisation of cheque(s)

For & on behalf of

Magma HDI General Insurance Company Ltd.

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