Date: 24/08/2022

ARV ENGG.CO.LLP
6200558545 00 00
1101 LE PAPEYON CHS From 24/08/2022 to Midnight Of
MOUNT MARY ROAD BANDRA WEST 23/08/2023
MUMBAI - 400050
MAHARASHTRA From 24/08/2022 to Midnight Of
INDIA 23/08/2025
65256

Dear ARV ENGG.CO.LLP,

Welcome to Tata AIG General Insurance Company Limited's family & we thank you
for choosing our Bundled Auto Secure - Private Car Policy (1 Year Term for Own
Damage & 3 years for Third Party) for your vehicle insurance.
We are enclosing Policy schedule cum certificate of insurance of your vehicle. You
are requested to visit our website www.tataaig.com for policy wording.
We would like to inform you that policy has been issued based on the information
and declaration provided by you. No Claim Bonus (NCB) if shown on your policy
schedule has been allowed as you had not reported any claim in the previous
policy.
Kindly go through the enclosed information/declaration provided by you and in
case your policy shows No Claim Bonus, for which you are not entitled as
explained above or any other error/discrepancy then we request you to get in
touch with us within 15 days of receipt of the policy for correction otherwise all
particulars will be deemed to be correct.
You may reach us at our 24*7 helpline 1800 266 7780 for providing any information
or in case you desire to have a printed copy of policy wording.
We, thank you once again, for choosing Tata AIG General Insurance Company
Limited for insuring your vehicle. We assure you of our best of services at all
times. Happy driving!

Sincerely ,

TATA AIG General Insurance Company Limited,

Regd. Office: 15th floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg,Off Senapati Bapat Marg, Lower Parel, Mumbai- 400 013.
IRDAI Regn. No.108, CIN No.: U85110MH2000PLC128425, PAN: AABCT3518Q, UIN No.: IRDAN108RP0006V02201819
Website : www.tataaig.com 24X7 Tollfree Helpline 1800-266-7780 E-mail: customersupport@tataaig.com
Agent Name : DEEPALI KAUR GAVENDRA SINGH TANK
Agent License Code: AIG2318L Agent Contact No.: 9820118559 (mobile or landline)
6200558545 00 00
6200558545 00 00 Bundled Auto Secure - Private Car Policy (1 Year Term for Own Damage & 3 years for
Third Party)
00/00/3184/00

ARV ENGG.CO.LLP 16:52 24/08/2022

1101 LE PAPEYON CHS 23/08/2023
MOUNT MARY ROAD BANDRA WEST 16:52 24/08/2022
MUMBAI - 400050 23/08/2025
MAHARASHTRA
INDIA

N/A
MAHARASHTRA
27

N/A
MUMBAI A India,
N/A

TOYOTA / INNOVA
NEW CRYSTA / 2.4 GX AT 2GDA674284 MBJJB8EMX016281570822 2022 2393 NA 7
7 STR / MUV

1 2,055,800 0 0 0 0 0 2,055,800

Basic OD Premium 14,143.90 Basic TP premium 24,596.00

14,143.90
PA cover to unnamed passengers (IMT 16)
1,050.00
Add: Depreciation Reimbursement (TA 01) 6,167.40 No. of passengers: 7
CSI per passenger: 100,000.00
Add: Return to Invoice (TA 05) 2,466.96 PA cover to paid driver (IMT 17)
Add: Loss of personal belongings (TA 09) 110.00 No. of persons: 1 75.00
Sum Insured: 10000 SI for paid driver: 50,000.00
Add: Emergency transport and hotel expenses (TA 10)
Any One Accident : 5000 110.00
Add: Legal liability to paid driver (IMT 28) 150.00
Any One Year : 10000 Number of persons: 1
Add: Key Replacement (TA 15) 265.00 25,871.00
Sum Insured: 25000 per occurrence limit 50% of SI
55,302.00
Add: Engine Secure (TA 16) 2,055.80 NET PREMIUM (A+B+C)
4977.00
Add: Tyre Secure (TA 17) 3,083.70 SGST/UGST @ 9%
CGST @ 9% 4977.00
Add: Consumable expenses (TA 18) 1,027.90
Add : Repair of Glass, Rubber & Plastic Parts (TA08) 0.00
136.88
15,286.76

Persons or classes of persons entitled to drive: 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 a person satisfies the requirements of Rule 3 of the Central Motor Vehicles Rules, 1989.
The Policy covers use of the vehicle for any purpose other than : a) Hire or Reward other than for the purpose of driving tuitions 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

Number of claims covered under

Such amount as is Depreciation Reimbursement
necessary to meet the Cover: 2
Basis of claim settlement for Tyre
requirements of the 7,50,000 N/A
Secure cover : REPLACEMENT
Motor Vehicles Act,
BASIS
1988.

TATA AIG General Insurance Company Limited,

Regd. Office: 15th floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg,Off Senapati Bapat Marg, Lower Parel, Mumbai- 400 013.
IRDAI Regn. No.108, CIN No.: U85110MH2000PLC128425, PAN: AABCT3518Q, UIN No.: IRDAN108RP0006V02201819
Website : www.tataaig.com 24X7 Tollfree Helpline 1800-266-7780 E-mail: customersupport@tataaig.com
 IRDAN108RP0006V02201819/A0033V01201819 (TA 08),
IRDAN108RP0006V02201819/A0029V01201819 (TA 01),
Compulsory Deductible : 2,000
IRDAN108RP0006V02201819/A0031V02201819 (TA 05),
Voluntary Deductible: 0
IRDAN108RP0006V02201819/A0034V01201819 (TA 09),
Imposed Excess: 0 .00 IRDAN108RP0006V02201819/A0035V01201819 (TA 10),
Franchisee: 0.00
IRDAN108RP0006V02201819/A0036V01201819 (TA 15),
5% of claim amount in case of repair and 10% of claim amount in
IRDAN108RP0006V02201819/A0038V01201819 (TA 16),
case of replacement
IRDAN108RP0006V02201819/A0039V01201819 (TA 17),
IRDAN108RP0006V02201819/A0040V01201819 (TA 18),
IRDAN108RP0006V02201819/A0041V01201819 (TA 19)
16,17,28,32,22
B) TATA AIG Auto Secure Endorsement Number (TA): 08,01,05,09,10,15,16,17,18,19

age

N/A N/A N/A N/A N/A

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.
In witness whereof this Policy has been signed at Mumbai on 24/08/2022

Consolidated Stamp Duty has been paid to the State Exchequer

27AABCT3518Q1ZW - MAHARASHTRA
99713434 Authorized Signatory

GHATKOPAR, GHATKOPAR, OFFICE NO. 508A & 509, 5TH FLOOR, GHATKOPAR 400077, Tel NO:9029010575
Warranted that the insured named herein/owner of the vehicle holds a valid Pollution Under Control (PUC) Certificate, as applicable, on the date of commencement of the
Policy and undertakes to renew and maintain a valid and effective PUC, as applicable, during the subsistence of the Policy. Further, the company reserves the right to take
appropriate action in case of any discrepancy in the PUC

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 Vehicles Act, 1988 is recoverable from the Insured. See the clause headed 'AVOIDANCE OF CERTAIN TERMS
AND RIGHT OF RECOVERY'.
:You are advised to go through the policy schedule cum certificate of insurance which is issued based on information and declaration provided by you. Transcript of
Information & Declaration is also provided herewith to enable you to go through the same again and if any error/ discrepancy is found in respect of vehicle details, No Claim
Bonus or any other information provided by you, it should be brought to our notice within 15 days of receipt of this policy for necessary correction along with the supporting
documents, otherwise it will be deemed to be correct. You may visit the company website at www.tataaig.com for detailed benefits, terms & conditions and exclusions of the
policy issued and held by you. You may also reach us at our 24*7 helpline 1800 266 7780 in case you desire to have a printed copy of policy wording. Our grievance redressal
procedure and details about ombudsman are available at the company website www.tataaig.com. You may also reach us at our 24*7 helpline 1800 266 7780 for grievance
redressal procedure and details about ombudsman. Please note that any misrepresentation, nondisclosure or withholding of material facts will lead to cancellation of policy ab
initio with forfeiture of premium and non consideration of claim, if any. We will specifically seek confirmation on No Claim Bonus availed by you from your previous insurer. In
case we receive confirmation that you had lodged claim with them then we will intimate you to pay the No claim Bonus Amount within 20 days. In case we don’t receive the
No Claim Bonus recovery then it will be adjusted against claim amount payable to you if any. This Schedule, Policy terms and conditions available on the company website
and Endorsements mentioned herein above shall read together and word or expression to which a specific meaning has been attached to/in any part of this Policy or of the
Schedule shall bear the same meaning wherever it may appear. Any amendments/modifications/alterations made on this system generated policy document is not valid and
the Company shall not be liable for any liability whatsoever arising from such changes unless written request is made to the Company and the Company accepts the
requested amendments/modifications/alterations and records the same through separate endorsement.

TATA AIG General Insurance Company Limited,

Regd. Office: 15th floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg,Off Senapati Bapat Marg, Lower Parel, Mumbai- 400 013.
IRDAI Regn. No.108, CIN No.: U85110MH2000PLC128425, PAN: AABCT3518Q, UIN No.: IRDAN108RP0006V02201819
Website : www.tataaig.com 24X7 Tollfree Helpline 1800-266-7780 E-mail: customersupport@tataaig.com
1. Name (Registered Owner of the Motor Vehicle): ARV ENGG.CO.LLP

2. Address for Communication : 1101 LE PAPEYON CHS MOUNT MARY ROAD

BANDRA WEST MUMBAI 400050
MUMBAI - 400050
MUMBAI MAHARASHTRA INDIA

3. Vehicle Details: TOYOTA / INNOVA CRYSTA / 2.4 GX AT 7 STR / MUV

4. Fuel Type: DIESEL

5. Insured’s declared value : 2,055,800

6. Previous Insurance Particulars:

Policy Number: N/A
Date of Expiry: N/A
Type of Cover : N/A
Name of the Insurer: N/A
Claim in the previous policy period: N/A
NCB in previous policy: N/A
NCB claimed: N/A

7. Own Damage period of insurance desired from: 24/08/2022 to midnight of 23/08/2023

8. Liability period of insurance desired from: 24/08/2022 to midnight of 23/08/2025

9. Compulsory PA cover for owner driver period of insurance desired : N/A

10. Financier’s Details: N/A

11. Extra Benefits opted

Unnamed Persons Personal Accident Cover for seating capacity, including driver CSI: 700000
Wider Legal Liability to Paid Driver (As per Workmen’s Compensation Act, Fatal Accident Act & Common Law) :N/A
Compulsory PA Cover for Owner Driver: N/A Term: N/A
Name of the Nominee & Age: N/A & N/A Relationship: N/A
Name of Appointee (if Nominee is Minor): N/A Relationship to the Nominee: N/A

12. Restriction of Cover/Discounts/Concessions/Extended Covers

Automobile association membership opted: No
Third Party Property Damage Cover restricted to 6,000/ only: No
Is Voluntary Deductible opted : No Amount of Deductible opted : N/A
Vehicle is fitted with Anti Theft Device approved by ARAI : No

13. Add on covers: Repair of Glass, Rubber & Plastic Parts,Depreciation Reimbursement,Return to Invoice,Loss of personal
belongings,Emergency transport and hotel expenses,Key Replacement,Engine Secure,Tyre Secure,Consumable expenses,Road Side
Assistance,Additional Third Party Property Damage

14. Declaration for No Claim Bonus: (If NCB Confirmation is not submitted but NCB claimed) I/We declare that the rate of NCB claimed
by me/us is correct and that NO CLAIM has arisen in the expiring Policy Period (Copy of Policy enclosed). I/We further undertake that if
this declaration is found incorrect all benefits under the Policy in respect of Section1 of the Policy will stand forfeited.

15. I hereby give my consent to receive one page insurance policy.

16. AML Guidelines:

1. I/we hereby confirm that all premiums have been/will be paid from bonafide sources and no premiums have been/will be paid out of
proceeds of crime related to any of the offence listed in Prevention of Money Laundering Act, 2002.
2. I understand that the Company has the right to call for documents to establish sources of funds.
3. The insurance company has right to cancel the insurance contract in case I am/have been found guilty by any competent court of law
under any of the statutes, directly or indirectly governing the prevention of money laundering in India.

17. We have issued the policy basis your confirmation that you hold a valid PUC and/or Fitness certificate, as applicable.

TATA AIG General Insurance Company Limited,

Regd. Office: 15th floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg,Off Senapati Bapat Marg, Lower Parel, Mumbai- 400 013.
IRDAI Regn. No.108, CIN No.: U85110MH2000PLC128425, PAN: AABCT3518Q, UIN No.: IRDAN108RP0006V02201819
Website : www.tataaig.com 24X7 Tollfree Helpline 1800-266-7780 E-mail: customersupport@tataaig.com