S. J. Institute of Pharmacy Fire-22-23

Ref.
No: W127419689
Date: Jan 17, 2022
S. J. INSTITUTE OF PHARMACY C/O SARDAR VALLABH BHAI

PATEL SHIKSHAN SANSTHAN
GHATUKHEDA, RAMAIPUR
.
KANPUR
UTTAR PRADESH
209214
Risk Assumption Letter

Dear Sir/Madam,
SYSESB001056126251
Thank you for choosing ICICI Lombard as your preferred General Insurance service provider. We
understand that you have different choices available, and appreciate the fact that you have
placed your trust in us.
Please find attached herewith Policy No. 1016/237195328/00/000 which has been issued based
on the details furnished to us on Jan 17, 2022.
Please go through the details as furnished in the format and also as provided in the policy
document to ensure that they are in order. If you feel that there are any discrepancies/variations,
please write to us immediately for the necessary changes/rectification. In the absence of any
communication from you in this regard within a period of 15 days of receipt of this letter, we would
understand that you have accepted the contents and the coverage to be in accordance with your
proposal.
Thank you once again and look forward to a lasting relationship.
Yours sincerely
ICICI Lombard General Insurance Company Ltd
ICICI Lombard General Insurance Company Limited

ICICI BHARAT SOOKSHMA UDYAM
IRDA Reg. No. 115 CIN: L67200MH2000PLC129408 UIN : IRDAN115RP0006V01202021
SURAKSHA
Mailing Address: Registered Office Address Toll free no : 1800 2666
601 & 602, 6th Floor, Interface 16 ICICI Lombard House,414, Veer Savarkar Alternate no : 86552 22666 (chargeable)
New Linking Road, Malad (West) Marg,Near Siddhi Vinayak Temple, E-mail : [email protected]
Mumbai - 400 064 Prabhadevi, Mumbai 400 025 Website : www.icicilombard.com
ICICI BHARAT SOOKSHMA UDYAM SURAKSHA
SCHEDULE
Insured Details
Policy Number 1016/237195328/00/000

Issued At MUMBAI
Name of the Insured S. J. INSTITUTE OF PHARMACY C/O SARDAR VALLABH BHAI PATEL SHIKSHAN
SANSTHAN
Mailing Address of the GHATUKHEDA, RAMAIPUR, ., KANPUR, UTTAR PRADESH - 209214
Insured
Intermediary Details
Agency/Broker Code 201593216650

Agency/Broker Name P V KRISHNAN
Agent's/Broker's Mobile No. 9936420088
Agent's/Broker's Email ID [email protected]
Policy Details
Period of Insurance From : 00:00 Hours of 17/01/2022 To : 23:59 Hours of 16/01/2023

Hypothecation Details As per annexure I
Details of Property Insured As per Annexure II
Details of Sum Insured
Interest covered: Sum Insured

Basic Cover (`): 20000000
Premium computation
Premium excluding Terrorism (`) : 4000

Terrorism Premium (`) : 3000
Net Premium (`) : 7000
SGST : 630
CGST : 630
Total Amount : 8260
Clauses / Conditions / Warranties
Subject to Clause(s) / Endorsement(s) as attached herewith

1 Designation of Property Clause
2 Earthquake (Fire and Shock)
3 Reinstatement Value Policies
4 Terrorism Clause
5 Local Authorities Clause
Subject to Conditions as mentioned below:
1 No cover for storage or manufacturing of any kind of single use plastics or like, under the scope of this policy.
2 The Policy shall be void-able in the event of mis-representation, mis-description or non - disclosure of any material particular
3 Warranted that the claims experience is nil for last 3 years
4 <BR/>
Subject to Warranties as mentioned below

1 "1. Warranted that incurred claims ratio for the preceding 36 months including the expiring policy period is nil 2. Warranted that Kutcha Construction &
Basement are not covered under the policy 3.It is the condition in the policy that pressurized fire extinguishers in working condition are installed in the risk
premises. "
2 Warranted any contents in basement are excluded from the scope of cover
3 Warranted that construction type is RCC
Please scan QR Code or click https://www.ilgi.co/0A85C706D0 for Policy Wordings.

SURAKSHA
GSTIN No. : 27AAACI7904G1ZN
Place of Business : 414, ICICI Lombard House Veer Sawarkar Marg Mumbai-Prabhadevi Maharashtra 400025
Category : General Insurance Business Services 9971.
The stamp duty of ` 0.5 paid in cash or by demand draft or by pay order, vide Reciept / Challan No. CSD232202184 dated Jan 06, 2022.
Subject otherwise to terms and conditions of ICICI BHARAT SOOKSHMA UDYAM SURAKSHA Policy.
Signed for and on behalf of the ICICI Lombard General Insurance Company Limited, at Mumbai on Jan 17, 2022.
ICICI Lombard General Insurance Company Ltd.

SURAKSHA
Annexure – I
yes
HYPOTHECATION DETAILS
Attached to and forming a part of Policy No. : 1016/237195328/00/000
Sr. No. Name of the Bank Type of charge

1 NA NA
no
Annexure – II
DETAILS OF PROPERTY INSURED
Attached to and forming a part of Policy No. : 1016/237195328/00/000
Location of Risk 1 : GHATUKHEDA, RAMAIPUR------209214----UTTAR PRADESH--KANPUR

Occupancy 1 : Schools / Colleges
Sections Sum Insured
Building (With Plinth and Foundation) 20000000

SURAKSHA

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S. J. INSTITUTE OF PHARMACY C/O SARDAR VALLABH BHAI

Risk Assumption Letter

ICICI Lombard General Insurance Company Ltd

ICICI Lombard General Insurance Company Limited

Policy Number 1016/237195328/00/000

Agency/Broker Code 201593216650

Period of Insurance From : 00:00 Hours of 17/01/2022 To : 23:59 Hours of 16/01/2023

Details of Sum Insured

Interest covered: Sum Insured

Premium excluding Terrorism (`) : 4000

Clauses / Conditions / Warranties

Subject to Clause(s) / Endorsement(s) as attached herewith

Subject to Warranties as mentioned below

Please scan QR Code or click https://www.ilgi.co/0A85C706D0 for Policy Wordings.

ICICI Lombard General Insurance Company Limited

ICICI Lombard General Insurance Company Ltd.

ICICI Lombard General Insurance Company Limited

Attached to and forming a part of Policy No. : 1016/237195328/00/000

Sr. No. Name of the Bank Type of charge

DETAILS OF PROPERTY INSURED

Attached to and forming a part of Policy No. : 1016/237195328/00/000

Location of Risk 1 : GHATUKHEDA, RAMAIPUR------209214----UTTAR PRADESH--KANPUR

ICICI Lombard General Insurance Company Limited

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