Issuing Office Name & Address

JEYPORE BRANCH ,MAIN ROAD, JEYPORE, KORAPUT, ODISHA, PIN : 764 001
Tel: Fax: 06854 232773
GSTIN No: 21AAACN9967E2ZE

National Insurance Company Ltd.

Registered & Head Office: 3, MIDDLETON STREET, POST BOX NO. 9229, KOLKATA - 700 071
CERTIFICATE OF INSURANCE CUM POLICY SCHEDULE
Form 51 of the Central Motor Vehicle Rules, 1989
Policy No: 1632052487521463245202 PCV 1 YEAR LIABILITY Only from 13:39 Hrs of 25/01/2024 to Midnight of 24/01/2025

Insured Details
Name : BRIDGE AND ROOF INDIA .CO LTD
Address : NALCO TOWNSHIP, DAMANJODI, KORAPUT, ODISHA ,PIN-763008
Pincode : 763008 Telephone : Email :
PAN No. : GSTIN No. : Aadhar No. :
Channel : FINHAT INSURANCE BROKING PRIVATE LIMITED Mobile : 7387942287 Email :

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Aadhar : PAN : xxxxxx936k Code. : 360401/91070100000001

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Vehicle Details

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Make & Model TATA MOTORS LTD.

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Reg. No. Engine No. Chassis No. Type of Body CC Mfg. Year Seat Cap. Reg. District

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AP-31TA-2532 19394 33795 CAB 1948 2010 10 -

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Geographical Area : INDIA.

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FastTag ID : 0.
Vehicle IDV Non Elec Access. Elec Access. Bi-fuel kit Trailer Total IDV

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- - - - - -

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OD Premium Breakup in Rs. TP Premium Breakup in Rs.

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Basic OD Premium Basic TP Premium 14760.00

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(+) Electrical Access. Premium - (+) WC for Driver -

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(+) Bi-fuel kit Loading - (+) Legal Liability to Passenger (4 No.) on Yes
(+) Geographical Area Extension - (+) Geographical Area Extension -
(-) Vol. Excess Discount - (+) PA to owner driver -
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(-) Auto. Assoc Discount - (+) PA to unnamed PAX -

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(-) Anti-theft Discount - (-) Discount For Limited TPPD -

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(-) Other Discount - (+) Bi-fuel kit Loading -

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(-) NCB Discount TP Total (Rounded Off) 14760.00

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(+) Nil Depreciation - OD Total (Rounded Off)

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(+) Nil Depreciation Plus - TOTAL PREMIUM 14760.00

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(+) NCB Protect - GST 3240.00

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(+) Engine Protect - NET PAYABLE

(+) Invoice Protect - Collection Number :163202542142124865523 dated 25-Jan-2024
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(+) Consumables Protect - Subject to IMT Endorsement No. 24,25

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(+) Lock-Key Protect - Prem: SI:

(+) Loss of Personal Belongings - Prem: SI:
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OD Total (Rounded Off)

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Excess : Compulsory: Rs. 0 Imposed: Rs. 0 Voluntary: Rs. 0

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Limitation 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
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making (e) Speed Testing and Reliability Trials (f) Use in connection with Motor Trade
Drivers Clause : Any person including Insured Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding or obtaining such a
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licence. Provided also that the person holding an effective Learner's Licence may also drive the vehicle and such a person satisfies the requirements of Rule 3 of Central Motor
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Vehicles Rules, 1989.

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Limits of Liability Clause: Under section 1(i) Such amount as is necessary to meet the requirements of the motor vehicle act 1988.
Under section 1(ii) Damage to third party property is Upto Rs. 7,50,000 .
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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 reasons of wider terms
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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
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RIGHT OF RECOVERY". For legal interpretation, English version will hold good.
UIN : IRDAN058RP0034V01100001
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Financier : SELF OWNED

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Prev Policy : NOT AVIALABLE

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NOTE : Warranted that in case of dishonour of the premium cheque, this document stands automatically cancelled 'AB-INITIO'.
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Policy stamp to be defaced at the respective policy servicing office.

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TP Rate Revision Notice: For all policies having an effective date on or after 1st April 2023, the TP premium is subject to revision as may be notified by the IRDAI.
The Insured should contact and submit the difference of premium to the policy issuing office on issuance of such notification by IRDAI.
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I/We hereby certify that this Certificate cum Schedule of Insurance is issued in accordance with the provisions of chapter X and chapter XI of Motor Vehicles Act,1988.
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Authorised Signatory
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For & On behalf of

National Insurance Company Limited
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