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P400 Policy # :72227001Insured's Name :

Period of Insurance From: 27/01/2012 00:00:00

To : Midnight on 26/01/2013 00:00:00

Geographical Area : Within India Only

Pin Code 600001

Address:Date of Issuance :

Agent No. 91777777Phone # (988) 409-6406

Regd. Office: IFFCO Sadan C1 Distt. Centre, Saket, New Delhi - 110017

Issuing Office:

Cover Note # :

TWO WHEELER POLICY CERTIFICATE OF INSURANCE CUM SCHEDULE

IFFCO-TOKIO GENERAL INSURANCE CO. LTD

22/01/2012

N. S U R E N D A R

IFFCO TOKIO GEN INSUR CO LTD. 28 (OLD NO.195)NORTH USMAN ROAD T NAGAR

CHENNAI

TAMILNADU 600017

INDIA

044 - 42178881/ 82/ 83Phone #

20, PALAYAPPAN ST, SEVEN WELLS,

CHENNAI-600001CHENNAI

INDIA

TAMILNADU

Policy # : 1-8VL01W

RegistrationMark & No.

Year ofManuf.

Type of Body

Make of Vehicle

CC IDV in Rs.Engine No.

Chassis No.

SeatingCapacity

TN02AQ1785 2010

-

TVS APACHE

OH1G42096120

DHVEJL38040160

249,000.00

Insured Motor Vehicle Details & Premium Calculation

Coverage

Package

Two Wheeler Side Car Accessories Elec./Elect. Acc. Bi-Fuel Kit Total Value Net Premium Rs.

49,000.00 0.00 0.00 0.00 0.00

B. Third Party (Rs.)A. Own Damage (Rs.)

Bonus Percent 25.00% 216.00

Bonus Percent (Deductions) 216.00

Add :

Rallies (IMT 31)

Foreign Vehicle Loading (IMT 19)

Geographical Area Extension (IMT 1)

PA Cover for Owner-Driver of Rs 100000

Add :

Legal Liability to Driver (IMT 28)

Legal Liability to Employee (IMT 29)

PA to Passenger (IMT 16)

Rallies (IMT 31)

Geographical Area Extension (IMT 1)

Less :

Third Party Property Damage (IMT 20)

Limit of Liability Under Section II-I (ii)

Any Other Loading/Discount

Net (A)

Any Other Loading Discount

Net (B)

Co-Insurance Details

49,000.00 1097.00

Less :

Voluntary Excess Less 0% (IMT 22A)

Anti Theft Device (IMT 10)

Automobile Association (IMT 8)

Handicap Discount (IMT 12)

Vehicle Use (IMT 13)No Claim Discount

Service Tax (Inc Edu.cess and Higher Edu.cess) 113.00

Rs. 1210.00

Rs. 1097.00

Registration Authority :

Basic Own Damage 863.00 Basic Third Party Liability 330.00

50.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.000.00

0.00

0.00

0.00

0.00-144.15

132.14 450.00

-44.05 0.00

Co-Insurer 1

Co-Insurer 2

Co-Insurer 3

Co-Insurer 4

Agent No./Share

No Co-Insurer!

No Co-Insurer! Net Premium 1097.00

No Co-Insurer!

No Co-Insurer!

Total Own Damage Premium 647.00

Unnamed PA Cover of Rs 100000 70.00

Total 863.00

100,000.00

( 45% )

( -25% )

Premium Paid Rs.

Total Premium (A + B)

Under Hire Purchase /Hypothecated/Lease Aggreement with NA

Subject to IMT Endorsement Nos.

Limitation as to use :

Use only for social domestic and pleasure purpose and for the insured's business orprofession. The policy does not cover use for hire or reward, tution, racing, pace-making,reliability trails, speed testing, carriage of goods(other than samples or personal

luggage) in connection with any trade or business or use for any purpose in connectionwith Motors Trade.

Any person including insured: provided that the person driving holds and effective drivinglicense at the time of the accident and is not disqualified from holding or obtaining such alicense. 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 The CentralMotor Vehicles Rules, 1989.

Driver Clause :

No Claim Bonus : The insured is entitled for a No Claim Bonus (NCB) on the own damage section of the policy, if no claim is made or pending during the preceding year(s) as per thefollowing table:s

Period of Insurance Percentage of NCB on OD Premium

The preceding year 20 %

Preceding two consecutive year 25%

Preceding three consecutive year 35%

Preceding four consecutive year 45%

Preceding five consecutive year 50%

No claim bonus will only be allowed, provided the policy is renewed within 90 days of the expiry date of the previous policy

Limit of Liability

Under Section II-I(i) Such amount as is necessary to meet the requirements of theMotor Vehicles Act, 1988

Under Section II-I(ii) As per premium computation table

Under Sect ion I II PA Owner- Driver as per premium computat ion table

Compulsory Excess (IMT 22) Rs. 50

Printed herein/attached hereto

Imposed Excess Partial Loss

Imposed Excess Total Loss

0.00

0.00

Receipt Particulars S.Tax.No. D-III/ST/R-IV/GEN.INS./01/03

Cash / Cheque No : Dated : 22/01/2012

Premium :

Bank Details : ONLINE 008001

For IFFCO-TOKIO General Insurance Co. Ltd.

Authorised Signatory

1210.00

FOR CLAIMS CALL 1800 103 5499(Toll Free),0124-4285499 or SMS"CLAIM" to 56161

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