GENERAL RELIANCE Live Smart Follow us in O INSURANCE Welcome RELIANCE Selfi M / S SUDEEP LOGISTICS PVT LTD Download Now | NEAR GANRAJ RIKSHAW STAND PLOT NO 04 SAFALYA BUNGLOW WAIDWADI PROGRESSIVE MODEL CO My Policy Claim Status OPERATIVE SOCIETY HADAPSAR Attach , Access or Register , Track PUNE CITY Download your policy or Submit claim MAHARASHTRA India - 411013 documents 9326 * From here on , Locator ►Video Claim you're our responsibility . Go cashless , Assistance Tap and spot from Intimate claims Welcome on board . amongst 5000 + instantly through Your Reliance Commercial Vehicles ( Passengers network garages . live video streaming . Carrying 4W > 6 & 3W > 17 ) Package Policy - Click here to download Schedule , with Policy Number 170122523400000231 is now live to Customer Information Sheet ( CIS ) access your policy anytime , anywhere download our Reliance Selfi App and enjoy a host of special features . Now Live Smart With Reliance general Insurance . Tech + Best Regards , reliancegeneral.co.in 022 4890 3009 ( Paid ) 74004 22200 ( WhatsApp ) Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Floor , Oberoi Commerz , International Business Park , Oberoi Garden City , Off Western Express Highway , Goregaon ( East ) , Mumbai - 400 063 . Corporate Identity No. U66603MH2000PLC128300 . UIN : IRDAN103RP0012V02100001 .. Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under . License RGI / MCOM / CO / PCV / PS / Ver . 1.3 / 310118 . Page 1 of 13 ---PAGE END--- ny Digitally signed by Reliance reliancegeneral.co.in GENERAL RELIANCE General Insurance INSURANCE Company Limited 022 4890 3009 Date : 2025.01.28 19:24:02 74004 22200 IST Insince Carrying de eneral Policy Vehicmpany e Commercial ( Passengers Schedule - - 6 ° Important > 4W 1 ) The of this certificate of cum policy is subject to realization by the company of premium cheque paid by the elianc 2 ) as provided in GR 27 ( g ) of Erstwhile Indian Motor Tariff ( i.e. Sale of Vehicle ) , No NCB will be allowed when is not renewed within 90 days of Nurance its expiry . Policy Number : 170122523400000231 Proposal / Covernote No : R280125110840 Insured Name : M / S SUDEEP LOGISTICS PVT LTD Period of Insurance : From 19:23 Hrs on 28 - Jan - 2025 to Midnight of 27 - Jan - 2026 Communication Address & Place of Supply : NEAR GANRAJ RIKSHAW Policy Issuing Branch : A Block , Heritage House , Ground floor , 6 Ramabai STAND PLOT NO 04 SAFALYA BUNGLOW WAIDWADI PROGRESSIVE MODEL Ambedkar Road ,, PUNE , MAHARASHTRA , 411001 . CO OPERATIVE SOCIETY HADAPSAR PUNE CITY , PUNE , MAHARASHTRA , India , 411013 . Mobile No : 9326 ** ****** Tax Invoice No. & Date : R280125110840 & 28 Jan 2025 07:23 Email - ID NA GSTIN / UIN & Place of Supply : 27AATCS2867F1ZS and MAHARASHTRA Insured Vehicle Details Registration No. MH12KQ3272 Mfg . Month & Year JAN - 2016 Make / Model & Variant EICHER 10.75 H BUS CC / HP / Watt 3298 Engine No./Chassis No. E413CDGA063881 / MC2A5HRFOGA331953 LCC Including Driver 33 Limite Type of Body NA Total Premium 43406 RTO Location MAHARASHTRA - Pune Total IDV 790,000.00 Manufacturer fully build in Yes Hypothecation / Lease NA Vehicle Category Vehicle Usage Type Contract Carriage Company Vehicle Usage Sub Type School Bus Limited Insured Declared Value ( IDV ) Chassis IDV 0.00 Non Electrical Accessories 0.00 Body IDV 0.00 CNG / LPG Kit 0.00 Vehicle IDV 790,000.00 Trailer / Side Car 0.00 Compe Electrical / Electronic Accessories 0.00 Total IDV 790,000.00 o Premium Summary Own Damage - Section I Amount ( ` ) Liability - Section II Amount ( ` ) Basic OD 709.41 Basic Liability ( TPPD 1 ) 36,032.00 Covers for Lamps Tyres / Tubes Mudguards / Bonet / Side Total Basic Liability Premium 36,032.00 parts etc ( IMT - 23 ) 106.41 PA Benefits - Section III Total Basic Own Damage Premium 815.82 Legal Liability to paid driver and / or Conductor and / or Less cleaner 100.00 Deduct 20 % for NCB -163.16 TOTAL LIABILITY PREMIUM 36,132.00 Sub Total of Deductions -163.16 TOTAL PACKAGE PREMIUM ( Sec I + II + III ) 36,785.00 CGST ( @ 9.00 % ) 3311.00 SGST ( @ 9.00 % ) 3311.00 TOTAL OWN DAMAGE PREMIUM 653.00 TOTAL PREMIUM PAYABLE ( ` ) 43,406.00 GSTIN : 27AABCG IRDAN103 Insu Liede In HSN : 997134 , Description of services : Motor Insurance Service General " As per the GST regulations the amount GST will not be refunded if the policy / endorsement is cancelled after 31st October of the financial year . " , : elianc Consolidated Stamp duty Paid vide of Authorisation " NO LOA / ENF - 1 / CSD / 05 / 2025 / ( Validity Dt . 27/01/2025 to Dt . Date 24-01-2025 " at General Stamp Office , Mumbai . ** Applicable for the State of Jan Coy sujitlolage@gmail.com ***** 907 E VIN 332 me Intermediary Contact No. Intermediary E - mail ID POS UID No./ PAN No. inter elince Customer The Sheet ( CIS ) for this product is available on our website This Limha Inse https://www.reliancegeneral.co.in/insurance/about-us/downloads.aspx Relianc General Relian CO Company surance Lim IRDAN10301 Limited Reliance General Insurance Company Limited . IRDAI Registration No. 103 RGI An ISO 9001 : 2015 Certified Company / . Registered & Corporate ice : Reliance General | Company Limited , 6th Oberoi Commerz , , Limited Oberoi ( City , Off under ) , E66034H2000PLC128360 Western Express Highway Goregaon ( East . No. Insurance Onal Park LappseidankRcation U66603MH2000PLmited & / en Trade Business Corporate Identification UIN : to Anil Ambani Company MCOM pany Ventures Private Limited and used by Reliance General 1310118 License Page 2 of 13 anc ---PAGE END--- jar any GENERAL relio reliancegeneral.co.in RELIANCE Smart INSURANCE General 022 4890 3009 → Insce Limited 74004 22200 eliance rance pany Limits of liability for driver under section III CSI 0 ( a ) Under II ( 1 ) ( i ) of the Policy - Death or bodily injury to any : owner S General person so far as it is necessary to meet the requirements of the Motor Vehicle Act , 1988. ( b ) Under Section II ( 1 ) ii ( ) of the Policy - Damage to property other than property belonging to the insured or held in trust the custody of control of the insured up to the limits specified- ( TPPD 1 Sum Insured 7,50,000 / TPPD 2 Sum 6,000 / ) - - - , elianc . as to use The policy covers the use only under a permit within the meaning of Motor Vehicle 1988 or such a carriage falling under sub - section ( 3 ) of Sec 66 of the Motor Vehicle Act , 1988. The Policy covers use for any purpose other than : ( a ) Rnce Organized racing ( b ) Pace making ( c ) Speed testing ( d ) Reliability trials . ( e ) Use whilst drawing a trailer except the towing ( other than for reward ) of any one disabled mechanically propelled Persons / Classes of : Any person including insured : lee entitled to drive : Provided that a person driving holds a vali driving license at the time the accident and is not disqualified from holding or obtaining such a license Provided that the person holding a ' s license may drive the vehicle when not used . valid for the transport of goods at the time of the accident and that satisfies the 3 of the GenInsurance person of Central Motor Vehicles Rules , 1989 . ch Rule under Section - l : ( i ) Compulsory deductible 1000 / - ( ii ) Additional deductible 00 / - ( iii ) deductible 0 / - ments any / made was & Relland * No Bonus is subject to no on the previous policy . s under the policy stands d if claim is " It is hereby declared and agreed that any damages y losses occurred having been incurred , the commencement of cover under this policy are excluded from scope of this policy . " % of Discount on Own Premium Da Years Period of Insurance % of NCB on OD Premium The Preceding 20 % Preceding Two Consecutive Years 25 % Preceding Three Consecutive Years 35 % Preceding Four Consecutive Years 45 % Vanc Preceding Five Consecutive Years 50 % Compulsory PA cover for owner Insured is not eligible for the Compulsory PA cover for owner effective in this policy as the same not been opted for the reasons allowed as per motor tariff and / or basis insured's declaration given below : personal coas an " we hereby declare w that I / hold t insurance policy death and permanent ( total & partial ) and / or compulsory personal we accident ( CPA ) for owner driver in other vehicles ; whereby the Sum Insured limit is of Rs 1,500,000 or more in all such above mentioned conditions . " In case you have missed it , please opt for of insurance c shall commence from . the date of receipt of such additional premium . " It is hereby declared and agreed that all damages to the vehicle having occured prior to the The mencement of cover from the scope of the are policy policy " wordable.Liability Relianc provided is on Basic OD excluding Add - on with detailed terms , and exclusions are available on er applicable Statutory Provisions : " As per Section 146 of Vehicle Act , 1988 it is to have your against third party risk . ' As per Section 196 of Motor Vehicle Act , 1988 an uninsured vehicle is punishable with fine or Rs . 2000 imprisonment up to 3 for the first offence and fine of 4000 and / or imprisonment up to 3 months for the second offence . " I / We hereby that the Policy to which the certificate relates as well as this certificate of insurance are I in accordance with the of Chapter X and Chapter XI of M.V. Act , 1988 . ce Note : In the event policy document paying premium stands from i irrespective of whether communication is sent or not . by cancelled ally Pianc que your of dishonor Safeguard your I cheque / DD in favour of Reliance General Insurance Co. Ltd. transaction The policy has been issued based on the information provided by you and the policy is not valid if any of the information provided is incorrect . Subject otherwise to the the terms , conditions and exclusions of the Reliance Miscellaneous and Special Types of Vehicles Package Policy Certificate Cum Policy Schedule . In witness whereof this Messw Policy has been signed at Mumbai on policy tax invoice date in lieu of Proposal / Covernote No. as mentioned in the policy . This document shall be treated as a Tax Invoice as Rule 46 of the Central Goods and Services Tax Rules Updating Registration Number of vehicles within 15 days of policy inception is MANDATORY as per IRDA . provide the same to your Agent / Our Call IMPORTing centre / Policy Branch ( Applicable for p booked without Registration No of vehicles ) cies . anc made Relianc NOTICE : The insured indemnified if the vehicle is used or driven otherwise than n accordance with this Schedule Any payment 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 hold good . In case of a renewal , the benefits provided under the policy and / or terms and conditions of the policy including premium rate may be subject to change . As per National Highways of India kindly ensure t to affixed FASTag on your , Rechneral Genethority Limited Insuranan Comp Insurance Relianc General urance Reliance Limited Company * Reliance General Insurance Company Limited . IRDAN10301 IRDAN103R RGI An ISO 9001 : 2015 Certified Company Limited IRDAI Registration No. 103 / Limited . Registered & Corporate ice Reliance General | Company Limited , 6th Oberoi Commerz , Business Oberoi Off : U66603MH2000PL , City , al Mumbai - under East ) , : Western Express Highway Goregaon ( 063 . . Insurance No. mited Park / . General / / U66603MH2000PLC128300 en Identification Trade Company Corporate Corporate Identification No. UIN to Anil Ambani UIN : Cpany MCOM Ventures Private Limited and used by Reliance General 1310118 License Page 3 of 13 anc ---PAGE END--- any Stian GENERAL reliancegeneral.co.in O relio RELIANCE Live Smart INSURANCE General 022 4890 3009 O Insce Limited 74004 22200 ted pany rance Reliance Grievance Clause For resolution of any grievance Insured contact the branch of the Company or may call at 02248903009 or may y or may respective office , write an email at rgicl.services@relianceada.com . In case the insured is not satisfied with the response of the office , insured may contact the Nodal Grievance Officer of the Company at rgicl.grievances@relianceada.com . In the event of unsatisfactory response from the Nodal liane response from the Head Grievance Officer , he / she may , subject to vested jurisdiction , approach the Insurance Ombudsman for the redressal of grievance . Details of the offices of the Insurance Ombudsman are available at IRDAI website www.irda.gov.in or on company website Relianceneral www.reliancegeneral.co.in or on www.gbic.co.in. The insured may the following office the Insurance Ombudsman within whose contact the branch or office of the Company is jurisdiction of the Insurance Ombudsman , 3rd Floor , Jeevan Seva . V. Road , Santacruz Mumbai - 400 054. Tel .: 022 - 26106552 / 26106960 Fax : Email : bimalokpal.mumbai@cioins.co.in 6106052 Note : Kindly w the receipt of this In case you find any variations against your proposal or in the policy , contact us immediately . C Fast Relianc mpany eneral rance The policy does not cover liability death , bodily injury or as excluded under Section 150 ( 2 ) ( ii ) and ( iii ) : b and C of Motor Vehicles Act 1988 ( Inserted There Vide GSR no 164 ( f ) dated 25.02.2022 w . e . f 01.4.2022 ) 622 thin 7days from the date of os . In the unfortunate event of a claim , please call quoting your Policy No. on In the absence of any munication from you within a of 15 days of receipt of this letter , we will consider that issued policy is in order and as per your proposal . suhe Special Conditi ACERemark as ACE of Rs.25000 Additional Compulsory Excess of Rs.5000.0 RGICL_ORB . Lim Policy has been issued with reference to vehicle inspection report , reference lead no . & special conditions . The report remarks can viewed on website by the lead Renditi no . Reng InsLpany's For Reliance General Insurance Co. Ltd. Co. Geneo Reliance Gene Limited Authorised Signatory Reliance General Insurance Company Relianc General Reliance Company Limited Insurance Reliance General Limited Insurance Company Relianc General Reliance Company Limited Insurance Reliance General Insurance Company Limited Relianc General Reliance Limited Insurance Reliance Company General Limited Company Relianc Reliance urance Company * Reliance General Insurance Company Limited . IRDAI Registration No. IRDAN103RP0012 103 General An ISO 9001 : 2015 Certified Company Limited Registered & Corporate Office : Reliance General U66603MH2000 Company Limited , 6th Trade Garden City Off Insurance : al Oberoi Park , Western Express Highway , Goregaon ( East ) , Mumbai - lo 063 . Limited & . Identification Identification No. U66603MH2000PLC128300 No. Corporate Corporate 12V02100001 above belongs to Anil Ambani Business UIN , . 3101 hirub Ventures Private Limited and used by Reliance General Insurance Company Limited under License RGI / MCOM / CO / PCV / PS / Ver 1.3 / . . Page 4 of 13 anc ---PAGE END--- jar any GENERAL relic reliancegeneral.co.in RELIANCE Smart INSURANCE General 022 4890 3009 → Limited 74004 22200 Insce Reliance Risk Assumption Letter General Limited Insurance Company Dear M / S SUDEEP LOGISTICS PVT LTD Insurance . ral Thank you for choosing Reliance General Please fin enclosed policy no .: 170122523400000231 which has been issued based on the details declared by the applicant . Relianc Insured Vehicle Details Registration No. MH12KQ3272 Mfg . Month & Year JAN - 2016 Make / Model & Variant EICHER 10.75 H BUS 3298 ncompany CC / HP / Watt Engine No./Chassis No. E413CDGA063881 5HRFOGA331953 LCC Including 33 Reliant Type of Body NA Total Premium 43406 Limited RTO Location MAHARASHTRA - Pune IDV 790000 Manufacturer fully build in Yes Hypothecation / Lease NAG Insured's Declared Value ( IDV ) Chassis IDV 0.00 Non Electrical Accessories 0.00 Comany Body IDV 0.00 Kit 0.00 Lim 79000 PG Vehicle IDV r / Side Car 0.00 Electrical / Electronic Accessories 0.00 Total IDV 790,000.00 any ted Previous Policy Details Previous Year Policy No. Period of Insurance Previous Policy - Claim Status 4143932000 28/01/2024 To : 27/01/2025 midnight Yes No YOU HAVE G COVERS THE Relianc OPTED Standard Vehicle Own + Third Party FOR Generalerance Compus Cover Electrical / electronic accessories Non - electrical accessories - fuel kits comprising LPG / CNG systems Add - on Covers nei Reliance Nil Depreciat : Cover No for depreciation on vehicle parts other than tyres and tubes with respect of approved partial loss claims . analited towing Charges I cover for towing charges over and above the standard guideline as per the cover the Insured for an additional TPPD amount opted for to property other than property belonging to the Relianc Insured or held in trust or in custody of Insured . Emergency Hotel Provide allowance towards the Hotel accommodation vehicle met with stolen 200 kms away from the location Accomodation provided in policy copy . windowsurance NCB Retention No - Claim Bonus % is retained even after a would have become this cover . Total Cover Provides cover for registration charges , road Cover Sum Insured - ` EMI Protect Pays for car EMIs for the time period during which the vehicle is in one of network garages for % %% Daily Benefit Provides allowance as per plan opted if vehicle is in garage for more than minimum days & for initial eligible own damage , c claim . , and in case of theft where vehicle is not found for more than 90 days Daily Allowance Benefit Plus vides allowance plan opted if vehicle is in garage for more than minimum days & for e e own damage claim as per and , . , case of theft where vehicle is not found for more than 90 days Ranc Protector Covers repair or replacement expenses arising out of accidental loss or damage to tyre & tubes Rim Protector Covers repair or replacement expenses arising out of accidental loss or damage to Rims suis Personal belongings Cover Covers loss of personal belongings of insured or his while such items are in at the time loss or damage to the or vehicle Key Protect Cover Provides Icost of keys in the event keys are lost . It also covers replacement cost of locks if vehicle is broken into Assistance cover or support in various emergency situation to the insured Insured Vehicle due to or breakdown Provide ace Tools and Equipment Cover It will provide an allowance of specified amount for loss or damage to the tools and equipments at the time of event Voluntar Deductible The insured shall be given reduction in premium if insured opts for specified amount of voluntary deductible and will bear the ecified expense at the time of event Relianc No Claim Discount retension ? It will maintain the current NCB at the time of of the policy Insurance Comp Li Insu Reliance Limited General Insurance Company Relianc General urance Reliance Limited Company Reliance General Insurance Company Limited . IRDAI Registration IRDAN10301 No. 103 RGI An ISO 9001 : 2015 Certified Company Limited / Limited . Registered & Corporate ice Reliance General | Company Limited , 6th Oberoi Commerz , Oberoi ( Off : U66603MH2000PL , City , Highway ( East ) , Mumbai - under Western Express Goregaon 063 . . Insurance No. mited Onal Park / / en Trade Cpany Business Corporate Identification UIN : to Anil Ambani Company MCOM Ventures Private Limited and used by Reliance General 1310118 License Page 5 of 13 anc ---PAGE END--- RELIANCE discrepancies Please INSURAN changes take and a claims as / rectification , moment eral Inse Live nce ( Note- per please Smart . your on to subsistence the Warranted proposal . In let us carefully date the know of . Non absence check of the commencement that the disclosure immediately your of policy Policy insured any . pany Limited . and communication You details Urther of the named / or can Gener mentioned Reliance , the Policy herein misrepresentation write Company to and / owner from us undertakes you at rgicl.services@relianceada.com above . reserves of within and General the of eliance to vehicle te claims a in the the renew in period policy Compan right holds the of Insurance to and previous 15 schedule General take maintain a days valid Reliance appropriate a Pollution policy of receipt or . Kindly reliancegeneral.co.in any valid period call confirm rance a and Under of this us Reli effective Control can letter 022 that 022 in lead 48903009 Limited case to , we the 74004 4890 Company of PUC ( PUC cancellation will same Insurance any and ) consider ( Paid are 3009 General discrepancy / or fitness Certificate ) for in 22200 Stian Reliance of that necessary order ited and your the . In O For in the Certificate / or policy issued case D Ins valid General Reliance PUC or of , fitness policy Reliance or as applicable rejection Limited fitness certificate is of in Insurance Company General certificate , during your order , General as Relianc Reliance Insurance . ) the applicable Insurance Authorised , General Co. Reliance Signatory Ltd. Limited Company Insurance General Relianc Reliance Limited Company Insurance General Reliance Limited Company Insurance General Relianc Reliance Registered Reliance Company Limited Western General General Insurance Ventures Corporate Express & Reliance Identification Corporate Insurance Limited Private Highway Company surance Limited , Goregaon Office Company Relianc : and No. Reliance Limited Company Limited used U66603MH2000PLC128300 by Reliance ( East ) , Mumbai General . Reliance General Insurance Insurance Limited General - 400 063 Company IRDAI Insurance . . Relianc UIN Registration : Limited Limited Company IRDAN103RP0012V02100001 , 6th Floor No. General Insurance Company Limited 103 , Oberoi under License Commerz . Trade Reliance . , International RGI logo Limited / MCOM Company displayed al / Business An CO / PCV above ISO / PS belongs Park 9001 / Ver : 2015 , . 1.3 to Oberoi / 310118 Anil Garden Certified Relianc ny Dhirubhai Company City Ambani , Off Page 6 of 13 ance ---PAGE END--- jar any GENERAL relic reliancegeneral.co.in RELIANCE Smart INSURANCE General 022 4890 3009 > 74004 22200 Limited Insence rance neral pany Reliance Know your policy Remember to carefully go through the Risk Assumption Letter and confirm your personal as well as your vehicle details . nited In case of discrepancy in the policy details kindly revert within 15 days from the policy start date on 022 48903009 ( Paid ) or visit a of our branches . elianc , addy Kindly r to the Key Feature Document and Policy Wording at www.reliancegeneral.co.in to understand your policy better and lan more about the policy coverages , à covers and Policy Exclusion This document is a statement of the specific provisions that form the Terms and Conditions of this Policy . . What documents do you require for making any change to your policy 1. Changes in vehicle make & model / cubic capacity / seating capacity / engine & chassis no./year of facturistration n Cation / address Documents required : Letter for change , policy copy and registration certificate copy along with additional cheque if applicable Premium , . 2. Changes in electrical and non electrical accessories / CNG / LPG kit G Documents required : Letter for policy copy , invoice copy of accessories , endorsed istrar stra certificate copy ( for à kit ) and cheque for : premium . ease Hire / details 3. Changes in purcha financier Documents required : Letter for change , policy copy , endorsed registration certificate copy no objection certificate from financier ( not mandatory for deletion , if registration certificate copy is endorsed ) . How to register a Claim - Cashless C Ou F טם Report vehicle Claim registration Survey , Document verification , Cashless Amount Vehicle at Network Garage by Network Garage Loss Assessment & Re - inspection Confirmation Delivery How to register a Claim - Reimbursement nc TY Registration Report Vehicle Survey , Document Vehicle Submission of Claim Settlement of Claim at Garage verification , Loss Assessment Delivery Original Repair Bills + to Customer and Re - inspection Payment Receipt What documents do you require to register a Claim 1 . form duly filled and signed Company stamp in case of company registered vehicles ) 23 Registration 2 . c Relianc 3. Driving License of the the time of loss General 4 . Policy copy Company Vehicle fitness certificate Limited 5 . 6 . Vehicle route permit 7 . Vehicle carriage permit 8 . Road tax copy Reliance 9 . Load Challan ( if applicable ) ompany Limited Insurance Note : 1. As soon as a claim occurs , please intimate immediately to our call centre 022 48903009 ( Paid ) . in intimation would the violation of policy So ? condition 2. Any additional document will be informed Relianc if . , ited Gene amp How to renew your policy conveniently Payment Modes Internet banking C www . Cheque / DD Visit reliancegeneral.co.in Call 022 4890 3009 ( Paid ) Submit a cheque / DD along with signed Renewal Credit / Debit Card and renew online and renew Notice to branch / agent and renew anc The content on this page is for additional information & Should not be considered as part of the policy document / Schedule uns Con Reliance General Insurance An ISO 9001 : 2015 Certified Limit Company Limited . IRDAI Registration No. 103 / Company Registered & Corporate ice : Reliance General | No. Company Limited , 6th Trade Oberoi Commerz , Onal Business Park Garden Company under . C City , Of RGI : Western Express Highway Goregaon ( East ) , Mumbai - U66603MH2000PLC128300 063 . IRDAN10301 . Imm Identification No. IRDAN1033 . Corporate Identification UIN Ambani Oberoi Corporate belongs to Anil U66603MH2000PL UIN : , Insurance MCOM Ventures Private Limited and used Reliance General 1310118 License / by Limited Page 7 of 13 anco ---PAGE END--- jar any GENERAL relic reliancegeneral.co.in RELIANCE Smart INSURANCE General 022 4890 3009 → Insence 74004 22200 Limited Reliance urance Proposal for POS Commercial Vehicles Package oneral Limited any ( Other Motor Trade Int Risks Policy ) than made / details stated are the minimum requirement to be furnished by a proposer . Relianc quer The Insurer may seek any other as desired for under for underwriting purpose . ) General * ( Applicable to all classes of vehicles with suitable amendments in ' Limitations as to Use ' ) Company e PCV GCV Trailer For Office Use Only Policy Number 17012252 Lind Savvion Reference No. Inspection L No. and Intermediary Details ( To be filled BLOERS Intermediary Name RANSHUR in Code Branch Name Code Limit Sales Manager Name Anikesh Kailas Kolhapure Code * POS PAN No. ***** ** 907 E * POS UID Aadhaar No. any olíance AuralAN Details ( To be filled in BLOCK LETTERS ) 1 . This Proposal is for Renewal of Policy Others ( Please specify ) 2a Proposer's Full Name Mrs. SUDEEP LOGISTICS PVT LTD ranny . 2b Relianc . Address for where vehicle is normally kept and Used Co NEAR GANRAJ STAND PLOT NO 04 Canted Flat / Building / Door / B SAFALYA BUNGLOW WAIDWADI Road / Street / Sector PROGRESSIVE MODEL CO OPERATIVE SOCIETY HADAPSAR Nearest Reliance Area Limited Commuran Insurance City CITY Relianc MAHARASHTRA General Country India Rese company Insuranc Phone Mobile Limited Emergency Contact No. Blood Group #Email Fax rand Reliance 3 . Period of 28/01/2025 Το 4 . Business Profession Salary Income Savings , 5 . Monthly Income Upto 20,000 ` 20,001 to ` 50,000 ` 50,001 to 1,00,000 1,00,001 and above 6 . Aadhaar No. | No. ***** 907 E Relianc 8 . Fast Tag ID GOPAN R Compimited 9 . Are you an existing General Yes copyelinsuranc Insurance Customer If Yes , please the Policy No .: eliance #The Policy all related documents shall sent to the email ID provided above . If you wish to receive copy and related documents in physical form to the aforesaid communication address , please us an email at rgicl.services@relianceada.com Lited Ingrance Details of the Vehicle 10. Registration Number MH12KQ3272 of Registration 14/03/2016 Rence ananymited 12. Registering Authority & Locati MAHARASHTRA - Pune Comp , 13. Year & Month of JAN - 2016 14. Cubic Capacity 3298 15. Engine Number E413CDGA063881 16. Chassis Number MC2A5HRFOGA331953 eral Reliance 17. Make of EICHER Limited 18. Type of NA / 10.75 Compted 19 . Gross Vehicle Weight ( GVW ) / Cubic Capacity ( C.C. ) 20 . ds type ( Applicable only if ) Hazardous Goods Goods Insurance500kgs Relianc 21 . the Vehicle made in India ? No Reliance General Limited . IRDAN10301 IRDAN103Ral An ISO 9001 : 2015 Certified Company Limited IRDAI Registration No. 103 UIN Registered & Corporate ice Reliance General | Company Limited , 6th Oberoi Commerz , Oberoi ( Off : , City : , Western Express Highway Goregaon ( East ) , Mumbai - 063 . . Onal . No. U66603MH2000PLimited Park Insurance 66603 NH2000PLC128300 en Corporate Corporate Identification identification No. WIN Trade above belongs to Anil Ambani any Business : Ventures Pivate Limited and used by Ralance General Insurance Company Limited under License . RGIXCOM COPCV / PS / Ver . 1310118 Page 8 of 13 anc ---PAGE END--- jar any GENERAL relic reliancegeneral.co.in RELIANCE Smart INSURANCE General 022 4890 3009 → Limited 74004 22200 Insce pany neral Reliance 22. 22 Max . Licensed carrying capacity ( No. of Passengers ) in case of Passenger carrying vehicles 32 Limited 23 . Vehicle Category Curance usage type ( Applicable if Contract Carriage Carriage Private : usage ty if Contract ) e Carriage ) : School Bus Employee pickup Bus Others Relianc S Gorge ( 24 . capacity ( Including sub 33 mite Comp Details of the Vehicle Type and Use 25 . a . Whether the is driven by source of power ? Yes No If yes Bi Fuel CNG Electric 1960 antonal Insured's Value Electronic accessories Value of CNG / Total Value ( ) - vehicle Chasis accessories fitted to the fitted to the vehicle ( ) Fuel ( ) ( IDV ) Lim of s Body vehicle 0.00 Ranc have valid PUC ? Yes . Do you a No Rol , mite ( Note- Warranted that the insured named herein / owner of the vehicle holds a valid right Under Control ( PUC ) Certificate and / or valid fitness certificate , as a applicable , on the date of commencement of the Policy and undertakes to renew and effective valid PUC and / fitness Certificate applicable during and or as to , , the subsistence the Policy Further the Company action in case of any discrepancy in the PUC or fitness certificate . ) take of reserves the . , Pe 26 . Details of Driver ( a ) Age of Owner ( b ) Does the driver suffer from defective vision or hearing or any physical infirmity Yes Limit . No Inomy or If es " please give any Relianc Ceral ( c ) Has the driver ever been for causing any or loss ? Yes ☐ No If " Yes " please give details as under including the I prosecution , if any : - Reliance ( d ) D.O.B. mo Genence Limited Insurance 27 . Add On ( Subject to availability and eligibility ) and Instalment Protection RGI Easy Monthly Cover : ( MO A00-00-17 V01-14-15 ) - - - RelinCovers Relianc If Yes please one option ; General , CLENA Relio Company Plan I - 1 EMI , Amount : Limi Plan II - 2 EMIS , EMI Amount : EMIS , EMI Amount : Reliance imited ( b ) Towing Charges % Insurance Company Depreciation Cover : Total Cover No Relianc NO Deductible ( ) Voluntary General e Reliance Company Voluntary Deductible amount opted : ( f ) Emergency Hotel Accommodation 2 Limited Reliance ( g ) limit of TPPD Insurance imited amount opted : % Personal Belongings Relianc General Benefit Amount : Relanorance Company Limited ( i ) Daily Benefit No Per day amount opted : Company Days opted : Reliance 4imited ( j ) Allowance Benefit Plus Company Per day allowance amount opted : Coverage Days opted : Relianc imited Reliance uran Company Reliance General Insurance Company Limited . IRDAN10301 RGI An ISO 9001 : 2015 Certified Company Limited IRDAI Registration No. 103 Insurance / % IRDAN103Reneral Limited . Registered & Corporate ice Reliance General | Company Limited , 6th Oberoi Commerz , Business Oberoi Off : , City , al under Western Express Highway Goregaon ( East ) , Mumbai - 063 . . Insurance No. UIN Park / : U66603MH2000PLimited / en Corporate Corporate Identification Identification No. U66603MH2000PLC128300 UIN . Trade to Anil Ambani Company CO5pany : MCOM Ventures Private Limited and used by Reliance General 1310118 License Page 9 of 13 anc ---PAGE END--- jar any GENERAL relic reliancegeneral.co.in RELIANCE Smart INSURANCE 022 4890 3009 → General 74004 22200 Insce Reliance ( k ) and Equipment Cover Limited Limited Insurance other Details acneral Relianc the vehicle fitted with any device approved by Yes General Company If Yes , please attach in the by Automobile Association of India . Company chce 29 . Are you a member of Association of India ? If Yes , please submit membership copy . No 은은 56 30 . Whether the is used for Driving Tuitions ? No 은은 Rell 31 . Whether use Vehicle is limited to Own No KKK 32 . Whether commercial vehicle is also for Private purposes ( excluding use for hire or reward ) ? Yes Li No Insurance Lis 33 . the Vehicle is fitted with Fibre Glass Tank ? Yes No elianc 34 . the Vehicle belongs to / Consulate of a ? ? Yes Embassy duty element in the IDV ? Country so , is the General 35. Whether the Vehicle n for Challenged Yes No as country Date of purchase VehiVehicle of by the Proposer use 14 / Mar / 2016 of any Whether the at the time of New Second Hand Company diagn Risk Inclusions for 38 . Do to restrict the above limits to the statutory TPPD Liability limit of 6000 / - only ? Yes No byRelian Do you wish to cover legal liability to ? ellanc ( a ) Driver / Conductor / Cleaner ( No. of persons ) Yes Re ( b ) Other employees ( No. of Persons ) Yes No Company ( c ) Non - fare paying No. of Limited incassenger ( persons ) Yes No y Generalurance ahmed 39 . Do you wish to personal Accident ( P.A. ) for paid drivers , cleaners Cs conductors ? No If Yes give and Capital Sum Insured ( 1 ) opted for The maximum person is 1 in the case of Motorised two wheelers and 2 , . per me lakhs for other classes of vehicles . Limone Inance or 40 . Accident Cover for Owner Please give details of nomination Name of the ( if Name of the Nominee Nominee Address Relianc Nominee Name is Minor ) Belia ( Note : 1. Personal Accide cover for owner driver is compulsory for Sum Insured 15,00,000 / - for Two Wheeler , Private Car , GCV , PCV and Misc - D 2. Compulsory PA cover for owner driver be granted where a is owned by a company , a firm or a similar body corporate or cannot where owner - driver does not hold a effective driving license ) InsurPartnership Rial an 41 . Do you to include Personal Accident over Named Persons ? Yes No ish Limi Name of Appointee the Name CSI Name of Nominee Age of Nominee of Address ( If is Minor ) Ship Seling Refend Con * Extension of Geographic Whether extension of Geographical Area to the Countries required ? 1. Banglade Reliance 2. Bhutan Limited Insurance CompaLim Nepal Relianc General 5. Pakistan Company Limited Insurance 6. Sri Lanka al ance my Details of Hire Agreement snce 43 . Please state vehicle is under Hire Purchase Lease Hypothecation on If so name and address of parties . , 44 . Full 45 . neral Relianc ance mpany Note Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Registered & Corporate : Reliance General Insuran Company Limited , 6th Oberoi Commerz , Business Garden City Off , . avice lo Oberoi Western Express Highway , Goregaon ( East ) , Mumbai , . IRDAN103R001 U66603MH2000PLC063 Park Corporate Identification No. UIN : above belongs to Anil Ambani al Trade Ventures Pivate Limited and used by Ralance General Insurance Company Limited under License . RGIXCOM COPCV / PS / Ver . 1310118 Page 10 of 13 anc ---PAGE END---jar any GENERAL relio reliancegeneral.co.in RELIANCE Smart INSURANCE General 022 4890 3009 → Limited 74004 22200 Insence eral eliance pany The Insured's Declared Value ( IDV ) of the vehicle will be deemed to be the ' SUM INSURED ' for the purpose of tariff and it will be fixed at commencement of each policy period for each insured vehicle . inc The IDV of vehicle is to be fixed on the basis of manufacturers ' listed selling price of the brand & model as the vehicle proposed for e at the , commencement insurance of e / renewal , and adjusted for depreciation as per policy wordings . Details of Previous Insurance Cited 46 . Full Name of previous insu KOTAK MAHINDRA GENERAL INSURANCE COMPANY LIMITED 47 . Address 48 . Policy Number Previous Policy 27/01/2025 oral 49 . Type of Cover Liability only others ( to mellanterance 50 . NO CLAIM S allowed under policy ( % ) 0 previou Limited 51 . Claims in previous policy Yes No If of Claims Claims Raken elianc 52 . you entitled to No Claim Bonus Yes e , please submit / attached Gerince If yes thereof Company Payment Details Cheque / DD Cheque / DD No. Cheque / DD Date Cash Others Proposer's Bank Details 53. Name of Bank Account Holder Canymited 54 . Acc No .: 55 . Current Zank 56 . of the Bank Relianc 57 . Branch Genne Compted 58 58 . MICR Code ( 9 digit MICR number of the bank and appearing on the cheque issued by the bank ) 59 . IFSC Code ( 11 code appearing on your leaf ) I understand that y refund due the premi ment / any to be directly credited to my Bank Account * on payment . Insudoresaid * As per IRDAI , its mandetory that all payments to the insured are only through electronic mode . Limited Gurance Comited Relianc General Reliance Company Limited Insurance Reliance General Limited Insurance Company Relianc General Reliance Company Limited Insurance Reliance General Insurance Company Limited Relianc General Reliance Limited Insurance Company Reliance General Limited Company Relianc Reliance urance CO Limited Company Reliance General Insurance Company Limited . IRDAN10301 RGI An ISO 9001 : 2015 Certified Company Limited IRDAI Registration No. 103 Insurance / IRDAN103Reneral Limited . Registered & Corporate ice Reliance General | Company Limited , 6th Oberoi Commerz , Oberoi ( Off : U66603MH2000PL , City , - under Western Express Highway Goregaon ( East ) , Mumbai 063 . . UIN Insurance No. mited Onal Park : / / en & Identification Trade Business Corporate Corporate Identification No. U66603MH2000PLC128300 UIN . to Anil Ambani Company : MCOM pany Ventures Private Limited and used by Reliance General 1310118 License Page 11 of 13 anc ---PAGE END--- jar any GENERAL relic reliancegeneral.co.in RELIANCE Smart INSURANCE General 022 4890 3009 → Insence Limited 74004 22200 pany Reliance GENERAL DECLARATION : DECeral I understand that as per the new AML / CFT Guidelines issued Reliance General Insurance Co. Ltd will be verifying lying my details details pertaining pertaining t to KYC and PAN provided at my verance the time of oposal . I addrance I further do hereby agree and consent that in the case of the event of a mismatch of information provi by me in the proposal form , identification i proof and , , , proof at the time of issuance of the policy . I request Reliance General Insurance Company Limited to issue the policy with the details appearing as per my proposal form . I will be solely responsible for any consequences arising out of the difference in detail ven by me during the verification of supporting documents provided by me at the time of issuance of the policy or otherwise . PEP Declaration : Are you a Politically Exposed Person ( PEP ) ? No Com If yes , mention the position held Avance Is of your close relation a PEP ? Yes No omanLI o If yes , please mention the name relation and the position by such member . close mence I hereby declare that in if me , any of my close family attains of PEP I shall confirm the same to Reliance General 3 s or any of my r a position Insurance Co. Ltd as mandate . I understand that is a crucial information under the PMLA Rules and AML / Guidelines and shall confirm that the answers given by me is In case the company comes to know that this is a misrepresentation and concealment of on then the policy shall be b put on hold for scrutiny by the pany and I shall be solely responsible for the same . Note : " Politically Exposed Persons " ( PEPS ) individuals who have been entrusted with prominent c functions in a foreign cou e.g. , Heads of are are or Revanc Callece pub States / Governments , senior politicians , senior government / judicial / military officers , senior executives of state - owned corporations , important political party officials , offcia etc ( As per sub clause ( xii ) of 3 ( b ) of Chapter I of Master Direction - Know Your Customer ( KYC ) Direction , 2016 issued by Reserve Bank of India ( RBI ) . Declaration by Proposer I declare the statements made by me / us in this Proposal Form are true to the best of my / our knowledge and belief and I / We hereby agree that this / We hereby that declaration shall form the basis of the contract between me / us and RELIANCE General Insurance Company Limited . I / We also declare that , if any additions or alterations are carried out after the submission of this proposal form , then the same would be conveyed to the insurers immediately . I / We hereby declare that the contents of the form and documents have been fully explained to me / us and that I / We have fully understood the significance of the proposed contract . I / We agree to accept a policy subject to the condition prescribed by the company . I have read and understood the brochure , prospectus , sales literature & Policy wordings and confirm to anck abide by the same . I / We declare that the rate of NCB stated above by me / us is correct and that no h has arisen in the expiring policy ( copy of the policy enclosed I / We further undertake that , if this declaration is found to be incorrect , all benefits under the policy in 2ect of section I of the policy will stand forfeited I / We further . understand and agree that RELIANCE General Insurance will seek confirmation of above stated details from my / our previous insurers . Pending receipt of necessary confirmation , I / We agree that , though coverage under the policy will be available to me / us , RELIANCE General Insurance will be liable to release the payment towards any claims under section I of the policy only after a confirmation in this regard is received . In the event this declaration is found to be incorrect , any and all coverage available under section I of the policy from the date of commencement of the policy shall stand automatically forfeited . Further , any survey arranged / allowed by RELIANCE General Insurance of the motor vehicle , pending confirmation of the declaration from my / our previous insurers , shall be without prejudice to any of the rights and remedies available to RELIANCE General Insurance as contained herein and under the relevant laws and regulations . I / We acknowledge and agree that , Pending receipt of confirmation of the declaration from my / our previous insurers , the " cash - less repair facility " provided by RELIANCE General Insurance shall stand suspended . • I / We also shall endeavour to procure the renewal notice and pass on the same to RELIANCE General Insurance immediately upon the receipt of such renewal notice . anc Mode of Payment : Secure your payment by cheque / DD favouring Reliance General Insurance CO.Ltd . This policy shall be voidable at the option of the Company in the event of mis - representation , mis - description of nondisclosure of any material particulars by the Proposer . Any person who , knowingly and with intent to defraud the Insurance Company or other persons , files a proposal fo insurance containing any false information , or conceals for the purpose of misleading , information , information concerning any fact material thereto , commits a fraudulent act which will render the policy voidable at the company's sole discretion and result in a denial of insurance benefits .. I / We here by state that the above mentioned address shall be taken as address on record for the purpose of GST . ⚫ I / We hereby confirm that the contents of the proposal form and fully ✓cted have been explained to me / us and Wet fully understood the significance of the proposed contract . This proposal form wa completed by Rent cura documents can support our Go Green Initiative by saying " No " to Policy kit , Renewal Notice and Communications hard copy . We will be sending you a digitally signed soft copy on your registered Email ID & Mobile number . Go Green Hard copy required No Relianc Name Date : 28 Jan 2025 28 Jan 2025 07:23 Limited lancempa companynited Signature Signature of Proposer & Company Seal pany Gellanceneral Prohibition of Rebates - Section 41 of the Insurance Act , 1938 as amended by Insurance Laws ( Amendment ) Act , 2015 1. No person shall allow or offer to allow , either directly or indirectly , as an inducement to any person to take out or renew or continue an insurance in respect of any kind of risk relating to lives or in India any rebate of the whole or part of the commission payable or rebate of the premium shown on the r property , any polic th nor shall any person taking out or renewing or continuing a accept any rebate , except such rebate as may be allowed in accordance with the published prospectuses or tables of Reneral lick ver General Insurance Reliance An ISO 9001 : 2015 Certified Lim Limited . IRDAI Registration No. 103 Company Registered & Corporate vice : Reliance General Mumbai I - U66603MH2000PL 400 063 Company . Limited , 6th 01. Oberoi Commerz , Onal , Oberoi ( City , Off Western Express Highway , Goregaon ( East ) , No. IRDAN103RP Trade Business en Corporate Identification UIN above belongs to Anil Ambani Park : Ventures Pivate Limited and used by Ralance General Insurance Company Limited under License . RGIXCOM COPCV / PS / Ver . 1310118 Page 12 of 13 anc ---PAGE END--- RELIANCE 2 . INSURANCE GENERAL I confirm Supporting Any Name person Place the making neral Ins Live ace C ( In Date case of IRDAI above Confirmation signature default Smart * Agent The Mandatory of in / Vide policy Direct Broker tobe of complying GSR does details of Agent no Bus the Relianc to Insuran registered with pany Limited 164 not be Name / Broker the ( f ) cover filled ☐ provisions dated & Mr. owner 25.02.2022 liability Signature / SM ☐ / CSO for of of death of Mrs. the this w , CSO vehicle section . Reliance General Insurance e . f bodily / SM Limite proposed Reliance General 01.4.2022 to shall injury be be ) or taken for liable damage ) insurance for a as penalty excluded which reliancegeneral.co.in Reliance General Insurance Company Limited Reliance Gene rance any under may Section extend 022 150 to ten 74004 4890 ( 2 ) lakh ( ii ) and rupees nited 22200 3009 urat Signature Compa ③ lian Reliance General Insurance Company Limited Reliance General ( iii . ) : O b and of C of IRDAI the Agent Motor / Vehicles Broker Company Limited Reliance General Insurance Company nite Reline Reliance General Insurance Act 1988 ( Inserted Reliance General Insurance Company Limited Reliance General Insurance Company Limited Relianc Registered Reliance Corporate Western General Ventures Express & Private Identification Corporate Insurance Highway Reliance General Insurance Company Limited Relianc Limited Office Company surance Company Limited , and No. Goregaon : Reliance used U66603MH2000PLC128300 ( Limited by East General ) . Reliance , Mumbai General - Insurance Limited Reliance General Insurance Company Limited Relianc 400 Insurance . UIN 063 . Company IRDAI Company : IRDAN103RP0012V02100001 Limited Registration , 6th Limited Floor No. Insurance Company Limited Relianc 103 General , under Oberoi License . Trade Commerz . RGI logo , International / MCOM al displayed 0 Company Limited Reliance / CO / PCV above Business An ISO / PS / Ver belongs Park 9001 . , : 2015 1.3 / to Anil Oberoi 310118 Garden Certified Dhirubhai Relianc Ambani City Company , Off Page 13 of 13 ance ---PAGE END---