GENERAL RELIANCE Live Smart in INSURANCE Follow us O Welcome RELIANCE Selfi M / S SUDEEP LOGISTICS PVT LTD Now Download NEAR GANRAJ RIKSHAW STAND , PLOT NO 04 , SAFALYA BUNGALOW WAIDWADI , PROGRESSIVE MODEL CO Policy Claim Status My 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 170122523400000248 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--- far Digitally signed by Reliance reliancegeneral.co.in GENERAL eliny RELIANCE Smart General Insurance INSURANCE Company Limited 022 4890 3009 Date : 2025.02.04 16:24:31 74004 22200 IST Insence company ce eneral the Vehicmpany Commercial ( Passengers Carrying 4W > 6 & 3W > 17 ) Policy Schedule Polimited - of the Important by 1 ) y of this certificate of Insurance policy is subject to premium cheque paid by the Insured . ellanc cum realization 2 ) as provided in GR 27 ( g ) of Erstwhile Indian Motor Tariff ( i.e. Sale of Vehicle ) , No NCB will be allowed when a policy is not renewed within 90 days of Nurance its expiry . Policy Number : 170122523400000248 Proposal / Covernote No : R290125102850 Insured Name : M / S SUDEEP LOGISTICS PVT LTD Period of Insurance : From 00:00 Hrs on 28 - Feb - 2025 to Midnight of 27 - Feb - 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 BUNGALOW WAIDWADI , PROGRESSIVE Ambedkar Road ,, PUNE , MAHARASHTRA , 411001 . MODEL CO OPERATIVE SOCIETY , HADAPSAR PUNE CITY , PUNE , MAHARASHTRA , India , 411013 . Mobile No : 9326 ****** *** Tax Invoice No. & Date : R290125102850 & 04 Feb 2025 04:24 Email - ID NA GSTIN / UIN & Place of Supply : 27AATCS2867F1ZS and MAHARASHTRA Insured Vehicle Details Registration No. MH12KQ3360 Mfg . Month & Year FEB - 2016 Make / Model & Variant FORCE MOTOR TRAVELLER MINIBUS 3700 WB CC / HP / Watt 2596 Engine No./Chassis No. D63025963 / MC1E4DBA4GP022684 LCC Including Driver 18 Limite c Type of Body NA Total Premium 30360 RTO Location MAHARASHTRA - Pune Total IDV 945,000.00 Manufacturer fully build in Yes Hypothecation / Lease NA Vehicle Category Vehicle Usage Type Contract Carriage Vehicle Company 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 IN Vehicle IDV 945,000.00 Trailer / Side Car 0.00 Comp Electrical / Electronic Accessories 0.00 Total IDV 945,000.00 Premium Summary Own Damage - Section I Amount ( ) Liability - Section II Amount ( ) Basic OD 839.18 Basic Liability ( TPPD 1 ) 24,857.00 Covers for Lamps Tyres / Tubes Mudguards / Bonet / Side Total Basic Liability Premium 24,857.00 parts etc ( IMT - 23 ) 125.88 PA Benefits - Section III Total Basic Own Damage Premium 965.06 Legal Liability to paid driver and / or Conductor and / or Less cleaner 100.00 Deduct 20 % for NCB -193.01 TOTAL LIABILITY PREMIUM 24,957.00 Sub Total of Deductions -193.01 TOTAL PACKAGE PREMIUM ( Sec I + II + III ) 25,729.00 CGST ( @ 9.00 % ) 2316.00 SGST ( @ 9.00 % ) 2316.00 TOTAL OWN DAMAGE PREMIUM 772.00 TOTAL PREMIUM PAYABLE ( ` ) 30,360.00 Subject to I.M.T.Endt.Nos . & Memorandum printed / herein / attached hereto . IMT 40,23,21 GSTIN : 27AABCB1ZG Licodian Inner HSN : 997134 , Description of services : ST I be Insurance Service GST regulations the refunded if the policy / cancelled after the " As per the amount endorsement is 31st October of retea " will ez not , elianc Consolidated Stamp duty Paid of Authorisation " NO LOA / ENF - 1 / CSD / 05 / 2025 / ( Validity Dt . 27/01/2025 to Dt . / 12 / 2026 ) / 424 Date 24-01-2025 " * at vide General Stamp Office , Mumbai . ** Applicable for the State of Jammu & Kashmir . 23P68356 / SAMADHAN RANSHUR 9326689009 sujitlolage@gmail.com ***** 907 E ncel Intermediary Ode / Name diary Contact No. Intermediary E - mail POS UID Aadhaar No./ PAN No. ell The Customer Information Sheet ( CIS ) for this product is available on our website Lim InsuC Reliancegeneral.co.in/in Relianc General Aurance Company Limited Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Western Registered Express & Corporate Highway Office , Goregaon : Reliance ( East General ) , Mumbai Insurance - 400 063 Company . Limited , 6th . UIN IRDAN103RP0012V Oberoi Commerz 01. , logo Business , ational Oberoi Garden Garden City City , Of , Off : Park Cara Metalication Via U86600MH2000PLC128300 I above belongs to Anil Ambani Trade Ventures Private Limited and used by Relance General Insurance Company Limited under License . RGIMCOM.CO/PCV/PS/Ver . 1.3 / 310118 Page 2 of 13 yte anc ---PAGE END--- any liar GENERAL reliancegeneral.co.in relio RELIANCE Smart INSURANCE General 022 4890 3009 Limited 74004 22200 Insence eliance ance pany Limits of liability for driver under section III CSI 0 ( ) Under Sectia Il ( 1 ) ( i ) of the Policy - Death of or bodily injury to any : cover owner a 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 or in the custody of control of the insured up to the limits specified- ( TPPD 1 Sum Insured - 7,50,000 / - , TPPD 2 Sum Insured- 6,000 / - ) . as to use The policy covers the use only under a permit within the meaning of Motor Vehicle Act , 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 ) Rnceneral 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 vehicle . Persons / Classes of Any person including insured : : entitled to drive : Provided that a person driving holds a driving license at the time of the accident and is not disqualified from holding or obtaining such a license . Provided that the person holding a valid learner's license may drive the vehicle when not used for the transport of goods at the time of the accident and that such a person satisfies the requirements of Rule 3 of the GenInsurance cha Central Motor Vehicles Rules , 1989 . Deductible under Section - I : ( i ) Compulsory deductible 500 / ( ii ) deductible 00 / - ( iii ) deductible 0 / - - Addition Relianc * No Claim Bonus is subject to no claim on the previous policy . Benefits under the policy stands I if claim is / was made in policy . " It is hereby declared and agreed that any damages pre - existing , losses occurred & any Liability having been incurred , prior to the commencement of cover under this policy are excluded from scope of this policy . " the % of Discount on Own Damage Premium Period of Insurance % of NCB on OD Premium The Preceding Year 20 % car Preceding Two Consecutive Years 25 % Preceding Three Consecutive Years 35 % Preceding Four Consecutive Years 45 % Vance Preceding Five Consecutive Years 50 % Compulsory PA cover for owner driver : Insured is not eligible for the Compulsory PA cover for owner effective in this policy as the same has not been opted for the reasons allowed as per motor tariff and / or basis insured's declaration given below : an " hereby that I / personal we declare we hold it insurance policy coverin death and permanent disability ( total & partial ) and / or compulsory personal accident ( CPA ) for driver in other vehicles ; whereby the Sum Insured limit is of Rs 1,500,000 or more in all such above mentioned conditions . " own In case you have missed it , please opt for compulsory PA cover by payment of additional premium as applicable.Liability of insurance commence from the date of receipt of such additional premium . shall CO2 damages having " It is hereby declared and agreed that existing to the vehicle occured prior to the com of cover are from the scope of the policy " Relianc provided is on Basic OD Premium excluding Add - on applicable . The policy with detailed terms , conditions and exclusions are available on availab our website www.reliancegen Statutory Provisions : " As per Section 146 of the Motor Vehicle Act , 1988 it is to have your vehicle insured against third party risk . " As per Section 196 of the Motor Vehicle Act , 1988 an uninsured vehicle is punishable with fine or Rs . 2000 a imprisonment up to 3 1 for the first offence and fine of Rs . 4000 and / or imprisonment up to 3 months for the second offence . " I / We hereby certify that the Policy to which the certificate relates as well as this certificate of insurance are in accordance with the of Chapter X and Chapter XI of M.V. Act , 1988 . Note : In event of dishonor of cheque , policy document stands from incep irrespective of whether a communication is sent or not . Rianc cancelled y Safeguard your transaction by paying your premium via cheque / DD in favour of Reliance General Insurance Co. Ltd. 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 terms , conditions and exclusions of the Reliance Miscellaneous and Special Types of Vehicles Package Policy Certificate Cum Policy Schedule . In witness whereof this 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 per Rule 46 of the Central Goods and Services Tax Rules 2017 . Updating Registration Number of vehicles within 15 days of policy inception is MANDATORY as per IRDA . Kindly provide the same to your Agent / Our Call centre / Policy issuing Branch ( Applicable for policies booked without Registration No of vehicles ) . Relianc IMPORT 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 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 Authority of India , kindly ensure to affixed FASTag on your Revi Gene Limited Insuranan Comp Relianc General Reliance urance IRDAN103RP001201 Company Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Limited Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Oberoi Commerz , Oberoi Garden City Of USC3H290PLC128300 UIN , , Western Express Highway , Goregaon ( East ) , Mumbai - 400 063 . Trade Park : . . dtional logo LASTNO above belongs to Anil I Ambani Business Ventures Private Limited and used by Reliance General Insurance Company Limited under License . RGI / MCOM / CO / PCV / PS / Ver . 1.3 / 310118 Page 3 of 13 ance ---PAGE END--- t GENERAL lian RELIANCE INSURANCE Smart reliancegeneral.co.in eliany General 022 4890 3009 Limited ins 74004 22200 pany Clauseneral Grievance Reliance For resolution of any query or grievance urance , Insured may contact the respective branch office of the Company or write an email at rgicl.services@relianceada.com may call at 02248903009 or may . In case the insured is not satisfied Nodal Grievance with the response of the office Officer of the Company , insured may contact the at rgicl.grievances@relianceada.com . In the event of unsatisfactory response from the Nodal response from lane the Head Grievance Officer , he / she may , subject to vested jurisdiction grievance , approach the Insurance Ombudsman . Details of the offices of the Insurance for the redressal of Ombudsman are available at IRDAI www.reliancegeneral.co.in website www.irda.gov.in or on or on www.gbic.co.in. company website The insured may also contact the territorial following office the Insurance jurisdiction the branch or office Ombudsman within whose of the Company th is located . Office of the Insurance of Ombudsman , 3rd Floor , Jeevan Seva Annexe , S. V. Road , Santacruz Mumbai - 400 26106960 Fax : 022 -26106052 054. Tel .: 022 -26106552 / Email : bimalokpal.mumbai@cioins.co.in Note : Kindly acknowledge the receipt of this In case p you find any variations against your proposal or any in the policy , contact C us immediately . Fast 248903009 eneral France eneral Relianc The policy does not cover liability for death , bodily injury or as excluded under Section Vide GSR no 164 ( f ) dated ( 2 ) ( ii ) and ( iii ) : b and C of Motor 25.02.2022 w . e . f 01.4.2022 Vehicles Act 1988 ( Inserted ) In the unfortunate event of a claim , please call quoting your Policy No. on 022 In the absence of communication and register your claim immediately any fr from you within within 7days from the date of loss a period of 15 days of receipt . of this letter , we will consider that proposal . the issued policy is in order as per your Special ACERemark as ACE of Rs.25000 Instmpany Policy Lindom has been issued with reference to vehicle inspection report , reference lead no . & special conditions.The viewed on company's website by the report remarks can be lead no . Renc Reliance For Reliance Gene General Insurance Co. Ltd. Co. Limite Insured Authorised General Signatory Company Insurance Reliance Relianc General Insurance Company Limited Reliance General Company Insurance Limited Reliance Relianc General Insurance Company Limited Reliance General Company Insurance Limited Reliance Relianc General Company Insurance Limited Reliance General Company Insurance Limited Reliance Relianc urance General * Reliance General Insurance Company Limited . Limited Company IRDAI Registration No. 103 Registered & Corporate Office An ISO 9001 : 2015 Certified : Reliance General Insurance IRDAN103RP001201 Company Company Limited , 6th Oberoi Western Express Commerz , Park Highway , Goregaon ( East ) , Mumbai Oberoi Garden City - 400 , Off 063 . , : Business Corporate identification No. U66603MH2000PLC128300 national Ventures Prvate Trade logo Limited . . above and used by Rellance belongs to Anil Dhirubhai UIN General Insurance Company Limited under License . RGIMCOM Ambani COP CVPS / Ver . 1.31310118 Page 4 of 13 anc ---PAGE END--- liar GENERAL reliancegeneral.co.in elicany 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 Thank you for choosing Reliance General Insurance . Please find enclosed policy no .: 170122523400000248 which has been issued based on the details declared by the applicant . Relianc Insured Vehicle Details Registration No. MH12KQ3360 Mfg . Month & Year FEB - 2016 company Make / Model & Variant FORCE MOTORS TRAVELLER MINIBUS 3700 WB CC / HP / Watt 2596 Engine No./Chassis No. D63025963 / MC1E4DBA4GP022684 LCC Including 18 Rental Type of Body NA Total Premium 30360 Limited RTO Location MAHARASHTRA - Pune IDV 945000 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 CNG / LPG Kit 0.00 Lim Vehicle IDV 945000 Trailer / Side Car 0.00 Electrical / Electronic Accessories 0.00 Total IDV 945,000.00 ted rance bany Previous Policy Details Previous Year Policy No. Period of Insurance Previous Policy - Claim Status 3035122501 From : 28/02/2024 To : 27/02/2025 midnight ☐ Yes No YOU OPTED FOR THE FOLLOWING COVERS HAVE Relianc Standard Vehicle Own Damage + Third Party General Compos Cover Electrical / electronic accessories Non - electrical accessories Bi - fuel kits comprising systems Add - on Covers Reliance urance Depreciatenc Nil Cover No for depreciation on vehicle parts other than tyres and tubes with respect of approved partial loss claims . towing Charges Provides cover for towing charges over and above the standard property guideline as per the cover by customer ( Sum Insured 0.0 / - ) . accidented to Indemnify the Insured for an additional TPPD amount opted for other than t property belonging to the Relianc Manamited Insured or held in trust or in custody of Insured . Emergency Hotel Provide allowance towards the Hotel accommodation vehicle met with V stolen 200 kms away from the location Accomodation provided in policy copy . NCB Retention No - Claim Bonus % is retained even after a claim , which would have become 0 % without this cover . Total Cover Provides cover for registration charges , road tax and insurance premium ( Total Cover Sum Insured - EMI Protect Pays for car EMIs for the time period during which the vehicle is in one of our network garages for repair . Benefit Provides allowance as per plan opted , if vehicle is in garage for more than minimum days & for initial two eligible own damage claim . , and in case of theft where vehicle is not found for more than 90 days owance Benefit Plus Provides allowance as per plan opted , if vehicle is in garage for more than minimum days & for own damage claim . , 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 & Rim Protector Covers repair or replacement expenses arising out of accidental loss or damage to Rims Personal belongings Covers loss of insured or his f while such items are in vehicle at the time loss or damage to the ongings a / b of vehicle Provides ver Key Protect cost of keys in the event keys are lost . It also covers cost of locks if the vehicle is broken com the into on Assistance cover Provides or support in various emergency situation to the insured and Insured Vehicle due to or breakdown 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 Deductible The insured shall be given reduction in premium if insured opts for specified amount of voluntary deductible and will bear the ry specified expense at the time of event No Claim Discount retension Relianc It will maintain the current applicable NCB at the time of renewal of the policy Insurance Comp Li Insura Reliance General Limited Insurance Company Relianc urance Reliance General Company Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Limited Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Oor Oberoi Commerz I inal Trade Park Oberoi Garden City Off , , , , Western Express Highway , Goregaon ( East ) , Mumbai - 400 063 . IRDAN103RP0012V02100001 . logo VETENPLC128300 UN d above belongs to Anil Dhirub Ambani : Business Vertures Private Limited and used by Reliance General Insurance Company Limited under License . RGIACOMICQPCV.IPS./Ver . 1383 10118 Page 5 of 13 anc ---PAGE END--- RELIANCE discrepancies Please INSURANCE GENERAL and changes take claims a as / rectification moment ( Note- per , please neral Insce Live on . your to Smart subsistence the Warranted carefully date proposal . let In us of the know of commencement that . Non absence immediately check the the disclosure your Policy insured of any policy . pany Limited Further communication . Reliance Gener of the named and You details / or can , Policy the herein misrepresentation write mentioned Company and / owner from to undertakes us reserves of you at rgicl.services@relianceada.com above the within vehicle of and General to claims eliance the a in General Insurance Compa renew period the Reliance right holds in and the of policy to a take maintain valid previous 15 schedule appropriate days a Pollution policy of . valid receipt or Kindly reliancegeneral.co.in action and Under period of call confirm rance any Limited Reli this us General Insurance Company in effective Control can letter 022 that Reliance case lead 48903009 022 ( , the of PUC PUC to we any and ) Certificate cancellation will same 74004 4890 Tcy discrepancy / or consider ( Paid are fitness ) for in order 22200 3009 Stian the PUC and mp of that necessary ited For in in Certificate / or your the . In General Limited Reliance the valid General Insurance Company Reliance or PUC policy issued case D Reliance fitness , as fitness or policy of or applicable rejection A General fitness certificate certificate is in certificate , of your order during , as Insurance applicable Relianc Insurance Co . ) . ) the General Insurance Company Limited Reliance General Authorised , Reliance Co. Signatory Ltd. Limited Relianc Insurance Company Reliance General Company Limited General Insurance Reliance Reliance Western Registered Ventures Corporate General Express & Private Identification Corporate Insurance Insurance Company Limited Relianc Highway Reliance General Company Limited Limited Office urance No. , Goregaon : Company and U66603MH2000PLC128300 Reliance used Limited ( East General by Reliance ) . Relianc , Limited Mumbai Insurance General Insurance Company Limited Reliance General - 400 Insurance . UIN 063 Company IRDAI . Company : IRDAN103RP0012V02100001 Limited Registration , Relianc 6th Company Limited Limited Floor No. General Insurance , 103 under Oberoi License . Trade Commerz . RGI logo , International / MCOM Relianc displayed Company Limited / CO / above Business An PCV ISO / PS belongs / Park 9001 Ver : . 1.3 to , Oberoi 2015 / 310118 Anil Certified Dhirubhai Garden Relianc Ambani City Company , Off Page 6 of 13 anc ---PAGE END--- any liar GENERAL reliancegeneral.co.in elic RELIANCE Smart INSURANCE General 022 4890 3009 22200 Insce 74004 Limited eral rance pany Reliance Know your policy Remember to carefully go through the Risk Assumption Letter and confirm your personal as well as your vehicle details . nyited In case of y discrepancy in the policy details kindly revert within 15 days from the policy start date on 022 48903009 ( Paid ) or visit an of our branches . elianc , Kindly refer to the Key Feature Document and Policy Wording at www.reliancegeneral.co.in to understand your policy better and learn more about the policy coverages , add - on 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 manufacture / registration no./ location / address Documents required : Letter for change , policy copy and registration certificate copy along with additional cheque if applicable , . 2. Changes in electrical and non electrical accessories / CNG / LPG kit nium Documents Letter for addition policy copy invoice copy of accessories endorsed i certificate copy ( for CNG / LPG kit ) and cheque for additional Chaquired : , , , premium . Reng 3. s in financier details ( Hypothecation / Lease / Hire purchase ) Documents required : Letter for change , policy copy , endorsed registration certificate copy and no objection certificate from financier ( not mandatory for deletion , if registration certificate copy is endorsed ) . How to register a Claim - Cashless LY ά 茴 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 B = 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 Cla 1 . Claim form duly filled and signed stamp in case of company registered vehicles ) 2 . Registration copy Suncompany 3. Relianc Driving License of the driver the time of loss General 4 . Policy copy Company Limited 5 . Vehicle fitness certificate cat 6 . Vehicle route permit 7 . Vehicle carriage permit 8 . Road tax copy Reliance ompany 9 . Load Challan ( if applicable ) Limited Insurance ha Note : 1. As oon as a claim occurs , please intimate immediately to our call centre 022 48903009 ( Paid ) . in intimation would result in the violation of policy ? conditions 2. Any additional document , if I will be informed . Relianc ited Genie 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 and The content on this page is for additional information & Should not be considered as part of the policy document / Schedule Re Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Oberoi Commerz , Business . logonal Park , Oberoi Dhirden ( City , Off Western Express Highway , Goregaon ( East ) , Mumbai - - 400 063 . expense hentication No. 8603 MH2000PLC128300 UIN d above belongs to Anil Ambani IRDAN103RP0012V02100001 . : Trade Ventures Private Limited and used by Rellance General Insurance Company Limited under License . RGI / MCOM : COIPCV / PS / Ver . 1.3 / 310118 Page 7 of 13 e anc ---PAGE END--- any liar GENERAL reliancegeneral.co.in elio RELIANCE Smart INSURANCE General 022 4890 3009 Limited Insence 74004 22200 Reliance Proposal Fo for POS Vehicles Package I oneral Commercial Limited Insurance ( Other Motor Trade Inte Risks Policy ) than ferpany are the minimum requirement to be furnished by a proposer . Relianc The Insurer may seek any other information as desired for under for underwriting purpose . ) General more * ( Applicable to all classes of with suitable amendments in ' Limitations as to Use ' ) Company ce for PCV GCV For Office Use Policy Number 170122523400000248 Date Goal Lind Savvion Reference No. Inspection Lead No. ny tance Intermediary Details ( To be filled in BLOCK LETTERS ) Intermediary Name SAMADHAN RANSHUR Code 23P68356 Gelaar Branch Name Code 1701 Limits Sales Manager Name Anikesh Kailas Kolhapure Code 71016662 * POS PAN No. ** 907 E LETTERny * POS UID Aadhaar No. liance and Details ( To be filled in BLOCK 1 . This Proposal is for A new Policy Renewal of Policy ( Please specify ) 2a . Proposer's Full Name Mrs. SUDEEP LOGISTICS PVT LTD Poser 2b . where Relianc Address Address for Communication vehicle is normally and Used NEAR GANRAJ RIKSHAW STAND , PLOT NO Read Coated Flat / Building / Door / Block No. 04 , SAFALYA BUNGALOW WAIDWADI , Road / Street / Sector PROGRESSIVE MODEL CO OPERATIVE SOCIETY , HADAPSAR Nearest Landm Reliance Area Limited Insurance CITY 411013 Reliance MAHARASHTRA General Country Researc India Phone Mobile Insuranc Limited Emergency Contact No. Blood Group #Email Fax Reliance 3 . Period of 28/02/2025 To 4 . Source of Funds Business Profession Salary Agricultural Income Savings Income ☐ 20,001 to $ 50,000 1,00,001 and above 5 . Monthly Upto 20,000 50,001 to 1,00,000 6 . Aadhaar No. ***** 907 E Relianc 8 . Fast Tag ID Grandompany R nite Comimited 9 . Are you an existing General Yes No Insurance Customer copyrancmpany If Yes , please the Policy No .: eliance rance pany #The Policy all related documents shall be sent to the email ID provided above . If you wish to receive copy and related in physical form to the aforesaid communication address , please drop us an email at rgicl.services@relianceada.com Details of the Vehicle 11. Date of Registration Rend MH12KQ3360 Lited 10. Registration Number 22/03/2016 Loca 12. Registering Authority & MAHARASHTRA - Pune Compted , 13. Year & Month of Manufacture FEB - 2016 14. Cubic Capacity 2596 15. Engine Number D63025963 16. Chassis Number MC1E4DBA4GP022684 Para Reliance 17. Make of Vehicle FORCE MOTORS Limited 18. Type of Body / Model NA / TRAVELLER 19 . Gross Vehicle Weight ( GVW ) / Cubic Capacity ( C.C. ) Comp any 20 . type ( Applicable only if c W 7500 kgs ) Hazardous Non - Hazardous Goods + Goods Relianc 21 . Is the Vehicle made in India ? No Limited Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company % Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Oberoi Commerz International Business Park Oberoi Garden City Off , , , , Western Express Highway , Goregaon ( East ) , Mumbai - 400 063 . Insurance eral Corporate Identification No. U66603MH2000PLC128300 . UIN 1 : : IRDAN103RP0012V02100001 . Trade logo displayed above belongs to Anil Dhirubhai Ambani IRDAN103RP001 Ventures Private Limited and used by Reliance General Insurance Company Limited under License . RGI / MCOM / CO / PCV / PS / Ver . 1.3 / 310118 Page 8 of 13 anc ---PAGE END--- any liar GENERAL reliancegeneral.co.in elia RELIANCE Smart INSURANCE General 022 4890 3009 74004 22200 Limited Insce Reliance 22 . 22 Max Licensed carrying capacity ( No. of in case of Passenger carrying vehicles 17 . neral Limited Insurance 23 . Vehicle Category Vehicle usage type ( Applicable if bus ) : Carriage Vehicle usage sub type ( Applicable if Contract Carriage ) : School Bus Employee pickup Bus Others Relianc 24 . Seating capacity ( Including Driver ) 18 Gen Comp Details of the Vehicle Type and Use onlimited 25 . a Whether the Vehi is driven by Non - conventional source of power ? Yes No If yes Bi Fuel CNG LPG Electric . Insured's Declared Value Non electrical Electronic accessories Value of CNG / LPG Kit Bi Total Value ( ) IDV ) of vehicle Chasis Fuel Lin ( accessories fitted to the fitted to the vehicle ( ) ( ) Body vehicle 0.00 0.00 Vanc . Do you have a valid PUC ? Yes Gel b No coy mite ( Note Warranted that the insured named herein / owner of the vehicle holds a valid Pollution Under Control ( PUC ) Certificate and / or valid fitness certificate , as applicable , on the date of commencement of the Policy and undertakes to renew and maintain a valid and effective PUC and / or fitness Certificate , as applicable , during the subsistence of Policy . Further , the Company reserves the right to take appropriate action in case of any discrepancy in the PUC or fitness certificate . ) Age of Owner Ron 26 . Details of ( a ) the ( b ) Does the driver suffer from defective In Limit or hearing or any physical infirmity . Yes No scalin If " Yes " please give any eral Relianc Ra ( c ) Has the driver ever been involved for causing any accident or loss ? Yes on If " Yes " please give details as under including the pending prosecution , if any : - Reliance ( d ) D.O.B. Genece Insurance Limited 27 . Add On Covers ( Subject to availability and eligibility ) Easy Monthly Instalment Protection Cover : GI MO - A00-00-17 V01-14-15 ) - - Relianc If Yes , please choose any one option ; General Rella Company Plan I - 1 EMI , EMI Amount : Plan II - 2 EMIs , EMI Amount : Plan 3 EMIS , EMI Amount : Reliance Limite mited ( b ) Additional Towing Charges % Insurance Company Nil Depreciation Cover : Total Cover No Relianc ( e ) Voluntary Voluntaryance General Reload Company Company amount opted : Limited ( f ) Emergency Hotel Accommodation No Reliance 16imited 16 limit of TPPD Insurance Company Additional amount opted : ce Personal Belongings No Relianc General Benefit Amount : Renance Company sur Limited ( i ) Daily No Per day amount opted : Reliance Days opted : Insurance j ) Allowance Benefit Plus 16imited ( Company Per day allowance amount Coverage Days opted : Relianc General Reliance Company Limited Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Registered & Corporate : Reliance General Insurance Company Limited 6th F Highwffice a , Western Express Goregaon ( East ) Mumbai - 400 063 . , , Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License . RGI / MCOM / CO / PCV / PS / Ver . 1.3 / 310118 Page 9 of 13 anc ---PAGE END--- liar GENERAL reliancegeneral.co.in elicany RELIANCE Smart INSURANCE General 022 4890 3009 74004 22200 Ince Limited Reliance and Equipment Cover Limited Insurance other Details Company ancneral Is the vehicle Bellanc fitted with any t device approved by the ARAI ? Yes Company If Yes please attach of Installation in the vehicle , issued by Automobile Association of India . certificate , Are you a member of Automobile Association of India ? , If Yes , please submit membership copy . Yes No 은은 30. Whether the Vehicle is used for Driving Tuitions ? Yes No Pro2 은은 Relleneral 31. Whether use of Vehicle is limited to Own Yes KKK 32 commercial vehicle is also used for Private purposes ( excluding use for hire or Li . Whether reward ) ? Insurance Yes 33 . the Vehicle is fitted with Glass Tank ? Yes llanc other 34 . the Vehicle belongs to bassy / Consulate of a Country ? ? Yes the % W / so , is the duty element in the IDV ? General of Company Country Vehicle Handic 35 . Whether the is for use Challenged Yes No Blind 36 . Date of purchase of the Vehicle by the Proposer 20 Whether the Vehicle anyon 37 . at the time of purchase was New Second Hand Vehicle Relian Risk Inclusions 38 . Do wish to restrict the above limits to the statutory TPPD Liability limit of 6000 / - only ? Yes No you wish to cover legal liability to to ? ellanc ( a ) Driver / Conductor / Cleaner ( No. of persons ) Yes Generalurance Re ( b ) Other employees ( No. of Persons ) Yes No Company Limited ( c ) Non - fare paying inclSsenger ( No. of persons ) Yes No nce 39 99 . Do wish to personal Accident ( P.A. ) for paid drivers , cleaners conductors ? No you e Co If Yes , give name and Capital Sum Insured opted for . The maximum CSI available per person is 1 Lakh in the case of Motorised wheelers and 2 lakhs for other classes of vehicles . Lowes 40 . Accident Cover for Owner Please give details of nomination al Name of the Appointee ( if Name of the Nominee Nominee Address Roland Nominee is Minor ) Relia ( Note : 1. Personal Accident cover for owner driver is compulsory for Sum Insured of 15,00,000 / - for Two Wheeler , Private Car , GCV , PCV and Misc - D 2. Compulsory PA cover for owner driver cannot be granted where a is owned by a company , a partnership firm or a similar body corporate or owner - driver does not hold effective driving license ) Ricofance Do to include Personal Accident cover Named Persons ? Lim 41 . you Yes No Insurny Name of the Appointee Name CSI Name of Nominee Age of Nominee Relationship Address ( If is Minor ) Relianc Reno 42 . Extension of Geographical Area Whether extension of Geographical Area to the Countries required ? 1 . Reliance 2 . Insurance CompaLin 4. Nepal Relianc General 5. Pakistan Limited Insurance Limited 6. Sri Lanka el ance Details of Hire Purchase / Hypothecation concerny / Lease 43 . Please state if the vehicle is under Hire Purchase Lease ☐ Hypothecation Agreement If give and address of parties . Company so name , 44 . Full Name 45 . Address Relianc mpany Note Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company IRDAN103RP0012nce Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Oberoi Commerz , International Business Park , Oberoi Garden City , Off Western Express Highway , Goregaon ( East ) , Mumbai - 400 063 . Corporate Identification 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 10 of 13 nce ---PAGE END---any liar GENERAL reliancegeneral.co.in elic RELIANCE Smart INSURANCE General 022 4890 3009 Limited 74004 22200 Insence neral 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 Meliance each policy period for each insured vehicle . anc The IDV of the vehicle is to be fixed on the basis of manufacturers ' listed selling price of the brand & model as the vehicle proposed for at the commencement of insurance / renewal , and adjusted for depreciation as per policy wordings . Details of Previous Insurance 46 . Full Name of previous insurer KOTAK MAHINDRA GENERAL INSURANCE COMPANY LIMITED 47 . Address 48 . Policy Number 3035122501 Previous Policy Expiry 27/02/2025 49 . Type of Cover ☐ Package Policy others ( to be mellanrance 50 . NO CLAIM allowed under revious policy ( % ) 0 Limited 51 . Claims taken in previous policy Yes No If yes , No. of Claims Claims ellanc 52 . Are you entitled to No Claim Yes thereof Gerlinceited If yes , please submit / attached proof mited Company Payment Details Cheque / DD Cheque / DD No. Cheque / DD Date Cash Others Proposer's Bank Details 53 . Name of the Bank Account Holder 54 . Bank Account No .: ☐ Savin Current 56 . of the Bank Relianc Rame 57 . Branch Gen Commited 58 . MICR Code ( 9 digit MICR number of the bank and branch appearing on the e issued by the bank ) 59 . IFSC Code code appearing on your ue leaf ) Lane I understand that ( refund due the payment / any payment / claims to be directly credited to my aforesaid Bank Account . * 11 y on premium * As per IRDAI , its mandetory that all payments to the insured are only through electronic mode . Limited Instance Comited Reliance General Relianceurance Company Insurance Limited Reliance General Limited Insurance Company Relianc Reliance General Company Limited Insurance Reliance Limited General Insurance Company Relianc General Reliance Company Limited Insurance Reliance General Limited Insurance Company Limited Relianc General Reliance urance Company Limited Reliance General Insurance Company Limited . IRDAI Registration No. 103 disploe An ISO 9001 : 2015 Certified Company Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Oberoi Commerz , International Business Park , Oberoi Garden City , Off . IRDAN103R0001 logo Western Express Highway , Goregaon ( East ) , Mumbai - 400 063 . Trade Company : Corporate kentification No. U66603MH2000PLC128300 UIN I 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 11 of 13 inc ---PAGE END--- any liar GENERAL reliancegeneral.co.in elic RELIANCE Smart INSURANCE General 022 4890 3009 Limited 74004 22200 Insence rance bany Reliance ceral GENERAL DECLARATION : I understand that as per the new AML / CFT Guidelines issued Reliance General Insurance Co. Ltd will be my details pertaining to KYC and PAN provided at anc the time of proposal . provising t I further do hereby agree and consent t in the case of the event of a mismatch of information d by me in the proposal form identification proof and address , , , 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 given 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 ically Exposed Person ( PEP ) ? No LIN If yes , mention the position held Vanc Is any of f your close relation or a PEP ? Yes No ite Generans oman If yes , please mention the name relation and the position hold 2 by such close relative / family member . memnce I hereby declare that in future if me , any of my close s or any of family r attains position of PEP the I shall confirm the same to Reliance General my a Insurance Co. Ltd as a mandate . I understand that t this is a crucial information under the PMLA Rules and AML / CFT Guidelines and shall confirm that the answers that given by me is true . In case the company comes to know that this is a misrepresentation and concealment of then the policy shall be put on hold for scrutiny by the company and I shall be solely responsible for the same . Note : Politically Exposed Persons " ( PEPs ) e individuals who or have been entrusted with prominent public functions in a foreign country Heads of are Revanc , States / Governments , senior politicians , senior government / judicial / military officers , senior executives of state - owned corporations , important political party officials , das 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 / We hereby declare that 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 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 anc abide by the same . • I / We declare that the rate of NCB stated above by me / us is correct and that no claim 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 respect 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 . 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 documents have been fully explained to me / us and I / We understood the s Onificance of the proposed contract . Reefully This proposal form You 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 your registered Email ID & Mobile number . Go Green Hard copy required No Relianc Name Date : 04 Feb 2025 04 Feb 2025 04:24 Limited panmited Signatur Signature Signature of Proposer & Company Seal pany neralcance Relianceneral 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 an any kind of risk relating to lives or property in India any rebate of the the whole or part of the commission payable or any rebate of the premium shown on the policy , 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 the insurer . the Re Reliance General Insurance Company Limited . IRDAI Registration No. 103 An ISO 9001 : 2015 Certified Company Limit Registered & Corporate Office : Reliance General Insurance Company Limited , 6th Oberoi Commerz , Park Oberoi Garden City Off 103 RP0012V02100001 , , Western Express Highway , Goregaon ( East ) , Mumbai - 400 063 . logo barance di . Trade Dhirub Business Tagasis fedfcnferno 166540 MH2000PLC128300 UIN : IRDAN d above belongs to Anil Ambani . onal Ventures Private Limited and used by Reliance General Insurance Company Limited under License . RGI / MCOM / CO / PCV / PS / Ver . 1.3 / 310118 Page 12 of 13 anc ---PAGE END--- RELIANCE 2 . INSURANCE GENERAL I confirm Supporting Any Name person Place the neral Ins Live ace Date of above Confirmation making Smart ( In IRDAI * Mandatory case signature default The Agent of in Vide policy Direct / Broker to of complying details be GSR does Ass of Agent the Relianc no to Bus Insura registered with pany Limited 164 not , / Broker be N the ( f ) cover filled ☐ provisions dated liability & Signature Mr. owner / SM 25.02.2022 / CSO for of of death Mrs. the this of vehicle CSO section w , Reliance General Insurance . e . bodily pal / SM Limit proposed Reliance General f 01.4.2022 to shall injury be be or taken for liable ) damage ) insurance for a as excluded penalty Reliance General Insurance Company Limited Reliance under Section Generance which may extend reliancegeneral.co.in 022 any 150 to ten 74004 4890 ( 2 lakh ) 3009 ( ii Reliance General Insurance Company Limited Reliance General ) and ran Signature Compa rupe nited 22200 ③ Stian ( iii ) : O b and of C of IRDAI the Agent Motor / Vehicles Broker General Insurance Company Limited Reliance General Insurance Company nite Rec Reliance Act 1988 ( Inserted Reliance General Insurance Company Limited Relianc Reliance Reliance General Insurance Company Limited Western Registered Ventures Corporate General Express & Private Identification Corporate Insurance Highway surance Company Limited Reliance General Insurance Company Limited Relianc Limited Office Company , and No. Goregaon : Reliance used U66603MH2000PLC128300 by Reliance ( East ) , General Limited . Mumbai Insurance General Limited Reliance General Insurance Company Limited Relianc - 400 Company Insurance . UIN 063 IRDAI . : Registration Company IRDAN103RP0012V02100001 Limited , 6th Limited Floor No. General Insurance Company Limited Relianc , 103 under Oberoi License . Trade Commerz . RGI logo , International / MCOM displayed 67 Company Limited Relianc / CO / PCV above Business An ISO / PS belongs / Ver Park 9001 . : 2015 1.3 , to Oberoi / 310118 Anil Certified Dhirubhai Garden Relianc Ambani City Company , Off Page 13 of 13 anc ---PAGE END---