Welcome to Aditya Birla Insurance Brokers Limited, a subsidiary of Aditya Birla Capital Limited!

Dear MR. JATINDER SINGH,

We thank you for the trust you have shown by making us your preferred choice for your motor insurance needs. It͛s our pleasure to
have you as a valued customer. Aditya Birla Capital͛s protecting solutions enable you to protect against risks to you and your vehicle.

Your decision to choose your Motor Insurance under the TVS Insurance Program will not only protect you against the risks, but it also
gives you a host of unique features such as:

‡ Instant online policy schedule cum certificate of insurance

‡ Online payment facility
‡ Fast, hassle-free and cashless claim settlements at the dealerships. Please note that the admission and settlement of claim is at
sole discretion of Insurance Company
What͛s more, this policy program is recognized by all TVS dealers across the country, thus, leaving you with even lesser worries! Please
find enclosed the following:
‡ A Policy Schedule cum Certificate of Insurance, containing details of your vehicle insurance cover and premium calculation
‡ A Policy Wording Document with Terms & Conditions, as per your motor insurance policy. For detailed policy wording kindly refer
respective Insurance Company website
We hope that you were satisfied with all the insurance company options that were presented to you by your dealer and policy was
issued as per your choice of insurers
Meeting your life͛s money needs
Our purpose at Aditya Birla Capital is to make money matters simpler to understand to help you live the life you imagined. Therefore, all
ƚŚĞĮŶĂŶĐŝĂůƐĞƌǀŝĐĞƐďƵƐŝŶĞƐƐĞƐŽĨĚŝƚLJĂŝƌůĂ'ƌŽƵƉǁŝůůŶŽǁƐĞƌǀĞ/ŶĚŝĂĂƐŽŶĞďƌĂŶĚʹAditya Birla Capital. One trusted name you can
rely on to understand and meet all your money needs throughout your life.
While you have availed our Protecting solution through Motor Insurance under the TVS Insurance Program, Aditya Birla Capital also
ŽīĞƌƐƚŽŚĞůƉLJŽƵŝŶ/ŶǀĞƐƚŝŶŐƉƌƵĚĞŶƚůLJĨŽƌLJŽƵƌĨƵƚƵƌĞƚŽĞŶĂďůĞLJŽƵƚŽůŝǀĞƚŚĞůŝĨĞLJŽƵĂƐƉŝƌĞ͖&ŝŶĂŶĐŝŶŐLJŽƵƌůŝĨĞ͛s immediate
desires and fueling your ambitions without having to wait; and in Advising the right solutions for your needs throughout your life.

We assure you of the best customer service always. Looking forward to a long and successful journey ahead!

Yours sincerely,

Aditya Birla Insurance Brokers Limited

 ICICI Lombard General Insurance Co. Ltd.
Bundled - Two wheeler Policy
Receipt Number: 180721247632
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989) UIN - IRDAN115RP0007V01201819
Policy No 3005/TV-16333971/00/000 Proposal No. & Date PT18813924, 28 Jul 2021
Policy Issued On 28 Jul 2021 11:28AM Period of Own Damage 28 Jul 2021 11:28AM to 27 Jul 2022 11:59PM(Midnight)
Period of Liability 28 Jul 2021 11:28AM to 27 Jul 2026 11:59PM(Midnight)
Insured Name MR. JATINDER SINGH Previous Policy No. NA
Insured Add. HMAYUPURA HIMAYUPURA LUDHIANA , Previous Insurer NA
LUDHIANA , PUNJAB-142022 ,GSTIN No:N/A
Nominee Name Age 0 Relation --Select--
Servicing Office of Insurer: TF 1 - 5, Third Floor, 88, The Mall, The Mall, Ludhiana, Punjab 141001, , ,LUDHIANA , PUNJAB-141001 (State Code-03)
PAN: AAACI7904G GSTIN : 03AAACI7904G1ZX
Make Model-Variant Cubic Capacity/KW Manufacturing Year Seating capacity
TVS JUPITER BSVI 110.000 2021 2
Body Type Registration No. RTO Hypothecation/Lease* Fuel Type Chassis No.
SOLO New LUDHIANA Yes PETROL MD626CG53M3G01946
Engine No. Invoice Date Vehicle IDV Elec. Accessories Non-Elec. Accessories Total IDV
CG5GM3700592 28 Jul 2021 64,407 0 0 64,407
Schedule of Premium (Amount in Rs.)
Own Damage Premium (A)
Amount (Rs.) Amount (Rs.)
Basic Premium Discounts
Vehicle 864 Voluntary Deductibles (0) (IMT-22A) 0
Elec. Accessories (IMT-24) 0 Anti Theft Device (IMT-10) 0
Non-Elec. Accessories (IMT-24) 0 AA Membership (IMT-8) 0
Sub Total (Basic Premium) 864 No Claim Bonus (0%) 0
Geographical Area Extension (IMT-1) 0 Handicap Discount (IMT-12) 0
IMT 33 0 Sub Total (Deductibles) 0
Sub Total-Addition 864 Add On Coverages (Zero Dep ) 290
Net Own Damage Premium (A) 1,154
Liability Premium (B)
Basic Third Party Liability (Including TPPD) 3,285 PA Cover For Owner Driver of Rs. Rs. 0 (IMT-15) 0
Third Party Liability Geographical Area Extension 0 PA Cover ( 0 Per Person) for 0 Persons(IMT-16) 0
Third Party Liability For Bi-Fuel Kit 0 Sub Total (PA Cover) 0
Legal Liability For Paid Driver (IMT - 28) 0
Net Liability Premium (B) 3285
Total Premium(A+B) 4,439
SGST (9%)
400
CGST (9%) 400
Gross Premium Paid 5,239

2.The Stamp duty µpaid vide deface no. CSD0820211460 dated Apr 12, 2021. Same need not to mention for policies
Note: 1.Policy issuance is subject to realization of cheque
being issued for the State of Jammu & Kashmir.
4.Geographical Area-India
3.The policy is subject to compulsory deductible of Rs.100 (IMT-22)
*Subject to IMT Endt. Nos.& Memorandum:7,22
Insured Declared Value : The schedule of age-wise insured declared value(IDV) as shown in the below table is applicable for the purpose of Total loss including Theft/Constructive Total Loss(TL/CTL)
claims only on basis of loss date falling in the respective year. A vehicle will be considered to be a CTL, where the aggregate cost of retrieval and/or repair of the vehicle subject to terms and conditions of
the policy exceeds 75% of the IDV.
Tenure 28 Jul 2021 to 27 Jul 2022 - - - -
Total IDV 64407 0 0 0 0
Limitations as to use: The policy covers use of the vehicle for any purpose other than (1) Hire or Reward (2) Carriage of goods (other than samples or personal luggage) (3) Organized racing (4) Pace
making (5) Speed testing (6) Reliability trials (7) Any purpose in connection with motor trade.
Driver¶s Clause: Any person including the insured: Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such
license. Provided also that the person holding an effective learner¶s license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central Motor Vehicle Rules, 1989.
Limits of Liability Clause: Under Section II-1(i) of the policy-Death of or bodily injury: Such amount as is necessary to meet the requirements of the Motor Vehicle Act 1988.Under Section II-1 (ii) of the
policy-Damage to third party property is Rs.1 lakhs PA Cover Under Section III for Owner-Driver is Rs. Rs. 0, TPPD 2 Sum Insured - 6,000.
No Claim Bonus: No Claim Bonus will only be allowed, provided the policy is renewed within 90 days of the expiry of the previous policy. No Claim Bonus is subject to no claim on the previous policy.
Benefits under the policy stands forfeited if claim is/was made in previous policy
Grievance Clause: For resolution of any query or grievance, Insured may contact the respective branch office of the company or may call at(18002666)or may write an email at
(customersupport@icicilombard.com). In case the insured is not satisfied with the response of the office, insured may contact the Grievance Officer of the Company at(customersupport@icicilombard.com)
.In the event of unsatisfactory response from the Grievance Office, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of Insurance
Ombudsman offices are available at IRDA website:www.irda.gov.in , or on the website of General Insurance Council:www.gicouncil.in or on the company websitewww.icicilombard.com. The policy
wording with detailed terms, conditions and exclusions are available on our websitewww.icicilombard.com.
Hypothecation Details: SHRIRAM CITY UNION FINANCE LIMITED , LUDHIANA - LUDHIANA MISP Code: AB-MTS003435, MISP Name: G.N MOTORS ,DP Name: MADHUMEET
KAUR, DP Code: AB-DPTS002303-8750
Important Notice: The insured is not indemnified, if the vehicle is used or driven otherwise than in accordance with the schedule.Any payment made by the company by reasons 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 & 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.
SAC: 997134 Description of service : Motor Insurance Place of supply: PUNJAB(State Code-03) Insurer invoice number : 180721247632
I/we hereby certify that the policy to which this certificate relates as well as this certificate of insurance are issued in accordance with the provisions of Chapter X and Chapter XI of Motor Vehicle Act,
1988
For & On Behalf of ICICI Lombard General Insurance Co. Ltd.

Authorized Signatory
Broker Name & Add :Aditya Birla Insurance Brokers Limited,One World Centre, Tower-1, 7th floor, Jupiter Mill Compound, 841, Senapati Bapat Marg, Elphinstone Road, Mumbai 400013 . Broker
Code :10000001926

For Renewal/Claims assistance - please contact Insurance.Co./Broker through : G N MOTORS LUDHIANA at 0-94150341,9415034157
Introduction to Motor Insurance Policy Schedule of Depreciation for fixing IDV of the vehicle

A Motor Insurance Policy is mandatory under the Motor Vehicle Act Age of the vehicle % of Depreciation
ensuring s that the car owner is protected from financial losses,
caused by damage or theft to the vehicle and third party liability.
Not exceeding 6 months 5%
What does the policy cover?
ŶLoss or damage to your vehicle or the accessories due to: Exceeding 6 months but not exceeding 1 year 15%

- Natural Calamities: Fire, explosion, self ignition or lightning, Exceeding 1 year but not exceeding 2 years 20%
earthquake, flood, typhoon, hurricane, storm, tempest,
inundation, cyclone, hailstorm, frost, landslide, rockslide.
Exceeding 2 years but not exceeding 3 years 30%
- Man-made Calamities: Burglary, theft, riot, strike, malicious
act, accident by external means, terrorist activity, any damage
in transit by road, rail, inland waterway, lift,elevator or air, etc. Exceeding 3 years but not exceeding 4 years 40%

ŶPersonal Accident cover for individual owners of the vehicle

Exceeding 4 years but not exceeding 5 years 50%
while driving.
ŶPersonal Accident cover for individual owners of the vehicle IDV for the vehicle of age exceeding 5 years would be determined mutually by
while driving. insurer and insured
ŶLegal Liability due to accidental damage for Schedule of Depreciation for parts replaced
- Any permanent injury/death of a person 50% for all rubber/nylon/plastic parts, tyres, tubes, batteries and air bags

- Any damage caused to the property. 30% for all fiber glass components

ŶTowing charges up to Rs. 300 Nil for all parts made of glass

Optional Extensions In the case of painting, the depreciation rate of 50% shall be applied only on the
material cost of total painting charges.In the case of a consolidated bill for painting
charges,the material component shall be considered as 25% of
total painting charges for the purpose of applying the depreciation.(Applicable for
ŶLoss of Electrical/Non-Electrical accessories policies with risk inception date on or after 1st February 2013)

For all other parts depreciation rate is applicable as following:

ŶPersonal Accident cover for the occupants

Age of the vehicle % of Depreciation

Not exceeding 6 months Nil

Other Salient Features Exceeding 6 months but not exceeding 1 year 5%

ŶNo Claim Bonus available on subsequent renewals in lieu of

Exceeding 1 year but not exceeding 2 years 10%
claims free experience

ŶDiscount for opting higher voluntary excess Exceeding 2 years but not exceeding 3 years 15%

ŶDiscount for installation of approved anti-theft devices Exceeding 3 years but not exceeding 4 years 25%

ŶDiscount for AAI membership Exceeding 4 years but not exceeding 5 years 35%

ŶPremium Concession for specially designed/modified vehicle

Exceeding 5 years but not exceeding 10 years 40%
for blind, handicapped and mentally challenged persons
ŶDepreciation is applicable for the parts needing replacement in
Exceeding 10 years 50%
accident

What is not covered in the policy? Addon Cover(s)

ŶMechanical/Electrical breakdown, manufacturing defect 1. Zero Depreciation - If opted, the benefits and exclusions applicable as per insurance
ŶConsequential loss, depreciation, wear & tear company's rules & regulations.
ŶAny contractual liability 2. Return to Invoice / Total Cover / New Vehicle Replacement - If opted the benefits &
ŶIntoxicated driving exclution applicable as per Insurance Company's rules and
ŶDeliberate accidental loss regulations .
ŶDamages due to nuclear weapons material or war
ŶAccidents outside the Geographical Area Additional Deductible
ŶPolicy Excess For multi-year policy (2/3 Years),Rs 500 or 5% of the claim value whichever is lower
for third admissible claim in the policy tenure.Rs 1000 or 10% of claim value
whichever is lower for 4th or subsequent admissible claims during the policy tenure.

The details furnished above do not constitute the entire terms & conditions.
For details please refer to insurance company's Policy Document on insurance
company's website www.icicilombard.com