Policy 1

Royal Sundaram Alliance Insurance Company Limited"Vishranthi Melaram Towers" No. 2 / 319,Rajiv Gandhi Salai (OMR),Karapakkam,Chennai - 600097.Registered Office: 21, Patullos Road, Chennai 600 002.Toll : 1860-425-0000 Mobile: 94444 48899.email:[email protected], Website: www.royalsundaram.in

POLICY SCHEDULE [Reprint]

Policy No : VOC0249861000100

Insured Name : CHILUMALA LINGA REDDY .

Address : S/O PULLA REDDYBUGGABAI GUDEM (V)VEMULAPALLY (M).NALGONDAANDHRA PRADESH 000000Tel: Mobile:

Business or Profession :

Carrying on or engaged in the business or occupation of and no other for the purposes of this Insurance

Period of Insurance : From 12:00:00 Hrs on 07/03/2014To Midnight of 06/03/2015

The Vehicle :

Type OfVehicle

Registration Mark ,Number & Place of

Registration

EngineNumber

&ChassisNumber

Make&

Model

Typeof

Body

CubicCapacity

Year ofManufacture

GrossVehicleWeight(Kgs)

Licensedcarryingcapacityincluding

Driver

IDV(InsuredDeclaredValue)

(inRs)

AgriculturalTractors NALGONDA 39.1354/STA01434A

WXTA31419134123Swaraj735 FE 39 2014 0 2 520,600

Trailer ~~~ NEW TRAILER 2014 50,000

GeographicalArea :India

Name of Registration Authority :NALGONDA

LIMITATIONS AS TO USE: As per Motor Vehicles Rules, 1989

DRIVER:Any person including the Insured:Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding or obtainingsuch a licence.Provided also that the person holding an effective learner's licence may also drive the vehicle when not used for the transport of goods at thetime of the accident and that such a person satisfies the requirements of Rule 3 of The Central Motor Vehicles Rules 1989.

LIMITS OF LIABILITY:

Under Section II-1(i) of the Policy - Death of or bodily injury Such amount as is necessary to meet thererequirements of the Motor Vehicles Act, 1988

Under Section II-1(ii) of the Policy - Damage to Third Party Property Rs.750000/- in respect of any one claim or series ofclaims arising out of one event

Personal Accident Cover for Owner - Driver under Section IV Capital Sum Insured : Rs. 200000 /-Deductible under Section -I :Rs.2,853 in respect of each and every claim.(Compulsory Deductible[Rs.2,853] and Imposed Deductible[Rs.0])

NO CLAIM BONUS

The insured is entitled for a No Claim Bonus (NCB) on the Own Damage Section of the policy, if no claim is made or pending during thepreceding year(s), as per the following table:

Period of Insurance % of NCB on OD premiumThe preceding year 20Preceding Two consecutive years 25Preceding Three consecutive years 35Preceding Four consecutive years 45Preceding Five consecutive years 50

No Claim Bonus will only be allowed provided the policy is renewed within 90 days of the expiry date of the previous policy.Signed at Chennai on 12/03/2014

For Royal Sundaram Alliance Insurance Company Limited

000 Authorised Signatory3ed031c43534a07450f05c13bc936405To prefer a claim in the event of accidental damage to your vehicle, JUST CALL US @ From 8.00 am to 8.00 pm Monday – Saturday -(Karnataka) - 98455 11123, (Tamilnadu) - 99406 11123, (Kerala) - 99953 11123, (Andhra Pradesh) - 99493 11123, (North ) - 99102 11123,(East) - 98313 11123, (Maharashtra) - 98190 11123 and (Gujarat) - 99741 11123.

After 8.00 pm to 8.00 am Monday - Saturday / Sunday and Holidays - 24 Hrs " 99404 11123 "

IRDA Regn. No. 102


MISCELLANEOUS AND SPECIAL TYPE OF VEHICLEPREMIUM COMPUTATION TABLE

Policy No. I N S U R E D'S D E CLAR E D V A L U E (IDV) [ in Rs.]

VOC0249861000100

For theVehicle

Fortrailers

Nonelectrical

accessories

Electrical/Electronic/Implements

accessories

Value ofCNG/LPG kit

Total Insured's DeclaredValue

520,600 50,000 0 0 0 570,600

A. OWN DAMAGE B. LIABILITY

Basic premium on Vehicle and Accessories Basic premium including premium for TPPD

Vehicle & Non ElectricalAccessories Rs. 6,195.14 Vehicle Rs. 1,750.00

TPPD restricted to statutory limit ofRs.6000/- (Endt. IMT. 20) Rs. 0.00

Electrical & Electronic accessories@ 4% (Endt. IMT-24) Rs. 0.00 Trailers ( IMT 48 ) Rs. 1,023.00

Bi-fuel kit (CNG) @ 4% -Endt.IMT-25 Rs. 0.00 Bi-fuel kit (CNG / LPG) Endt. IMT-25 Rs. 0.00

Total Rs. 6,195.00 Total Rs. 2,773.00Add: Add:

Personal Accident Benefitsa) Trailer Rs. 525.00 a) Under Section IV Rs. 100.00b) Overturning risk (IMT 47) Rs. 0.00c) Geographical Area Extn.(Endt. IMT-1) Rs. 0.00 b) PA to Paid Driver/ Cleaners Endt.

IMT-17 Rs. 0.00

d) Cover for Lamps, Bumpers,etc.Endt. IMT - 23 Rs. 0.00 Legal Liability

e) Fibre glass Tanks Rs. 0.00 c) To Paid Driver/ Cleaner (IMT 28) Rs. 50.00f) 60% on OD Premium forDriving Tution Rs. 0.00 d) To Coolies (IMT 39) Rs. 200.00

g) for any other Extra Rs. 0.00 e) Legal Liability to employees(IMT 39A) Rs. 0.00

h) ImplementsAccessories(IMT-59) Rs. 0.00 f) NFPP - Employees Endt. (IMT-37) Rs. 0.00

i) Hire or Reward (IMT-44) Rs. 0.00 g) NFPP Other than Employees Endt.(IMT-37A) Rs. 0.00

Sub Total (Additions) Rs. 525.00 h) To Passengers in Ambulance(IMT 46) Rs. 0.00

Less : i) Hire or Reward Rs. 0.00j) 50% Discount for Vehiclesspecially designed/modified forblind, handicapped and mentallychallenged persons.(IMT 12)

Rs. 0.00

k) Voluntary Deduction Discount Rs. 0.00 Sub Total (Additions) Rs. 350.00l) Usage within InsuredsPremises(IMT 13) Rs. 0.00

m) Discount for Anti-theft DevicesEndt. IMT-10 Rs. 0.00 TOTAL LIABILITY PREMIUM(B) Rs. 3,123.00

n) Deduct 0% NCB Rs. 0.00 PACKAGE PREMIUM (A + B) Rs. 9,843.00Sub Total (Deductions) Rs. 0.00 Add: % Underwriter Loading Rs. 0.00

Add: % Underwriter Loading Rs. 0.00 Less : Special Discount Rs. 0.00NET PREMIUM Rs. 9,843.00

Add: Additional Cover for PackagePolicies

1) Depreciation WaiverClause(RSMOAC701) Rs. 0.00 Add: Service Tax Rs. 1,181.00

2) WindShield Clause(RSMOAC702) Rs. 0.00 Education Cess Rs. 36.00

TOTAL OWN DAMAGEPREMIUM (A) Rs. 6,720.00 TOTAL PREMIUM PAYABLE Rs. 11,060.00

Subject to IMT Endt. Nos. & Memorandum: 7, 21, 28, 39, 48 Printed herein /attached heretoUnder Hire Purchase / Hypothecation /Lease Agreement with CHOLAMANDALAM INV & FIN CO LTD, CHENNAIDate and signature of proposal 12/03/2014In Witness whereof this Policy has been signed at Chennai on 12/03/2014In lieu of Cover Note No. CVL0384439 Date 07/03/2014 Receipt No CBCMOR1761257

Consolidated Stamp Duty Paid to Govt of TamilNadu For Royal Sundaram Alliance Insurance Company Limited

000 Authorised Signatory.IMPORTANT NOTICE:The Insured is not indemnified if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by the Company by reasonof wider terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the Insured. See the clause headedAVOIDANCE OF CERTAIN TERMS AND RIGHT OF RECOVERY.For Legal interpretation, English version will hold good.Service Tax No. AABCR7106GST001 PAN Number : AABCR 7106G

3ed031c43534a07450f05c13bc936405To prefer a claim in the event of accidental damage to your vehicle, JUST CALL US @ From 8.00 am to 8.00 pm Monday – Saturday - (Karnataka) - 9845511123, (Tamilnadu) - 99406 11123, (Kerala) - 99953 11123, (Andhra Pradesh) - 99493 11123, (North ) - 99102 11123, (East) - 98313 11123, (Maharashtra) -98190 11123 and (Gujarat) - 99741 11123.


IRDA Regn. No. 102


MISCELLANEOUS AND SPECIAL TYPE OF VEHICLECERTIFICATE OF INSURANCE

Policy No. VOC0249861000100 Certificate No. VOC0249861000100

Particulars of Vehicle insured:

TypeOf

Vehicle

RegistrationMark ,

Number& Place ofRegistration

Engine Number&

Chassis Number

Make&

Model

Year ofManufacture

TypeOf

Body

GrossVehicleWeight(Kgs)

PublicCarrier /PrivateCarrier

NetPremium

(inRs)

AgriculturalTractors NALGONDA

39.1354/STA01434AWXTA31419134123

Swaraj735 FE 2014 0 Private

Carrier 11,060

Trailer ~~~ NEW TRAILER 2014

Geographical Area : India

Name of Registration Authority : NALGONDA

Registration Date : 07/03/2014

Name & Address of the Insured : CHILUMALA LINGA REDDY .S/O PULLA REDDYBUGGABAI GUDEM (V)VEMULAPALLY (M).NALGONDAANDHRA PRADESH 000000

Effective date & time of Commencement of Insurancefor the purpose of Act

: From 12:00:00 Hrs on 07/03/2014

Date of expiry of the Insurance : To midnight of 06/03/2015

Persons or Classes of Persons entitled to drive:Any person including Insured:

Provided that a person driving holds an effective driving licence at the time of the accident and is not disqualified from holding orobtaining such a licence.

Provided also that the person holding an effective learner's licence may also drive the vehicle when not used for the transport of goods atthe time of the accident and that such a person satisfies the requirements of Rule 3 of The Central Motor Vehicles Rules, 1989.

LIMITATIONS AS TO USE:

The Policy covers use only for Agricultural & Forestry purposes.

The Policy does not cover use fora) Use for Hire or Reward, Racing, Pace making, Reliability trials or Speed testingb) Use for Carriage of passenger for hire or rewardc) Use whilst drawing a greater number of trailers in all than is permitted under law

I/We hereby Certify that the Policy to which this Certificate relates as well as this Certificate of Insurance are issued in accordance withthe provisions of Chapter X and Chapter XI of the Motor Vehicles Act, 1988.

Signed at Chennai on 12/03/2014

For Royal Sundaram Alliance Insurance Company Limited

000 Authorised Signatory3ed031c43534a07450f05c13bc936405

To prefer a claim in the event of accidental damage to your vehicle, JUST CALL US @ From 8.00 am to 8.00 pm Monday – Saturday -(Karnataka) - 98455 11123, (Tamilnadu) - 99406 11123, (Kerala) - 99953 11123, (Andhra Pradesh) - 99493 11123, (North ) - 99102 11123,(East) - 98313 11123, (Maharashtra) - 98190 11123 and (Gujarat) - 99741 11123.


IRDA Regn. No. 102

Documents

Policy 1