CERTIFICATE CUM POLICY SCHEDULE

GCCV-PUBLIC CARRIERS OTHER THAN THREE WHEELERS PACKAGE POLICY - ZONE C

Issue Office: 10003-E - 8, RIICO INDUSTRIAL AREA SITA PURA -JAIPUR RAJASTHAN 302022 Tel Policy No : 10003/31/12/267749 Prev Policy No Insured's Code/ Name: 3187149 SURENDRAKUMARMISHRA Address: R/O 805/CIVIL LINES 228001SITA KANDSITAKUND SULTANPUR- UTTAR PRADESH Tel - Fax SULTANPUR Executive: NA0000000390 Broker Details :LC0000000002 M/S.R S I B P Ltd. Contact No: Period of Insurance : From 00:00 on 12/09/2011 To Midnight of 11/09/2012 Cvr Note No. Gross Premium: 17,835 Registration Mark & Place UP 44 F 9091 Sultanpur IDV For the Vehicle 5,52,698 Service Tax: 1,837 Total: 19,672 Type of Body STD Collection No & Dt BG Year Of Seating Capacity Cubic Capacity G. V. W Manf (Including Driver) 1 25000 2004 1+1 Total Value 5,52,698 Geographical Area

Issue date

Engine No Chassis No 40G62347711 426021HVZ006052 IDV For Trailers 0

Make - Model
TATA MOTORS LTD-2515 TC (STD)

Non Electrical Accessories

Electrical Accessories

CNG KIT SI 0

A. OWN DAMAGE BASIC OD COVER LESS :DETARIFF DISCOUNT ON BASIC OD LESS :NO CLAIM BONUS-GR27 OD TOTAL

SCHEDULE OF PREMIUM
13,625.00 2,725.00 3,815.00 7,085.00

B. LIABILITY 10,550.00 100.00 50.00 25.00 25.00 10,750.00 17,835.00 1,837.00 19,672.00

BASIC TP COVER ADD :GR36A-PA FOR OWNER DRIVER ADD :LL TO PAID CLEANER COUNT : 2 ADD :LL TO EMPLOYEES COUNT : 1 ADD :LL TO PAID DRIVER COUNT : 1 TP TOTAL TOTAL PREMIUM ADD :SERVICE TAX TOTAL AMOUNT

* NCB discount - 35 % Deductibles under Section-I : Compulsory Deductible Rs.1500 Subject to IMT Endorsement Printed herein/attached to : IMT-39 , IMT-40 , IMT-28 , IMT-21 SHRIRAM TRANSPORT FINANCE CO LTD, SULTANPUR, LUCKNOW, SULTNO003280003, Pin Code - Hypothecation Agreement with: Hire Purchase/Lease Agreement with: Limit of Liability
Under Section II-1(i) in respect of any one accident: as per Motor Vehicles Act, 1988. Under Section II-1(ii) in respect of any one claim or series of claims arising out of one event is Rs. 750000 P.A. Cover under Section III for Owner - Driver (CSI) : Rs. 200000

Driver's Clause
Any person including insured: Provided that a person driving holds an effective driving license at the time of the accident and is not disqualified from holding or obtaining such a license. Provided also that the person holding an effective Learner's license may also 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 Central Motor Vehicles Rules, 1989.

Limitations as to Use
Use only for carriage of goods within the meaning of the Motor Vehicles Act. The Policy does not cover: 1) Use for organised racing, pace-making, reliability trial or speed testing. (2) Use whilst drawing a trailer except the towing (other than for reward) of any one disabled mechanically propelled vehicle. (3) Use for carrying passengers in the vehicles; except employees (other than the driver) not exceeding the number permitted in the registration document and coming under the purview of Workmen's Compensation Act 1923. The insurance under this policy is subject to conditions, clauses, warranties, endorsements as per forms attached.Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and the policy shall be void abinitio (from inception). I/We hereby certify that the policy to which the certificate relates as well as this certificate of insurance are issued in accordance with the provision of Chapter X and Chapter XI of Motor Vehicles Act, 1988. In witness whereof the undersigned being authorised by and on behalf of the company has/have herein to set his/their hands at Head Office - III on 18-AUG-11 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 reason of wider terms appearing in the Certificate in order to comply with the MVAct, 1988 isrecoverable from the Insured. See the Clause headed "AVOIDANCE OF CERTAIN TERMS AND RIGHTS OF RECOVERY". POLICY IS SUBJECT TO EXCLUSION OF DAMAGES NOTED DOWN BY OUR AUTHORISED REPRESENTATIVE DURING THEIR INSPECTION. Preinspection Report: Not Applicable Note: In case of new vehicle, Insured have to submit registration documents within a period of 15 days from the date of issue of Registration Certificate of Vehicle.

Entered By Examined By

: : SVS0R144 Proposal Date : 18/08/2011 Date : 18/08/2011

For and on behalf of SHRIRAM GENERAL INSURANCE COMPANY LTD

Place : JAIPUR

All the Amounts mentioned in this policy are in Indian Rupees Service Tax Reg. No. AAKCS2509KST001 Authorised Signatory Page 1 of 1