NOTE

I/We declare that the rate of Ncb Claimed by Me/Us is correct. I further undertake that if this declaration is found to be incorrect, than all benefits under the policy with respect to own damage will stand forfeited. I hereby agree to confirm within 7 days in case of any objection or disagreement with the above on 1800-419-419-9

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AHD-0202936-01

MAGMA HOUSE, 24 PARK STREET , KOLKATA -700016

COMMERCIAL VEHICLE CLASS (GCV) PACKAGE POLICY CERTIFICATE OF INSURANCE CUM SCHEDULE
IMPORTANT - 1) The Validity of this Certificate of Insurance cum Schedule is subject to realisation of the premium cheque. 2) No Claim Bonus will only be allowed provided the Policy is renewed within 90 days of the expiry date of the previous policy. Policy Servicing Office 1st Floor, Suncity House, Mithakali Six Road, Ahmedabad-380006 AHMEDABAD - 380006 GUJARAT PH: FAX: Policy No P0014200007/4103/155492 Period Of 00:00 Hrs of From Geographical Area India Insurance 26/06/2013 SUNRISE LOGISTICKS Insured Midnight of To Address PROP TUSHAR N PATEL, NR RAMJI MANDIR HIGHWAY 25/06/2014 ROAD, AT SANAND Agent No BRC0000011 382110 AHMEDABAD GUJARAT Business / Covernote No None Profession Covernote Date Contact Number 9123456789 PG/IR No. Zone Zone-C Carrying on or engaged in the business or occupation of and no other for the purposes of this Insurance INSURED MOTOR VEHICLE DETAILS AND PREMIUM COMPUTATION Licensed Carrying Registration Mark Year of Public/Private Engine No. Chassis No. Make/Model/Type of Body CC/HP/GVW capacity including & No. Manufacture Carrier Driver GJ - 01 - CZ 2012 400510 D2026 ASHOK LEYLAND/2516/OPEN 25000 Public Carriers 5 2092 IDV (INSURED'S DECLARED VALUE) Non Electrical Electrical/electronic Bi-Fuel kit(LPG/CNG) Other IDV of Chassis IDV of Body Trailers Total Value Accessories Accessories accessories 1770000 300000 0 0 0 0/0 0 2,070,000.00 A-OWN DAMAGE B-LIABILITY Own Damage Premium on vehicle and accessories Basic Cover Basic - OD EXTENSIONS UNDER OWN DAMAGE SECTION Loss/damage to lamps/tyres/mud guards etc. - IMT-23 DISCOUNTS UNDER OWN DAMAGE SECTION No claim bonus 20% TOTAL OWN-DAMAGE PREMIUM Third Party Premium Basic Cover 21,188.63 Basic - TP Legal Liability 5,885.73 Under WC act-Driver/cleaner/employees-IMT 28 Liability to Workmen 5,414.87 TOTAL LIABILITY PREMIUM 21,659.00 TOTAL POLICY PREMIUM Service Tax(Including education cess & higher education cess) TOTAL 50.00 100.00 15,124.00 36,783.00 4,546.38 41,329.00 14,974.00

Hire Purchase/ Lease /Hypothecated with INDUSIND BANK LTD LIMITATIONS AS TO USE - THE POLICY COVERS USE ONLY UNDER A PERMIT WITHIN THE MEANING OF THE MOTOR VEHICLES ACT, 1988 OR SUCH A CARRIAGE FALLING UNDER SUB-SECTION 3 OF SECTION 66 OF THE MOTOR VEHICLE'S ACT 1988. The Policy does not cover use for a) Organised racing, b) Pace Making, c) Reliability Trials, d) Speed Testing, e) Use whilst drawing a trailer except the towing (other than for reward) of any one disabled Mechanically propelled vehicle (only for Passenger Carrying Vehicles). Persons or classes of persons entitled Any person including Insured: to drive: 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 a license.Provided also that the person holding an effective learner's license may also drive the vehicle when not used for Goods carriage the transport of passengers at the time of the accident and that such a person satisfies the requirements of Rule 3 of The Central Motor Vehicles Rules, 1989. Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or Non-transport 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 passengers at the time of the accident and that such a person satisfies the requirements of Rule 3 of The Central Motor Vehicles Vehicles Rules, 1989. LIMITS OF LIABILITY Under Compulsory excess in Under In respect of any Under Section Damage to Third Party Property Rs. Under PA Owner Driver as per Section I respect of each and Section one accident -- As II-I (ii) 750000/- in respect of any one claim Section premium computation table every claim under Sec I II-I (i) per Motor Vehicle or series of claims arising out of one III: of motor policy : Rs. Act event. 1500/Subject to I.M.T Endorsement Nos. IMT 7,IMT 21,IMT 23,IMT 28,IMT 39 NOMINATION DETAILS Name Of the Nominee Date of Birth of Nominee Age of Nominee Address of Nominee Relationship Percentage

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 M.V. Act, 1988. In case of Claims, please contact us at 1-800 - 3002 - 3202 For Magma HDI General Insurance Co. Ltd. Date of Issue : 29/06/2013 Place : Kolkata Consolidated Stamps Duty on the issue of General Insurance Policies paid vide G.O. No 1598- F.T. dated 27/9/2012 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 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 be good. Service Tax Registration no : AAGCM1685CSD001

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RECEIPT

Receipt Number Receipt Date Business Channel

PIS/200007/14/100058057 29/06/2013

Received with thanks from

SUNRISE LOGISTICKS

(Customer ID : 20000121271) a total sum of Rupees Forty-One Thousand Three Hundred Twenty-Nine Only

Instrument Type CHEQUE

Instrument No. 132849

Date 24/06/2013

Bank Name HDFC BANK LTD.

Branch Name DARPAN SIX ROADS

Amount 41,329.00

Total Amount Rs.41,329.00

Note: * The insurance cover for the risk shall be as per the terms and conditions of the Insurance Policy as detailed in Policy Document.

* Receipt is Subject to realisation of cheque(s)

For & on behalf of

Magma HDI General Insurance Company Ltd.

Authorised Signatory

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