AAA Plus Risk Management Pvt Ltd REF

Address : 802-804, 8th Floor, Vijaya Building, Barakhamba Road, New Delhi 110001 NO. USGI99141922
Phone No.: 18001026425 Email : support@aaaplus.io

Insurer/Broker Company Reference No. Purpose Inspector Inspection Place

NA Preinspection RAHUL KUMAR 213 Meerut Uttar Pradesh India
Meerut Uttar Pradesh 250001

Request Date and Time Inspection Date and Time Proposer Requestor
24, May 2019, 04:22 PM 25, May 2019, 02:04 PM MOHD AYYAZ Krishna Anand Shn
Mishra

Commercial Vehicle
Inspection Status

RECOMMENDED
Vehicle No. UP15ET2793
Make eicher Model 10.9
Year 2015 Chassis No. C312631 Fuel Used Diesel
Color GOLDEN BROWN Engine No. C024690 Odometer 187122

Front Left & Right Others

Cowl Intact LT Side Body Intact Rear Indicator Lights Intact
Dashboard Intact RT Side Body Intact Front Excavator Missing
Bonnet Missing LT Rear View Mirror Intact Crane Bucket Missing
Grill Intact RT Rear View Mirror Intact Crane Hook Missing
Bumper Intact Boom Missing
Body Intact AC Missing
Indicator Lights Intact Fans Missing
Head Lights Intact Glass Hydraulic System Missing
Chassis Frame Intact
Windshield Glass Intact Fuel Tank Intact
LT Back Glass Missing Seats Intact
RT Back Glass Missing Tyres Average
Excavator Cabin Glass Missing Stepney Missing
Crane Cabin Glass Missing Roof Panel Intact
Undercarriage Intact
Floor Intact
Silencer Intact

Remark/Reason:
RC SEEN

Declaration of Owners:
I/We hereby confirm that the vehicle has been inspected in presence of me/my/our
representative.
I/We hereby confirm that the identification details and damages of vehicle as noted/
photographs taken by the inspecting officer are correct. Nothing has been hidden/undisclosed.
I/We agreed that Repair/Replacement of dented/cracked parts & repair painting of dented/
scratched panels as per inspection photograph shall be excluded in event of any claim lodged
during the policy period.
I here certify that I have shown the same vehicle which I have to get insured and if later at the
time of claim it is found that vehicle shown and accidental are different then no claim is payable
to me.
I here certify that I will not claim for damages existing in my vehicle whether same are
mentioned in report or not if same are seen in photograph taken by the inspector.

Customer Signature :

Executive Name : Suman QC Done by : KAUSHAL