-*- Demonstration Powered by HP Exstream 04/01/2019, Version 8.0.

301 64-bit (DBCS) -*-

Date : 02/04/2019
Policy No.: W0077078
shashank
1363 Nehru Kunj, GAIL Gaon, Dibiyapur,
Uttar Pradesh,
Auraiya, Pincode: 206244
Telephone(Mob) : 7902111161
Email Id : shashank.s2611@gmail.com
60053339 - IAG
Dear shashank
Welcome to the Future Generali Experience.
We thank you for choosing us for your insurance requirements. Your Policy No. is W0077078.
Our initiatives will provide you with the highest standards of service, convenience and quality in insurance and it is our endeavour to
constantly better your experience by innovating and evolving our basket of conveniences.
The policy has been issued on the basis of the proposal form. A copy has been enclosed for your reference. We would request you to
peruse the policy and satisfy yourself that it meets your requirements fully.
Please confirm that the proposal form contains the correct information and is signed by you.
In case of any service requirement, do call our care lines below:
1800-220-233, 1860-500-3333, 022-67837800.
Once again, thank you for choosing to insure with Future Generali and we look forward to being of service to you.
Assuring you of our best services at all times.
For Future Generali India Insurance Co. Ltd.

(Authorised Signatory)

Please review the communication address, email or contact nos. noted on this letter for correctness. In case of any change please contact our nearest
branch or call our care lines mentioned above. This will ensure you do not miss out on 'Service Updates' and 'Renewal Reminders'. Now you can buy
Health, Personal Accident, Travel, Home, Motor insurance & also renew your Future Generali Private Car Insurance policy online. Visit us at
www.futuregenerali.in
For any service request please sms SERVE to 9222211100. To provide feedback on our service, kindly sms HAPPY or UNHAPPY to 9222211100.
We will call you back.

Future Generali India Insurance Company Limited, Corporate & Registered Office: 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat
Marg, Elphinstone Road, Mumbai - 400013, Maharashtra. Care Line:- 1800-220-233, 1860-500-3333, 022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287.
-*- Demonstration Powered by HP Exstream 04/01/2019, Version 8.0.301 64-bit (DBCS) -*-

Tax Invoice

INSURED DETAILS
Policy Number : W0077078 Address of Service Provider: Off Code-10,Future Generali India Insurance Co
Ltd, 6th Floor, Tower - 3, Indiabulls Finance
Invoice Number : Center, Senapati Bapat Marg, Elphinstone Road,
Mumbai, Maharashtra, Pincode - 400013

Reverse Charge : No Area Code : CORPORATE OFFICE Branch Office

Name of Insured/Proposer : shashank FGI State Code :
Address : 1363 Nehru Kunj, GAIL Gaon, Dibiyapur, Auraiya, FGI GSTIN Number :
Uttar Pradesh, Pincode- 206244
Place of Supply (State Code): Intermediary Name \ Code : Direct
GSTIN / UIN Number : Date of Issue \ Invoice : 02/04/2019
Date
Period of Insurance : From 07:38 hours 02/04/2019 HSN : 997137
To Midnight of 01/04/2020 Nature of Service : General Insurance Service

Received with thanks from shashank a sum of ₹ 393.00 towards Premium on the above mentioned policy.

PARTICULARS TAX(%) PREMIUM ( ₹ )

Gross Premium 333.02
Add : IGST 18% 60.00
Add : GST Cess 1%
Total (Rounded to nearest rupee) 393.00

NOTE :
1. In case of payment by cheque, in the event of dishonour of cheque for any reason whatsoever, insurance cover provided under this receipt automatically stands
cancelled from the inception irrespective of whether a seperate communication is sent or not.
2. Excess amount, if any, will be adjusted against subsequent policies, or will be refunded on demand

For FUTURE GENERALI INDIA INSURANCE CO. LTD.

(Authorised Signatory)

Signature Not Verified

Digitally signed by DS Future
Generali India Insurance Co.
Ltd.
Date: 2019.04.02 15:42:39 IST
Location: Mumbai

Note:This document is digitally signed by Sharada Ramakrishnan, Authorised Signatory of Future Generali
India Insurance Company Limited on 02/04/2019
Future Generali India Insurance Company Limited, Corporate & Registered Office: 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat
Marg, Elphinstone Road, Mumbai - 400013, Maharashtra. Care Line:- 1800-220-233, 1860-500-3333, 022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287.
 Home Insurance - Policy Schedule
Policy Servicing Office : Off Code-10,Future Generali India Insurance Co Ltd, 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat Marg, Elphinstone
Road, Mumbai, Maharashtra, Pincode- 400013., Tel_No:
Policy No : W0082562 Period of Insurance : From 07:38 19/07/2019 To midnight of 18/07/2020
Insured : Anuj Gupta Intermediary Name/Code : Direct
Address : 3083, Phase 3, GAIL Gaon, Dibiyapur, , , , Telephone : 1800-220-233,1860-500-3333
Auraiya, Uttar Pradesh, 206244
GSTIN / UIN Number : FGI GSTIN Number :
URN Number : -
In considerationof the Policyholdernamed herein paying to the Future Generali India Insurance Company Limited (hereinaftercalled the Insurer) the premium as stated
in the Schedule and in reliance upon the statements made by the Policyholder in the proposal including its attachments or otherwise, and the material incorporated
therein, the Insurer agrees to provide insurance against loss damage liability or expense to the extent and in the manner herein provided subject to all terms, conditions,
exceptions and warranties hereinafter set forth.
Co-insurance Details Schedule of Premium ( ₹ )
Insurer Share (In %) Gross Premium 333.02
Future Generali India Insurance Company Limited 100% Goods and Service Tax 60.00
Total Premium 393.00
Risk Details
Property Situated at :
Occupancy : NA
Hypothecated with : N.A.
Plan Name : Home Secure
Serial
Description Sum Insured ( ₹ ) Excess
No.
I Contents - Fire and Allied 200000
Perils
II Burglary Contents 200000
III Terrorism cover 200000
IIII Contents - Fire and Allied 200000
Perils
V Burglary Contents 200000
VI Terrorism cover 200000
VII Electronic Equipments 29850
Additional Clauses, Conditions, Warranties & Exclusions
Terrorism Damage Clause
IMPORTANT - 1. All other Terms, Conditions and Exclusions as per attached Policy Wordings. 2. In case of payment by cheque, in the event of dishonor of cheque for
any reasonwhatsoever, insurance cover provided under this document automatically stands cancelled from the inception irrespective of whether a seperate
communication is sent or not.
For FUTURE GENERALI INDIA INSURANCE CO. LTD.

Date of Issue :19/07/2019

Place of Issuance : Mumbai*

*Address as mentioned below.

(Authorised Signatory)

Note:This document is digitally signed by Sharada Ramakrishnan, Authorised Signatory of Future Generali
India Insurance Company Limited on 19/07/2019
The stamp duty of Rs. 0.25/- paid by Letter Of Authorisation CSD/118/2018/3179/18, dated 16/08/2018. Mudrank - 2017/C.R.97/M-1,dated 09/01/2018.

Future Generali India Insurance Company Limited, Corporate & Registered Office: 6th Floor, Tower - 3, Indiabulls Finance Center, Senapati Bapat
Marg, Elphinstone Road, Mumbai - 400013, Maharashtra. Care Line:- 1800-220-233, 1860-500-3333, 022-67837800, Email: fgcare@futuregenerali.in,
Website: www.futuregenerali.in. IRDA Regn.No. 132, CIN - U66030MH2006PLC165287.