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Policy Schedule For Burglary (Single Location) Insurance: AJANTA ROAD, JALGAON-425003 (M.H), 454552

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THE NEW INDIA ASSURANCE CO. LTD.

(Government of India Undertaking)

POLICY SCHEDULE FOR BURGLARY (Single Location) INSURANCE

Insured's Name : M/S SPECTRUM ELECTRICAL INDUSTRIES LIMITED


Insureds Details Issuing Office Details
Customer ID : PO56197268 Office Code : DHAMNOD D.O. (451700)
Address : PLANT NO 4, J-76/1, MIDC AREA, Address : A.B.ROAD,
AJANTA ROAD, JALGAON-425003 (M.H)
,454552

JALGAON ,MAHARASHTRA, 425003


Phone No : Phone No : 07291222544 / 07291222244
E-mail/Fax : slibindore@gmail.com, / E-mail/Fax : nia.451700@newindia.co.in /
07291233486
PAN No : S.Tax Regn. No : AAACN4165CST178
GSTIN/UIN : 27AAUCS2152E1Z7 / NA GSTIN : 23AAACN4165C1ZZ
: SAC : 997139 (Other non-life insurance services
excl RI)

Policy Details
Policy Number : 45170046180100000083 Business Source Code
Period of Insurance : From: 02/01/2019 12:00:01 AM To: Dev.Off. : JAINUINE INSURANCE BROKERS PVT.
01/01/2020 11:59:59 PM level/Broker/Corp. LTD. - (DA3388757)
Agent JAINUINE INSURANCE BROKERS
PVT.LTD. (SI00028623)
Date of Proposal : 02-Jan-19 Agent/Bancassurance :
Prev. Policy no. : Phone No : 025722225747, / NA
Client Type : Non-Corporate E-mail/Fax : / / /

Financier(s) Details
Sl. No. Name of the Financiers
1 AXIS BANK LTD, JALGAON

Premium(`) GST(`) Total(`) Total (` in words) Receipt No. & Date


7112 1280 8392 RUPEES EIGHT THOUSAND THREE 4517008118000000894
HUNDRED NINETY-TWO ONLY 4 - 31/12/18
Location Details : Plant No 4, J-76/1, MIDC Area, Ajanta Road, Jalgaon-425003 (M.H)

First Loss Percentage : 25%


Details of assets covered under the Policy
Stocks in Trade
Sl. No. STOCK DETAILS Sum Insured
1 On the stock of Raw Material Metal, Zinc, Copper, Silver,& Other 1500000
Component &/or accessories

Goods held in Trust / Commision


Sl. No. GOODS HELD DETAILS Sum Insured
1 NA 0

Furniture / Fixture / Fittings


Sl. No. FURNITURE/FIXTURE/FITTINGS DETAILS Sum Insured
1 fff/ 41400

Office Equipments
Sl. No. OFFICE EQUIPMENT DETAILS Sum Insured
1 office equipment computer & periphery & other instrument 312824

Coins / Currency notes


Sl. No. COINS/CURRENCY/CURIOS DETAILS Sum Insured
1 NA 0

Signature Not
Verified
Digitally signed
by Srinivasan Policy No. : 45170046180100000083Document generated by 37217 at 01/01/2019 11:08:25 Hours.
Vaideswaran Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
Date: 2019.01.01
For 11:08:25
redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
IST
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

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THE NEW INDIA ASSURANCE CO. LTD.
(Government of India Undertaking)

Description of other item


Sl. No. OTHER ITEM DETAILS Sum Insured
1 plant machinery comp.&other itmes off.equipment 15226509

Add on Covers Sum Insured (`)


Other Extension NOT OPTED
Theft Extension NOT OPTED
Terrorism NOT OPTED

Special Conditions : 25% percent first loss basis policy issued


Excess : 10
This Policy shall subject to BURGLARY policy clauses attached herewith.

Premium and GST Details


Rate of Tax Amount in INR
Premium ` 7112.00
SGST 0 0
CGST 0 0
IGST 18 1280
In witness whereof the undersigned being duly authorised by the Insurers and on behalf of the Insurers has (have) hereunder
set his (their) hand(s)
on this 01st day of January,2019.

For and on behalf of


The New India Assurance Company Limited

Date of Issue: 01/01/2019

Duly Constituted Attorney(s)

Mudrank_____________Dt.___________consolidated Stamp Fees Paid by Pay Order Number_______________vide receipt


number___________dt.__________. Stamp Duty under the Policy is `1/-.

Tax Invoice No : 45170018E0003268

IRDA Registration Number: 190

Policy No. : 45170046180100000083Document generated by 37217 at 01/01/2019 11:08:25 Hours.


Regd. & Head Office: New India Assurance Bldg., 87 M.G. Road, Fort, Mumbai - 400 001. TOLL FREE No. 1 800 209 1415.
For redressal of your grievance, if any,you may approach any one of the following offices- 1. Policy issuing office 2. Regional office 3. Head office.In case, you are not satisfied with
our own grievance redressal mechanism; you may also approach Insurance Ombudsman. For details of our office addresses and addresses of office of Insurance Ombudsman, please
visit our website http://newindia.co.in.

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