IFFCO - TOKIO GENERAL INSURANCE CO.

LTD Servicing Office:

Regd. Office: IFFCO SADAN,C1 Distt Centre,Saket,New Delhi- 110017 IFFCO TOKIO GENERAL INSURANCE COMPANY LTD

Fidelity Guarantee Policy Schedule 1ST. FLOOR COMMERCE HOUSE BUILDING

Cum Tax Invoice 7,RACE COURSE ROAD

ORIGINAL FOR RECIPIENT 452001, INDORE, MADHYA PRADESH

GST Applicable State Code: 23, GSTIN: 23AAACI7573H1ZK

General Insurance Services : 997139

Insured's Name : AMBIKA WAREHOUSE PROPRIETOR ANITA JAKHETIA

Address: VILLAGE: RAYATPURA, TEHSIL: DEPALPUR, DISTRICT: INDORE Unique Invoice No………….: 41090868

BETMA ,MADHYA PRADESH, 453001 INDORE Policy No…………………….: 41090868

BETMA KHURD , MADHYA PRADESH Pincode: 453001 Date of Issuance……………: 05/06/2024

State Code/ Place 23 Country Name: India GSTIN: Policy effective from 0001 hrs 31/05/2024

of Supply:

Phone Number: XXXXXXX697 C/N No: Agent No. 22002685 ITG To MidNight 30/05/2025

Aadhar No.:

Taxable Value CGST SGST IGST CESS

Rate 9.00 9.00 0.00 0.00

Amount 912.00 82.08 82.08 0.00 0.00

Total Tax ₹164.16 Total Value ₹1076.16

Whether GST is Payable on Reverse Charge Basis - No

We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate
turnover notified under sub-rule (4) of rule 48, we are not required to prepare an invoice in terms of the provisions of the said sub-rule.

The issuance of this Insurance Policy is subject to satisfactory verification of KYC documentation of the Client / Policyholder as per IRDAI
Master Circular dated 1st August 2022 on AML / CFT. In case, if any discrepancy is found in KYC Verification of the Client / Policyholder, it is
agreed by the Client / Policyholder to complete / rectify the discrepancy found in the KYC documents /information for the generation of CKYC
Number, failing which the policy will be considered ineffective / suspended / cancelled and no claim will be payable under this Insurance
Policy.

Location village rayatpura tehsil depalpur district indore betma

Madhya pradesh

Territorial Limits INDIA ONLY

Business Warehouse

Insured Employees Aggregate Sum Insured / Limit Of Guarantee

08 Un-Named Employees 3800000

Additional Details
Since the cover is on unnamed basis, the entire strength of

Signature Not Verified Fidelity Guarantee (UIN : IRDAN106P0009V01200102 )

Digitally signed by SUBRATA MONDAL Attaching to and forming part of Policy Number 41090868
Date: 2024.06.05 10:49:20 IST
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employees under the proposed category/designation has to be

covered.The insured must maintain daily attendance records

and make the same available on request. The policy is

subject to quarterly declaration and if it is discovered

that actual no of Employees in a category/designation are

more than the no of Employees noted in the policy schedule

against such category/designation, then the Insured shall

pay to the Insurer an additional premium for the increased

no. employees on the agreed per-capita rate

--

Excess: 5% of claim amount subject to minimum of Rs.10000/-

. on each and every claim

--

* Two door security should be maintained as per the MPWLC

guidelines and having 2 lock system of which keys are

available with 2 different persons, one with warehouse

person and other with NAN (Nagrik Apoorti Nigam) official

* 24 hours security

* Per person limit for Fidelity guarantee : INR 25 Lakh or

sum insured limit whichever is lower.

--

* HP - MADHYA PRADESH WAREHOUSING AND LOGISTIC CORPORATION

LTD

--

Communicable Disease Exclusion Clause: - Losses or damages

caused directly or indirectly due to any infectious or

contagious disease, pandemic /epidemics as declared by WHO

and / or Government of India will be an exclusion under this

policy as per the attached clause.

Agent Name and Phone No. HEDA, PRITI

Standard Warranties
1. Warrantied that for unnamed policy the entire Employees shall be covered and no selection would be allowed.
2. Warranted that for unnamed policy based on designation / Cadre the entire strngth of Empolyees pertainng to specific designation / cadre
shall be included.

The coverage is as per policy wordings / endorsements / clauses attached. Please go through the Fidelity Gurantee Insurance Policy and in case of any

discrepancy, please inform us.

Exclusion: Losses or damages caused directly or indirectly due to any infectious or contagious disease, pandemic /epidemics as declared by WHO and / or

Government of India will be an exclusion under this policy.

Signature Not Verified Fidelity Guarantee (UIN : IRDAN106P0009V01200102 )

Digitally signed by SUBRATA MONDAL Attaching to and forming part of Policy Number 41090868
Date: 2024.06.05 10:49:20 IST
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Toll Free : 1-800-103-5499 ; Other : ( 0124) 428-5499 ; SMS "claim" to 56161

Coorporate Identity Number(CIN): U74899DL2000PLC107621

Signature Not Verified Fidelity Guarantee (UIN : IRDAN106P0009V01200102 )

Digitally signed by SUBRATA MONDAL Attaching to and forming part of Policy Number 41090868
Date: 2024.06.05 10:49:20 IST
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 Fidelity Guarantee Policy Wording
This Policy is evidence of the Contract between YOU and US. The proposal along with any written statement(s), declaration(s) of YOURS for purpose of this Policy

forms part of this contract.

This Policy witnesses that in consideration of YOUR having paid the premium for the period stated in the Schedule or for any further period for which WE may

accept the payment for renewal of this Policy, WE will insure YOUR Interests as specified in the Schedule during the period of Insurance and accordingly WE will

indemnify YOU in respect of events occurring during the Period of Insurance in the manner and to the extent set forth in the Policy, provided that all the terms,

conditions and exceptions of this Policy in so far as they relate to anything to be done or complied with by YOU have been met.

The schedule shall form part of this Policy and the term Policy whenever used shall be read as including the Schedule.

Any word or expression to which a specific meaning has been attached in any part of this Policy or of Schedule shall bear such meaning wherever it may appear.

YOUR Policy is based on information which YOU have given US and the truth of these information shall be condition precedent to YOUR right to recover under

this Policy.

Definition of Words

1.Proposal

It means any signed proposal by filling up the questionnaires and declarations, written statements and any information in addition thereto supplied to US by YOU or

on YOUR behalf.

2.Policy

It means the Policy Booklet, the Schedule and any applicable endorsements or memoranda. YOUR policy contains the details of the extent of the cover available to

YOU, what is excluded from the cover and the conditions, warranties on which the Policy is issued.

3.Schedule.

It means the latest schedule issued by US as part of YOUR Policy. It provides details of YOUR Policy including full description of employees including

designation, occupation and duties of employees, which are in force and the period of cover YOU have against the employees described.

4.A Revised Schedule will be sent at each renewal and whenever YOU request for a change in the cover.

5.Sum Insured/Limit of Guarantee

It means the Monetary Amounts shown against any employee.

6.WE/OURS/US

It means THE IFFCO-TOKIO GENERAL INSURANCE COMPANY LTD.

7.YOU/YOUR

It means the person(s)/the Company/the entity named as Insured in the Schedule and is the employer.

8.Employer

It means any person, partnership firm or any body of persons whether incorporated or not with whom employee who is included in the Schedule as a contract of

Service.

9.Employee

A person named in the schedule of the policy as the employee.

10.Period of Insurance

It means the duration of the Policy as shown in the Schedule.

11.Loss/Lost:

It means the Damage or Loss.

12.Excess.

It means the first part of any claim for which YOU are responsible. Any Sum Insured/Limit will apply after the Excess has been deducted.

General Conditions

1. Notice

YOU will give every notice and communication in writing to OUR office through which this insurance is affected.

2. Misdescription

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Digitally signed by SUBRATA MONDAL Attaching to and forming part of Policy Number 41090868
Date: 2024.06.05 10:49:20 IST
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This Policy shall be void and all premium paid by YOU to US shall be forfeited in the event of misrepresentation, misdescription or concealment of any material

information.

3. Changes in Circumstances

Unless WE are advised and OUR written approval be obtained, WE shall not be liable under this Policy -

a) In the event of any change in the nature of YOUR business or if the duties and conditions of service of employee shall be changed or if the remuneration of the

Employee be reduced or its basis altered or if the precautions stated by YOU with regard to accounting be not duly followed or if YOU shall continue to entrust the

employee with the monies or goods after having knowledge of any fact bearing on the honesty of the employee.

b)In the event of Checks for securing accuracy of accounts and stocks stated in the proposal not being duly observed.

4. Identification of Employees

For the purpose of identifying employee in all cases of change of residence or occupation or change of name whether by marriage or otherwise, due notice thereof

in writing shall be given by YOU, to US.

5. Claim Procedure and Requirements

Upon happening of an event giving rise or which may give rise to a claim

a)You or YOUR authorised representative shall forthwith give notice in writing to OUR nearest office with a copy to Policy issuing office with full particulars. A

written statement of the claim will be required and a claim form will be provided. This written statement of claim alongwith supporting documents i.e. proofs,

information and other evidences (verified by statutory declaration if so required) relating to the claim alongwith particulars of other Insurances covering the same

risk must be delivered to US at YOUR expenses within 14 days of discovery of loss.

b)YOU shall lodge a complaint with the Police at the earliest after happening of the incident and take all practicable steps to apprehend the guilty person and

prevent further loss.

6. Claim Control and Subrogation

a)WE are entitled to

i)Receive all information, proof of loss and assistance from YOU and any other person seeking benefit under the Policy.

ii)Take proceedings at OUR own expenses and for OUR own benefit, but in YOUR name to prosecute all claims and exercise all rights of action competent to YOU

against the employee in respect of any act insured against in connection with which WE might make payment under this policy and YOU shall give to US all such

information and assistance as may be reasonably required for maintaining such claims or rights.

iii)Send OUR Authorised Representative in case of any loss to YOU and YOU will permit him/her at all reasonable times to examine into circumstances of such

loss and YOU shall on being required to do so by US produce all books of accounts, receipts and documents relating to or containing entries relating to the loss in

his/her possession and furnish copies of or extracts from such of them as may be required by US so far as they relate to such claims or will in any assist US to

ascertain the correctness thereof or OUR liability under this Policy.

b)YOU shall if and when required by US, give information and furnish evidence to the Criminal Authorities of any act or acts insured against committed or supposed

to have been committed by any employee in consequence of which a claim may be made under this Policy and YOU shall if so required by US, forthwith prosecute

the employee for such acts subject to the payment by US in the event of a conviction of all expenses necessarily incurred by YOU in such prosecution.

c)YOU shall if and when required by US but at OUR expenses if a conviction be obtained, use all diligence in prosecuting any of the employee to conviction for any

act which such employee shall have committed and in consequence of which a claim will have to be made under such Policy and shall at OUR expenses give all

information and assistance to enable US to use for and obtain reimbursement by any such employee by reason of whose acts or defaults a claim has been made

or by the estate of such employee or money which WE shall have become liable to pay in respect thereof.

d)It is also provided that an amount equal to any salary or commission which but for the acts on which the claim shall be found would have become payable by

YOU to the employee in respect of whom the claim is made hereunder or any other money which shall be due to such employee from YOU shall be deducted from

the amount payable under this Policy and all money, estate and effects of such employee in the hands of or received or possessed by YOU and all sums which

may be or may prior to the settlements of claims become due from YOU to the employee and also all moneys or effects which shall come into YOUR possession

or power for or on account of such employee after discovery of any act on part of such employee in respect of which any claim shall be made on this Policy shall

be applied by YOU in and towards making good the amount to his/her claim under this Policy in priority to any other claim to YOU upon such monies, estate or

effects.

Signature Not Verified Fidelity Guarantee (UIN : IRDAN106P0009V01200102 )

Digitally signed by SUBRATA MONDAL Attaching to and forming part of Policy Number 41090868
Date: 2024.06.05 10:49:20 IST
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7. Limit of Liability

OUR liability under this Policy and/or any other Policy in respect of any defaulting employee shall not exceed the amount of Indemnity mentioned against his name.

8. Fraud

If any claim under this Policy is fraudulent in any respect with or without YOUR knowledge or if any fraudulent means or devices are used by YOU or on YOUR

behalf to obtain any benefit under this Policy, all benefits and rights under the Policy shall be forfeited.

9. Contribution

If YOU are or will hereafter be guaranteed by any other person, society or company or hold other security or Insurance against such loss as is hereby guaranteed

against, WE shall bear the loss in rateable proportion only.

10. Cancellation

WE may cancel this policy by sending 7 days notice in writing by Regd.A.D. to YOU at YOUR last known address. YOU will then be entitled to a pro-rata refund of

premium for the unexpired period of this policy from the date of cancellation, which WE are liable to repay on demand. YOU may cancel this Policy by sending

written Notice through Registered A.D. to US. WE will then allow a refund after the premium based on the following retaining table

Period of Cover Rate of Premium to be retained

Upto one month 25% of Annual Rate

Upto three months 50% of Annual Rate

Upto six months 75% of Annual Rate

Preceeding Six Full Annual Rate

11. Adjustment of Premium

If any part of premium or renewal premium is based on estimates furnished by YOU, YOU shall keep an accurate record containing all relevant particulars and shall

allow US to inspect such record. YOU shall within one month after expiry of each period of insurance furnish such information as WE may require. Premium or

renewal premium shall there upon be adjusted and the difference will be paid or allowed to US.

12. Renewal Notice

WE shall not be bound to accept any renewal premium or give notice that such renewal is due. Every Renewal premium which shall be paid and accepted in

respect of this Policy shall be so paid and accepted upon the distinct understanding that no alteration has taken place in the facts contained in the proposal herein

before mentioned and that nothing is known to YOU that may result to enhance OUR risk under the guarantee hereby given.

13. Scope of the Policy

What is covered What is not covered

WE will indemnify YOU against loss sustained by reason of any act of WE shall not be liable:

fraud/dishonesty committed by the Employee in connection with their/his/her "a) to pay more than one claim in respect of acts of any one of the

employment as specified in the Schedule hereto during uninterrupted Service with Employees.

YOU and within retroactive period as defined elsewhere in the Policy and discovered "b) In Retroactive period of Cover:

during the continuance of this Policy or within twelve months after the death, i) For losses not discovered within the period of Insurance

dismissal or retirement of such employee or within twelve months after this Policy has ii) In the event of non renewal or cancellation of this Policy, for losses not

ceased to exist as regards such employee whichever of these events shall first discovered within twelve months next following the date of expiry or the

happen. date of cancellation as the case may be (provided only that if there be any

other insurance in force during the said twelve months whether effected by

YOU or on YOUR behalf or otherwise, this Policy shall not cover or

contribute to any loss covered by such other insurance). The reinstatement

provision will not apply to such losses discovered within twelve months

from the date of non-renewal or cancellation.

iii) For losses not sustained in within a retroactive period, not exceeding

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Digitally signed by SUBRATA MONDAL Attaching to and forming part of Policy Number 41090868
Date: 2024.06.05 10:49:21 IST
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 two years from the date of discovery of any such loss or losses.

"Provided that in such retroactive period, the insurance was continuously in

force but in no event, WE shall be liable to pay any claim in respect of loss

sustained prior to the inception of the original Policy.

Further it is also provided that losses which become payable under this

clause shall be subject to the terms, conditions, exception of the Policy in

force on date of discovery or in case of non renewal / cancellation, on the

last date when such policy was in force.

14.Arbitration Should any dispute arise between YOU and US on quantum of amount payable (liability being otherwise admitted by US), such dispute will

independently of all other questions be referred to the decision of Arbitrator(s) in accordance with statutory provision of the country in force at that time.Further, if

/ when any dispute is referable or referred to Arbitration, the making of an award by Arbitrator(s) shall be a condition precedent to any right of action by YOU

against US.

15. Disclaimer Clause If WE shall disclaim OUR liability in any claim, and such claim shall not have been made subject matter of a suit in a court of law within 12

months from the date of disclaimer, then the claim shall for all purposes be deemed to have been abandoned and shall not thereafter be recoverable under this

Policy.

Any of the circumstances in relation to these conditions coming to the knowledge of OUR any official shall not be the Notice to or be held to bind or prejudicially

affect US notwithstanding subsequent acceptance of the premium.

WE shall not be bound to notice or be affected by any notice of any trust, charge, lien, assignment or other dealing with or relating to any contract of Insurance but

the receipts of YOURS, YOUR legal personal representative shall in all cases be valid and effected discharge to US.

In the event of any transfer of interest except by death, this insurance shall cease unless expressly agreed to by US and endorsed herein.

16. Interest/Penalty No sum payable under this policy shall carry any interest or penalty.

PROVISIONS

1.Limit of liability

OUR liability shall not exceed

a) In respect of any Employee the Sum Insured stated against his/her name or as declared herein.

b) In all claims under this Policy, the total Sum Insured.

2. If the Policy shall be continued in force for more than the one period of Indemnity or if any liability shall exist on OUR part under this Policy and also under any

other Policy in respect of fraud or dishonesty of the employee, OUR liability shall not be accumulated or increased thereby, but OUR aggregate liability during any

number of periods of Indemnity and for any number of acts of frauds or dishonesty committed by the Employee shall not

exceed the Sum Insured hereunder or the Sum Insured under any other such Policy as aforesaid whichever is greater.

********************************************************************************************************************************************************

Signature Not Verified Fidelity Guarantee (UIN : IRDAN106P0009V01200102 )

Digitally signed by SUBRATA MONDAL Attaching to and forming part of Policy Number 41090868
Date: 2024.06.05 10:49:21 IST
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Reason: Valid Policy Copy
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