Ref No.: GEN/WEL/SG/0008.

3/3615200500

Date: 19/08/2023

To,
MR. P R VAMSHI
: J 504 ARK HOMES BOLLARUM ALWAL, ALWAL, SECUNDERABAD, HYDERABAD, TELANGANA, 500010
TELANGANA
Hyderabad Ts - 500010
District: HYDERABAD TS
TELANGANA, India
Contact Details 7032457754

Policy number: 3615200500

Subject: Risk assumption for Kotak Car Secure

Dear MR. P R VAMSHI,

We welcome you to Kotak Mahindra General Insurance Company Limited and thank you for choosing us as your preferred service
provider.

This is with reference to your above mentioned Policy issued under Kotak Car Secure.

Enclosed please find the Policy Schedule outlining the details of your policy. Kindly note that the proposal is underwritten and policy is
issued based on the information submitted to us by you, as well as acceptance of the terms and conditions. Policy schedule must be read
in conjunction with the product brochure and policy wordings. Please visit https://www.kotakgeneralinsurance.com/customer-
support/downloads or scan above QR code for detailed policy wording.

We request you to carefully go through the same once again and in case of any disagreement, discrepancy or clarifications, please call us
on our toll free number 1800 266 4545 or write to us at [email protected] within 15 days from the date of this letter. Alternatively, you can
also write to us at 8th Floor, Zone IV, Kotak Infiniti, Bldg.No. 21, Infinity IT Park, Off WEH, Gen. AK Vaidya Marg, Dindoshi, Malad(E),
Mumbai – 400 097, India.

Please note that the information provided by you will be verified at the time of claim and the captioned Policy shall be treated as void in
case of any untrue or incorrect statement, misrepresentation, non-description or non-disclosure in any form whatsoever made by you or by
your agent, on your behalf, at any stage.

In case where premium is not received by us due to cheque dishonour or any other reason, the insurance cover shall be void ab-initio.

As a valued customer, we would like to provide regular updates on your policy through email and SMS. We therefore request you to keep
us updated of any change in your contact details.

Assuring you of our best services at all times.

Thanking you,

Yours sincerely,

For Kotak Mahindra General Insurance Company Limited

Authorised Signatory

Kotak Mahindra General Insurance Company Limited

CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
 Kotak Car Secure UIN:IRDAN152RP0006V02201516;
Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
 Kotak Car Secure
Comprehensive Policy
Certificate cum Policy Schedule
Policy / Certificate No: 3615200500
For any assistance please call 1800 266 4545 or visit www.kotakgeneralinsurance.com
INSURED DETAILS POLICY DETAILS

Name: MR. P R VAMSHI Policy Issuing Office: 201-204, 301 Chintamani Classique Vishweshwar Nagar,
Off Aarey Road Mumbai Maharashtra 400063.
Address: : J 504 ARK HOMES BOLLARUM ALWAL, ALWAL,
SECUNDERABAD, HYDERABAD, TELANGANA, Period of Insurance:
500010 TELANGANA Hyderabad Ts - 500010
From: 19/08/2023 00:00 to: 18/08/2024 Midnight
District: HYDERABAD TS TELANGANA(36), India
Type Of Vehicle: Private Car
Phone: NA
Policy issued on: 19/08/2023
Mobile: 7032457754
Cover Note No: NA
Email: [email protected]
Hypothecated to: POONAWALLA FINCORP LIMITED (5535)
GSTIN:

INTERMEDIARY DETAILS

CARS24 FINANCIAL SERVICES PRIVATE

Intermediary Code 2 3 5 6 1 1 0 0 0 0 Intermediary Name
LIMITED

Intermediary's Mobile No. Intermediary's Landline No. 1 8 0 0 2 5 8 5 6 5 6

VEHICLE DETAILS

Registration Manufacturer Model Variant Year of RTO Location Engine Vehicle Chassis/ Cubic Fuel Seating
Number Manufacture Number Trailer Chassis No. Capacity Type Capacity

TS08FB5870 HYUNDAI XCENT 1.2 VTVT 2016 MEDCHAL G4LAGM0917 MALA841CLGM193443F 1197 Petrol 5
MOTORS 08

Insured Declared Value Non - Electrical Electrical & Electronic Trailer (in ₹) CNG / LPG Kit Total Value of the
(IDV) of the Vehicle Accessories fitted to the Accessories fitted to the (in ₹) Vehicle
(in ₹) Vehicle (in ₹) Vehicle (in ₹) (in ₹)

3,45,000 0 0 0 0 3,45,000

PREMIUM COMPUTATION TABLE (IN ₹)

Section I Section II
Own Damage Liability
Basic Own Damage 4,488.10 Basic TP Including TPPD Premium 3,416.00
Legal Liability to Paid Driver 50.00
Total Liability Premium (B) 3,466.00

Section III
Personal Accident
PA Cover for Owner Driver of ₹ 15,00,000 330.00
PA Cover for Paid Driver ₹ 1,00,000/Per Person 50.00
Total Own Damage Premium (A) 4,488.10 Total Personal Accident Premium (C) 380.00
Taxable value of Services (A+B+C) 8,334.10
IGST @ 18% 1,500.14
Total Premium (in ₹ ) 9,834.00

Geographical Area INDIA Additional Excess ₹ 0 Compulsory Deductibles ₹ 1,000

Voluntary Deductible ₹ 0 Voluntary Deductible for Depreciation Cover ₹ 0 Total Deductible ₹ 1,000

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
NOMINEE DETAILS

*Nominee Name *Nominee Age *Relationship *Name of Appointee(if nominee is a minor) Relationship to the
Nominee

S GEETHA 57 Mother

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
CUSTOMER DECLARATION FOR CNG/ PNG KIT

I/ We agree and undertake to immediately inform the Company in case of change on account of addition of CNG/PNG kit and obtain necessary endorsement in the
Policy.

DISCLAIMER

For complete details on terms and conditions governing the coverage and NCB please read the Policy Wordings. This document is to be read with the Policy
Wordings(which are also available on the Company website i.e. www.kotakgeneralinsurance.com). Please refer to the claim form for necessary documents to be
submitted for processing the claim.

PUC DECLARATION

This policy has been issued subject to valid Pollution Under Control (PUC) Certificate/Fitness Certificate disclosed to our representative / declared by You prior to
commencement of risk under this policy and further undertaking to renew and maintain a valid PUC throughout the duration of the Policy.

LIMITS OF LIABILITY

Under Section II - 1(i) of the policy -> Death of or bodily injury: Such amounts is necessary to meet their requirements of Motor Vehicles Act, 1988.
Under Section II ­ 1(ii) of the policy ­> Damage to Third Party Property ₹ 7,50,000; PA Cover under Section III: for Owner Driver CSI ₹ 15,00,000

LIMITATIONS AS TO USE

Limitation as to use (Package Policy): The policy covers use of the vehicle for any purpose other than: (a) Hire or reward (b) Carriage of goods (other than samples or
personal luggage) (c) Organized racing (d) Pace making (e)Speed testing (f) Reliability trails (g)Use in connection with Motor Trade. Note: In case of vehicles used for
Driving Tuition the words “other than for the purpose of driving tuition” to be read after the words „hire or reward.

DRIVER'S CLAUSES

Any person including the insured: Provided that a person driving hold an effective Driving License at the time of accident and is not disqualified from holding or obtaining
such a license. Provided also that the person holding an effective Learners’ License may also drive the Vehicle and that such a person satisfies the requirements of Rule
3 of the Central Motor vehicles Rules 1989.

NO CLAIM BONUS SCALE

Number of Claims % of Discount on Own Damage Premium

No claim made or pending during the preceding full year of insurance 20%

No claim made or pending during the preceding 2 consecutive years of insurance 25%

No claim made or pending during the preceding 3 consecutive years of insurance 35%

No claim made or pending during the preceding 4 consecutive years of insurance 45%

No claim made or pending during the preceding 5 consecutive years of insurance 50%

*No Claim Bonus (NCB) is subject to no claim on the previous policy. Benefits under the policy will be forfeited if claim is/was made in previous policy. Please contact
our Customer Care team in case of wrong NCB % mentioned.

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 Policy 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 hold good.
Subject to I.M.T. Endt.Nos. & Memorandum 22, 17, GR36A, 28, 7 Printed/herein/attached hereto Under Hire Purchase Agreement with NA

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
TAX DETAILS

Service Tax/GST Registration No. 2 7 A A F C K 7 0 1 6 C 1 Z T Category : General Insurance Services

SAC Code 997134 Description Motor vehicle insurance services

Invoice Number 3615200500

DECLARATION

I/We hereby certify that the policy to which the certificate relates as well as the certificate of insurance are issued in accordance with the provision of chapter X, XI of
M.V.Act 1988.

In Witness whereof this Policy has been signed for and behalf of 201-204, 301 Chintamani Classique Vishweshwar Nagar, Off Aarey Road Mumbai Maharashtra 400063.
at Mumbai this 19 day of August of 2023

Stamp Duty of 0.50 is paid as provided under Article 47(B) of Indian Stamp Act, 1899 and included in Consolidated Stamp Duty Paid to the Government of Maharashtra
Treasury vide Order of Addl. Controller Of Stamps, Mumbai at General Stamp Office, Fort, Mumbai - 400001., vide this Order No. (LOA/CSD/528/2022/2021/Validity
Period Dt. 21/11/2022 To Dt. 31/12/2023 (O/w.No. 4882)/Date: 16/11/2022).

For Kotak Mahindra General Insurance Company Limited

Authorised Signatory

This document is digitally signed, hence counter signature / stamp is not required.

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
 Transcript of Online Proposal - Kotak Car Secure

Important Information for the Insured:

1. This is a transcript of the details declared by you on the e-proposal and shall be the basis of underwriting of the policy. Request you to carefully review the complete
information provided under this transcript and get back to us within 15 days of issuance of this document, in case there is any discrepancy found.
2. The policy is subject to receipt of complete premium and the risk under the Policy shall commence only from the date as specified in the policy schedule.
3. This document has to be read in conjunction with the policy schedule/document.
Refund, if any, with regard to the premium paid, would be processed in the same source / account (net banking / credit card / debit card) from where the premium
4.
payment has been originally made subject to policy terms and conditions.
5. The policy is subject to the underwriting guidelines of the Company and the details as declared by the Insured under the e-proposal.
6. Online premium payment should be made by the policyholder himself. No third party payment should be made using this mode of payment.
7. The Policyholder/ Insured has fully understood the terms and conditions of the Policy including all the features available thereunder.

Proposal No : 202308190208547

Proposal for : Rollover Policy

9,834.00 Premium Amount (Inclusive of taxes)

Type of cover: Comprehensive Policy

Vehicle Make/Model/
Registration No. Type of body Cubic Capacity Fuel Type
Variant

HYUNDAI
TS08FB5870 1197 Petrol
MOTORS/XCENT/1.2 VTVT

Year of Manufacture Insured Declared Value (IDV) Engine Number Chassis Number

2016 3,45,000 G4LAGM0917 08 MALA841CLGM193443F

Special conditions :

PROPOSER / OWNER’S DETAILS

1. Title and Name of the Insured: MR. P R VAMSHI

C O P S RAVI CHANDRAN VRR APTS F NO 403 S VTELANG TELANGANA District: K V RANGA REDDY 500083
2. Insured Permanent Address*
TELANGANA(36), India

If Correspondence Address different from : J 504 ARK HOMES BOLLARUM ALWAL, ALWAL, SECUNDERABAD, HYDERABAD, TELANGANA, 500010 TELANGANA
Permanent Address,please provide*: Hyderabad Ts - 500010 District: HYDERABAD TS TELANGANA, India

3.Phone 4.Mobile * 7032457754 5.Email ID* [email protected]

6.Gender 7.Date Of Birth * 8.Nationality Indian Resident

Proposal Date & Time: 19/08/2023 12:19

Policy Start Date: 19/08/2023 00:00

Policy End Date:

18/08/2024 at midnight
(Comprehensive)

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
Limitation as to use (Private Car): The policy covers use of the vehicle for any purpose other than: (a) Hire or reward (b) Carriage of goods (other than samples or
personal luggage) (c) Organized racing (d) Pace making (e)Speed testing (f) Reliability trails (g)Use in connection with Motor Trade. Note: In case of vehicles used for
Driving Tuition the words “other than for the purpose of driving tuition” to be read after the words „hire or reward.

Driver’s Clauses: Any person including insured: Provided that a person driving hold an effective Driving Licence at the time of accident and is not disqualified from holding
or obtaining such a licence. Provided also that the person holding an effective Learners’ Licence may also drive the Vehicle and that such a person satisfies the
requirement of Rule 3 of the Central Motor Vehicle Rules, 1989.

STATUTORY WARNING PROHIBITION OF REBATES (Under Section 41 of Insurance Act 1938)

1) No person shall allow or offer to allow, either directly or indirectly as an inducement to any person to take out or renew or continue an insurance in respect of any kind
of risk relating to lives or property, in India, any rebate of the whole or part of the commission payable or any rebate of the premium shown on the Policy, nor shall any
person taking out or renewing or continuing a Policy accept any rebate, except such rebate as may be allowed in accordance with the published prospectuses or
tables of the Insurer.
2) Any person making default in complying with the provisions of this section shall be punishable with fine, which may extend to ₹ 1,000,000/­
VEHICLE DETAILS

Date of CNG/LPG/Bi Lease / Hire / Hypothecation (Name and Color of Seating

Registration Authority and RTO Location
Registration Fuel address of concerned parties) Vehicle Capacity

POONAWALLA FINCORP LIMITED (5535)

MEDCHAL 03/12/2016 Petrol 5
DELHI

*Non - Electrical *Electrical & Electronic

*Insured Declared
Accessories Accessories Trailer *CNG / LPG Kit *Total Value
Value
fitted to the Vehicle (in fitted to the Vehicle (in (in INR) (in INR) (in INR)
of the Vehicle (in INR)
INR) INR)

3,45,000 0 0 0 0 3,45,000

PUC - NO

OPTIONAL ADD-ON COVERS

1. Depreciation Cover# 2. Engine Protect #If Depreciation cover is selected: Voluntary Deductible offered under the
“Depreciation Cover”, which would be applied over and above the Compulsory
3. Return to Invoice 4. Consumable Cover Deductible? No

6. Key Replacement
5. Road Side Assistance
Sum Insured
7. Loss of Personal Belongings
8. Tyre Cover
Sum Insured
9. Daily Car Allowance 10. NCB Protect
11. Meter (Switch On/ Switch Off)
Cover

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
 RISK INCLUSION / EXCLUSION

*Name of Appointee (if Relationship to the

1. *Personal Accident Cover of INR *Nominee Name and Age *Relationship
nominee is a minor) Nominee
15,00,000 for the Owner Driver
S GEETHA 57 Mother

2. Do you wish to include Personal Accident Name CSI Opted (Rs) *Nominee Name Relationship
cover for the Named passenger? No
Please give details mentioned aside:

3. Do you wish to include Personal Accident cover for the Un-named Passengers / hirer / pillion No. of Persons
C. S. I. (Per Person)
passenger? No As Per Seating Capacity
Please give details mentioned aside:

# The maximum CSI available per person is ₹ 2,00,000, each in multiples of ₹ 10,000.

4. Do you wish to restrict Third Party Property Damage of ₹ 7.5 Lakh to the statutory TPPD liability limit of ₹ 6,000/­ only? No

5. Do you wish to cover legal liability? A) Paid Driver Yes No If yes, no. of Person: 1

B) Other Employees Yes No If Yes, no. of Person: C) Unnamed Passengers Yes No If Yes, no. of Person: 0

Compulsory Personal Accident (PA) Cover for owner­driver (PA Cover for Owner –Driver is compulsory for individual vehicle owners)
I hereby declare that the Owner Driver does not require Compulsory Personal Accident Cover as
|__| Owner Driver has a separate existing Personal Accident cover against Death and Permanent Disability (Total and Partial) for Sum Insured of atleast 15
lacs.Tenure___ years |_____________| to |_____________|
|__| The Vehicle to be insured is not owned by an individual
|__| The Owner Driver does not have an effective driving license.
(Note: Where the owner driver owns more than one vehicle, compulsory PA cover can be granted for any one vehicle as opted by him/her). Personal Accident cover
for owner driver is compulsory for Sum Insured of 15 lacs for Two-wheeler, Private Car and Commercial Vehicles. Compulsory PA Cover for Owner Drivers cannot be
granted where the vehicle is owned by a company, a partnership firm or a similar body corporate.

DETAILS OF DEPRECIATION
Table 1:Schedule of depreciation for arriving at IDV:
The Insured's declared value (IDV) of the vehicle will be deemed to be the 'Sum insured' and it will be fixed at commencement of each policy period for each insured
vehicle
Age of The Vehicle % of Depreciation for fixing IDV Age of The Vehicle % of Depreciation for fixing IDV
Not exceeding 6 Months 5% Exceeding 2 years but not exceeding 3 years 30%
Exceeding 6 months but not exceeding 1 year 15% Exceeding 3 years but not exceeding 4 years 40%
Exceeding 1 year but not exceeding 2 years 20% Exceeding 4 years but not exceeding 5 years 50%
Note: IDV of obsolete models of vehicles (i.e. Models which the manufacturers have discontinued to manufacture) and vehicles beyond 5 years of age will be
determined on the basis of an understanding between the insurer and the insured.

PAYMENT DETAILS

Payment Mode : RTGS/NEFT

Payment Reference No : NEFTINW0642628959
Payment Amount: 15,00,000.00
Payment/Transaction Date: 11/08/2023
Bank Details:

I confirm that the premium is paid out of my legitimate sources of fund and the Company has the right to call for documents to establish sources of funds. The
Company has the right to cancel the policy in case I am/have been found guilty by any competent authority or court of law of violating any law/regulation.

Intermediary Code: 2356110000

This electronic proposal is validated by an OTP sent on the registered mobile number of the customer.

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152
 TAX INVOICE

Details of Receiver (Billed To) Details of Supplier (billed by)

Kotak Mahindra General Insurance
GSTIN/UIN Name :
Company Limited
Customer ID 1012417488 GSTIN : 27AAFCK7016C1ZT
Customer Name MR. P R VAMSHI Pan Number : AAFCK7016C
Email ID [email protected] CIN: U66000MH2014PLC260291
201-204, 301Chintamani
Contact No 7032457754 Address: ClassiqueVishweshwar Nagar, Off Aarey
RoadMumbai Maharashtra 400063.
: J 504 ARK HOMES BOLLARUM
ALWAL, ALWAL, SECUNDERABAD,
Address HYDERABAD, TELANGANA, 500010, Date of Invoice 19/08/2023
TELANGANA, HYDERABAD TS, 500010,
TELANGANA, India
IMD Code 2356110000 Invoice No 3615200500
Receipt No 1202400576373 Proposal No 202308190208547
Partner Application No
State Code 36 State Code: 27
Place Of Supply Name TELANGANA - 36 State Name MAHARASHTRA
IRN

HSN/SAC Description HSN / SAC Code Total Value of Supply (Rs.) Taxable value of Supply (Rs.) IGST Rate IGST Amt (Rs.)
997134 8334.1 8334.1 18% 1,500.14
Motor vehicle insurance services
Total 8334.1 8334.1 1500.14
Total Invoice Value (In Figure) 9,834.00
Total Invoice Value (In Words) Nine Thousand Eight Hundred Thirty Four
Whether Tax Payable on a Reverse Basis or Not No

For : Kotak Mahindra General Insurance Company Limited

Authorized Signatory

"I/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."

Kotak Car Secure UIN:IRDAN152RP0006V02201516;

Kotak Mahindra General Insurance Company Limited
CIN: U66000MH2014PLC260291, Registered Office: 27 BKC, C 27, G Block, Bandra Kurla Complex, Bandra East, Mumbai ­ 400051. Maharashtra, India.
Office: 8th Floor, Zone IV, Kotak Infinity, Building No.21, Infinity IT Park, Off Western Express Highway, General AK Vaidya Marg, Dindoshi, Malad(E), Mumbai ­ 400097. India.
Toll Free: 1800 266 4545 Email:[email protected] Website: www.kotakgeneral.com IRDAI Reg. No. 152