Address of Issuing Office : Address of Servicing Branch Office :

Reliance General Insurance Co. Ltd Reliance General Insurance Co. Ltd
Reliance Centre, South Wing, 4th Floor, Off. Western Express Highway , Policy Servicing Branch address : Flat No-10-15 14th Floor, Vijaya
Santacruz (East), Mumbai - 400 055. Building, 17, Barakhamba Road, NEW DELHI DELHI 110001, INDIA
Branch Contact No. 011-39975617

Burglary and Housebreaking Insurance Policy

Master Policy No :
Tax Invoice and Date:
Date of proposal & declaration : 11/09/2019
Name of the Insured :
Communication Address &
place of Supply :
Period of Insurance :
GSTIN / UIN of Insured:
Financial Interest
Financier Name
920291929110000046 Policy Certificate No : 130191929111041234
Y091219042756 & 12-Sep-2019
Kriti Arora
Village-Baneswarchak, Po-Golachak, Ps-Durgachak, Near Baneswarchak Sbi Koisk Bank, City : Haldia, State : WEST
BENGAL, PinCode : 721658,
Telephone No : , Mobile No : 9002551446
, Email ID : pranoydas9593@gmail.com
From : 17/08/2019 To : 16/08/2020
NA
Financier Type Financier Address/City

Description and situation of the premises containing the property insured :

Address :
Village-Baneswarchak, Po-Golachak, Ps-Durgachak, Near Baneswarchak Sbi Koisk Bank, City :Haldia, State : WEST BENGAL, PinCode : 721658
Property Insured :

Property Insured :
Make and Description Model No. Serial No. Identification No. Year of Mfg. Total Sum
Insured (in Rs.)
HP Notebook 14s-dk0093AU 5CG922205H TZOB773664TZ 2019 42500.00

Extensions :

Special Conditions :

Premium Details Amount (Rs.)

Net Premium : 212.50
IGST : (18.00) 38.25
Total Premium : 251.00
GSTIN : 07AABCR6747B1ZI SAC : 997139
Description of Services :Other non-life insurance services (excluding reinsurance services)
Consolidated Stamp Duty Paid with Receipt No. CSD/46/2019/2389 Dated 29 May 2019 ** Not Applicable for the State of Jammu & Kashmir
Note : In the event of dishonor of cheque, this policy document automatically stands cancelled from inception, irrespective of
whether a separate communication is sent or not.
In witness whereof this policy has been signed at Corporate Group - Delhi on 12-Sep-2019
This document shall be treated as a tax invoice as per rule 9(2) of the Goods and Services Tax invoice rule.
For any assistance with claims, please contact us on 1800 3009(toll free)/(022)4890 3009 or email us at services.rgicl@relianceada.com.
In case of a renewal, the benefits provided under the policy and/or terms and conditions of the policy including premium rate may be subject
to change.
Note : The policy wording with detailed terms, conditions and exclusions are available on our website www.reliancegeneral.co.in
Grievance Clause:-
For resolution of any query or grievance, Insured may contact the respective branch office of the Company or may call at 1800 3009 or may
write an email at rgicl.services@relianceada.com. In case the insured is not satisfied with the response of the office, insured may contact the
Nodal Grievance Officer of the Company at rgicl.grievances@relianceada.com. In the event of unsatisfactory response from the Nodal
Grievance Officer, insured may email to Head Grievance Officer at rgicl.headgrievances@relianceada.com. In the event of unsatisfactory
response from the Head Grievance Officer, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal
of grievance. Details of the offices of the Insurance Ombudsman are available at IRDAI website www.irda.gov.in or on company website
www.reliancegeneral.co.in or on www.gbic.co.in. The insured may also contact the following office of the Insurance Ombudsman within
whose territorial jurisdiction the branch or office of the Company is located. Smt. Sandhya Baliga Office of the Insurance Ombudsman,2/2
A,Universal Insurance Building,Asaf Ali Road,New Delhi – 110 002. Tel.: 011 - 23239633 / 23237532 Fax: 011 - 23230858 Email:
bimalokpal.delhi@gbic.co.in

Reliance General Insurance Company Limited. IRDAI Registration No. 103 Certified for Excellence - ISO 9001:2015
Registered Office: H Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai 400710.
Corporate Office: Reliance Centre, South Wing, 4th Floor, Off. Western Express Highway , Santacruz (East), Mumbai - 400 055.
Corporate Identity No.U66603MH2000PLC128300. UIN No: Page 1 of 2
RGI/UW/CO/2911/PS/1.0/010218
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License
 For Reliance General Insurance Company Limited

Duly Constituted Attorney(s)

Agent Code/Name: Direct / Direct

Reliance General Insurance Company Limited. IRDAI Registration No. 103 Certified for Excellence - ISO 9001:2015
Registered Office: H Block, 1st Floor, Dhirubhai Ambani Knowledge City, Navi Mumbai 400710.
Corporate Office: Reliance Centre, South Wing, 4th Floor, Off. Western Express Highway , Santacruz (East), Mumbai - 400 055.
Corporate Identity No.U66603MH2000PLC128300. UIN No: Page 2 of 2
RGI/UW/CO/2911/PS/1.0/010218
Trade Logo displayed above belongs to Anil Dhirubhai Ambani Ventures Private Limited and used by Reliance General Insurance Company Limited under License