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~ 3?•QQUGC1 "''4.,fi:ct Cbctqafl ~fliu ~Gft4lC1 l!li vaTil' Cfll'4ft'1'4 :

THE ORIENTAL INSURANCE COMPANY LIMITED Regd. & Head Office : . A-25/27, Asaf Ali Road, New Delhi- 110.002. Visit us at : www.orientalinsurance.org.tn

Tl-25127. 3fRfllS 3U!ft n . .q ~- 110 oo2. ~www.orientallnsurance.org.ln ~

Address all communications to Policy Issuing Office ~ ~ 'q'ifJ!fR~ ;:;rr8' 'iiRd ~-a 1l5't I

LIABILITY _INSURAN_CE ~NDER PUBLIC LIABILITY_IN~URANCE ACT, 1991) POLICY SCHEDULE

Policy No.

Cover Note No.

Insured's Code

Insured's Name

Address

Tei./Fax/Email

: 454700/48/2017/2249

: 76425398

: SOUTHERN REGION BULK L.P.G.TRANSPORT OWNERS ASSOCIATION A\c: Various Parties-251 nos.

No.87,SALEM ROAD NAMAKKAL 637001

Prev. Policy No. . _

Cover Note Date Consolidated Stamp Duty Paid Vide GO (Rt) No.407

Issue Office code 454700 Oated:27/09/2016 Paid by Issue Office Name : DO NAMAKKJ\O~IC~l.!R~O~·C::;e:,:i:,:.:m.:,:b:,:a:;t.:.O.;.;r~;.;·~_..

Address : KVA COMPLEX, 90-A, THURAIYUR ROAD, NAMAKKAL- 637001

NAMAKKAL TAMIL NADU 637001 NAMAKKAL TAMIL NADU 637001

I /9442177088/ Tei./Fax/Email 04286-220504,222504/04286-222104/ [email protected] 454 700@orientalinsurance .co. in

r Age~t/Broke-;:-D;tails ---------M. SELVARAJu Dev.Off.Code : NAooooo02595 M SELVARAJU Development OffK:ef Agent/Broker : BA0000118557 R.MOHAN Cell: 94432 5116, J.

Address : 1/38A, VAGURAMPATTY,VASANTHAPURAM,NAMAKKAL,SALEM,TAMIL NADU,637001

Tel/Fax/Email

L

: 9442227091/9442227091//N.o'

-------r--_j Period of Insurance

Collection No. & Dt.

: FROM 12:46 ON 05/12/2016 TO MIDNIGHT OF 04/12/2017

: CHQ 8935004034-05/12/2016

Gross Premium

Co-insurance Details

Nature of Business

Category of Industry

Indemnity Limit

Retroactive Date

Contribution to the Environmental Relief Fund

101 ,860

NIL

Service Tax 15278

TRANSPORT OPERATIONS

Stamp Duty : .5

GREEN Policy Purchaser Category : Handler

Rs. 5,00,00,000.00 Any One Accident

Total : 218,998

Rs. 15,00,00,000.00

Aggregate during the Policy Period (Not exceeding three times of any one accident of Indemnity Limit.)

08/11/2016

1,02,878.00 (included in the Total Premium)

TERRITORY/JURISDICTION : INDIA /INDIA

The Insurance under this policy is subject to terms and conditions given in the policy attached here to. Specific Conditions if any 251 NUMBER OF VEHICLES AS PER LIST ATTACHED

- - -- -------+-------

Excess : NIL

Place : NAMAKKAL For and on behalf of

Date : 05/12/2016 The Oriental Insurance Company Limited

Attached to and forming part of policy number 454700/48/2017/2249

Financier Names are as per the list attached: Not applicable

Warranted that in case of dishonour of premium cheque(s) the Company shall not be liable under the policy and the policy shall be void abinitio (from inception).

In witness whereof the undersigned being authorised by and on behalf of the Company has/have herein to set his/their hands at DO NAMAKKAL on 05TH DAY OF DECEMBER 2016

Entered By

Examined By

DURAISAMY

GANAPATHY

Place : NAMAKKAL

Date : 05/12/2016

For and on behalf of The Oriental Insurance Company Limited

11111111111111 ~1111111111 ~111111111111111~ 1111 ~ ~11111~111111111! II~ IRDA·REGN0-556

For and on behalf of The Oriental Insurance Company Limited

~\~NT 4( /. In case of any query regarding the Policy please cal &~~r\ Free No. 1800 11 8485 and 011 33208485. it ..,_ C. ·\ Authorised Signatory

...... '\ :rJ CIN : U66010DL1947GOI007158 AlltheAmounts entpne't,.i l"\.th.J o~yareinlndianRupees Paqe2of2

PLIINSURANCE ATTACHED TO AND FORMING PART OF POLICY NUMBER 454700/48/2017/ ~ ~ ~q

S.NO TRUCK NO OWNER NAME TRANSPORT NAME 1 KA01AG3993 T.SARASWATHI BHOOPATHI TRANSPORTS 2 MH06AQ7324 BALAJI TRANSPORTS&CO HARIESH TRANSPORTS 3 TN28BB4981 P.ARIVARASU SEVEN HILLS TRANSPORTS 4 KA01AG3335 V.VELUSAMY RING ROAD TRANSPORTS 5 KA01AG3343 M.S. MAN I KAN DAN M .K.BULK CARRIERS

6 KA01AG3322 M .S.MANIKANDAN M .K.BULK CARRIERS I

7 KA01AG3344 M.S.MANIKANDAN M .K.BULK CARRIERS 8 KA01AG3310 M.S.MANIKANDAN M .K.BULK CARRIERS 9 KA01AG3334 M.S.MANIKANDAN M .K.BULK CARRIERS 10 KA01AG3169 K.PALANISAMY R.C.S.BULK CARRIERS 11 TN88C0369 R.HEMACHANDRAN SIVASAKTHI ROAD WAYS

12 KA01AG4115 R.SAKUNTHALA K.R.S.TRANSPORTS I

13 KA01AG4116 R.SAKUNTHALA K.R.S.TRANSPORTS

14 KA01AF3979 V.SELLAPPA RSMN TRANSPORT

15 KA01AE6859 K.SELVAM SRI VEERAMATHIAMMAN TRANSPORTS

16 KA01AG3605 L.S.SANGATAMIL SANGATAMIL GAS MOVERS

17 TN28BB4539 J.MEGANATHAN SAl VARSHITHA TRANSPORTS

18 KA01AG3577 P.MANIKUMAR MURUGAVILAS GOLDEN TRANSPORTS

19 KA01AG3444 S.JAYAPRAKASH SRI SARASWATHI TRANSPORT

20 KA01AG3445 S.LOGANATHAN SRI SARASWATHI TRANSPORT

21 KA01AG3453 V.LOGANATHAN SRI SARASWATHI TRANSPORT

22 KA01AG3454 V.LOGANATHAN SRI SARASWATHI TRANSPORT

23 TN28AH9499 R.ASHOKAN SRI ETIUKKAIAMMAN TRANSPORTS

24 KA01AG3868 R.SIVANESAN SRI PALANIAPPA ROADWfWS

25 KA01AG3979 M.GANAPATHY AJITH BULK CARRIER

26 KA01AG3551 S.K.NATARAJAN TPN TRAANSPORT I 27 KA01AG3552 P.ARUN TPN TRAANSPORT

28 KA01AG3566 S.M.SEKAR S.M .TRANSPORTS

29 KA01AG3430 S.KAMALAM K.S.N.LORRY SERVICE

30 KA01AG4344 S.P.RAMESHKUMMAR K.S.N.LORRY SERVICE

31 KA01AG4109 R.RAJA RAJAMURUGAN TRANSPORT

32 KA01AG3515 N.GANESH CHANDRASEKARAN IYER S

33 KA01AG3516 P.SENTHILKUMAR CHANDRASEKARAN IYER S

34 KA01AG3517 K.ANNADURAI CHANDRASEKARAN IYER S ' 35 KA01AG4097 P.SUBRAMANIAN PRAGAN BULK CARRIER

36 KA01AG3629 K.SUBRAMANIAN SRI VIJAYALAKSHMI LORRif SERVICES

37 TN88B1148 P.KANDASAMY THENPANDIAN ROADWAYS

38 KA01AG4066 K.VEERAPPAN VELMURUGAN MOTOR SERVICE

39 KA01AG3210 S.N.PALANISAMY PAVITHRA BULK CARRIER

40 KA01AG3479 R.HEMACHANDRAN JAYALAKSHMI TRANSPORTS

41 KA01AG3537 R.HEMACHANDRAN JAYALAKSHMI TRANSPORtS

42 KA01AG3568 P.MANI SRI SELLANDIAMMAN BUL.K CARRIER

43 KA01AG3569 S. RAVICHAN DRAN MALAYAPPASAMY TRANSpORTS

44 TN28BB5527 S.K.M.V.TRANSPORT M.SARAVANAN

PERIOD OF INSURANCE 05/12/2016 TO 04/12/2d17

For THE ORIENTAL INSURANCE CO.LTD.,

~

Fnr Sor~thcrn Ucgion Bulk L.P.G. Transport Owners Association,

N} ~__

ATTACHED TO AND FORMING PART OF POLICY NUMBER 4S4700/48/2017/ ..?-..g_q-q 45 KA01AG3911 P. RAM ALl NGAM AAG ROAD LINES 46 KA01AG4309 S.RAMASAMY M .S.R.TRANSPORT 47 KA01AG3268 C.KANNAN SAl VARSHITHA TRANSPORT 48 TN88B9810 C.NATHI PRAKASH SAl VARSHITHA TRANSPpRT 49 KL09AL5945 V.MAHESWARI VASANTHAM TRANSPORTS so KA01AG4070 P.S.SUBRAMANIAN S.N.M.TRANSPORT 51 KA01AG4659 M .RAJENDRAN SRI NAMAGIRIAMMAN TRANSPORT 52 KL62116 K.C.ABRAHAM K C JACOB AND SONS 53 KA01AG2160 R.SRINIVASAN SHREEJI KRUPA CARRIERS 54 KA01AG3460 P.VIJAYAKUMAR SHREEJI KRUPA CARRIERS 55 KA01AG3501 R.KUMARESAN SHREEJI KRUPA CARRIERS 56 KA01AG3513 N.S.SETHURAJAN SHREEJI KRUPA CARRIERS 57 KA01AG3505 R.PALANISAMY SHREEJI KRUPA CARRIERS 58 KA01AG3370 TLS TRANSPORTS R.GOPAL TRANSPORT 59 KA01AG3380 TLS TRANSPORTS R.GOPAL TRANSPORT 60 KA01AG3390 TLS TRANSPORTS R.GOPAL TRANSPORT 61 KA01AG3518 TLS TRANSPORTS MRL ROADLINES I

62 KA01AG3528 TLS TRANSPORTS MRL ROADLINES

63 KA01AG3538 TLS TRANSPORTS MRL ROADLINES I

64 KA01AG3715 V.SUBRAMANIAN V.A.T.TRANSPORTS I

65 KA01AG4045 S.ASAITHAMBI G.S.T.TRANSPORT I

66 TN52W9870 P.GANESAN S.K.BROTHERS

67 TN88A9869 P.PANDIAN ANNAl BULK CARRIERS

68 TN88A9769 P.PANDIAN ANNAl BULK CARRIERS

69 TN88B9969 P.PANDIAN ANNAl BULK CARRIERS

70 KA01AG3969 P.CIBIPANDIYAN ANNAl BULK CARRIERS

71 TN88A9459 P.KALIAPPAN SIDDARTH TRANSPORT

72 TN88A9659 P.KALIAPPAN SIDDARTH TRANSPORT

73 KA01AG2176 R.SELVARAJU PRAVIEN ROADLINES

74 KA01AG3419 M .PONNAMBALAM KONGUNADU ROAD LINES

75 KA01AG4151 P.SURESH BABU JOTHI ANDAVARTRANSPORT

76 KA01AG3349 V.RAJASEKARAN RVR ROADWAYS

77 KA01AG3646 V.TAMILSELVAN SML ROAD LINES

78 KA01AG4595 P.NIRMALA KOWSHIK CARGO MOVERS

79 KA01AG3264 N.R.KARTHIK PAVITHRA BULK CARRIER

80 KA01AG3297 P.RAJU P.RAJU



83 KA01AG3386 P.RAJU P.RAJU I




87 KA01AG3396 P.RAJU P.RAJU I 88 KA01AG3397 P.RAJU P.RAJU



PERIOD OF INSURANCE 05/12/2016 TO 04/12/2017

For THE ORIENTAL INSURANCE CO.LTD .. r-

l f;r_~.,....,..,

f'~1~r So,~ tlu~m Ucgion Bulk L.P.G. lra nspo1·t Owners Association

I M ) ' PresidPnt_

ATTACHED TO AND FORMING PART OF POLICY NUMBER 4S4700/48/2017/ .a_~ A-q 91 KA01AG3495 P.RAJU P.RAJU 92 KA01AG3496 P.RAJU P.RAJU I

93 KA01AG3475 K.MUTHUSAMY K.R.C.BULK TRANSPORT CARRIERS 94 KA01AG3274 K.RAJA SAl VARSHITHA TRANSPpRTS 95 KA01AG6689 N.DEVRAJ SAl VARSHITHA TRANSPORTS 96 KA01AG3531 M .VIGNESH SAl VARSHITHA TRANSPpRTS 97 KA01AG3532 M.VIGNESH SAl VARSHITHA TRANSPORTS 98 KA01AG3533 M.VIGNESH SAl VARSHITHA TRANSPORTS 99 KA01AG3534 M.VIGNESH SAl VARSHITHA TRANSPORTS 100 KA01AG3535 M.VIGNESH SAl VARSHITHA TRANSPORTS 101 KA01AG3522 N.SANTHI SAl VARSHITHA TRANSPORTS 102 KA01AG3523 N.SANTHI SAl VARSHITHA TRANSPORTS 103 KA01AG3524 N.SANTHI SAl VARSHITHA TRANSPORTS 104 KA01AG3525 N.SANTHI SAl VARSHITHA TRANSPORTS 105 KA01AG3526 N.SANTHI SAl VARSHITHA TRANSPORTS 106 TN88B4232 K.KARUPPANNAN SAl VARSHITHA TRANSPORTS 107 TN88B4506 K.RAJA SAl VARSHITHA TRANSPORTS 108 KA01AG3506 P.RAVIKUMAR CHANDRASEKARANIYER 1S 109 KA01AG3507 P.RAVIKUMAR CHANDRASEKARANIYER 1S 110 KA01AG3508 P.RAVIKUMAR CHANDRASEKARAN IYER 1S 111 KA01AG3519 P.RAVIKUMAR A.SRI VEL CARRIERS 112 KA01AG3520 P.RAVIKUMAR A.SRI VEL CARRIERS 113 KA01AE9010 M.VALARMATHI BALAJI TRANSPORT CO 114 KA01AE9110 M.VALARMATHI BALAJI TRANSPORT CO

115 KA01AF5641 P.RAJU P.RAJU

116 KA01AF5643 P.RAJU P.RAJU 117 KA01AG4171 K.CH INN USA MY KAVIYA BULK CARRIERS

118 KA01AG3324 R.JOTHIBASU M.K.BULK CARIEERS


120 KA01AG3326 R.JOTHIBASU M.K.BULK CARIEERS 121 KA01AG3327 R.JOTHIBASU M .K.BULK CARIEERS

122 KA01AG3328 R.JOTHIBASU M.K.BULK CARIEERS I


124 KA01AF4434 R.JOTHIBASU M.K.BULK CARIEERS


126 KA01AF4436 R.JOTHIBASU M.K.BULK CARIEERS I



129 KA01AF4439 R.JOTHIBASU M.K.BU LK CARIEERS I


131 KA01AG3314 J.NARMADHA M.K.BULK CARIEERS

132 KA01AG3315 J.NARMADHA M .K.BULK CARIEERS

133 KA01AG3316 J.NARMADHA M.K.BULK CARIEERS i 134 KA01AG3317 J.NARMADHA M.K.BULK CARIEERS

135 KA01AG3318 J.NARMADHA M.K.BULK CARIEERS

136 KA01AF4441 R.RAMAMOORTHY ZEE BOOM BAA TRANSPORTS


For Soplhcrn Region Hull\ L.P.G. Translf>ort Owners Association,

Mf - L

President.

ATTACHED TO AND FORMING PART OF POLICY NUMBER 4'(J4700/48/2017/ .?._')_ 4 ~ 137 TN30BE1305 R.RAMAMOORTHY ZEE BOOM BAA TRANSPORTS

138 TN30BE1381 R.RAMAMOORTHY ZE E BOOM BAA TRANSPORTS 139 KA01AG3350 R.RAMAMOORTHY ZEE BOOM BAA TRANSPORTS

140 KA01AG3351 R.RAMAMOORTHY ZEE BOOM BAA TRANSPORTS



143 KA01AG3354 R.RAMAMOORTHY ZE E BOOM BAA TRANSPORTS


145 KA01AG1776 R.RAMAMOORTHY ZEE BOOM BAA TRANSPbRTS

146 KA01AG3293 R.KAVITHA ZEE BOOM BAA TRANSPbRTS

147 KA01AG3294 R.KAVITHA ZEE BOOM BAA TRANSPpRTS

148 KA01AG3295 R.KAVITHA ZEE BOOM BAA TRANSPORTS

149 KA01AG3296 R.KAVITHA ZEE BOOM BAA TRANSPORTS

150 TN90B3153 R.JOTHIBASU CIMA ROADLINERS

151 TN90B3154 R.JOTHIBASU CIMA ROADLINERS I

152 TN90B3156 R.JOTHIBASU CIMA ROADLINERS

153 KA01AG1245 R.JOTHIBASU CIMA ROADLINERS

154 KA01AF5781 R.JOTHIBASU CIMA ROADLINERS I 155 KA01AF5782 R.JOTHIBASU CIMA ROADLINERS

156 KA01AF5783 R.JOTHIBASU CIMA ROADLINERS



159 KA01AF5791 R.RAMAMOORTHY CIMA ROADLINERS

160 KA01AF5792 R.RAMAMOORTHY CIMA ROADLINERS

161 NL01N3118 ROUNAK MAGOO SURYAVANSHI ORGANISti.TION

162 NL01N3125 BHARTIMAGOO SURYAVANSHI ORGANISATION

163 TN28BB5097 P.SEKAR JAWAHAR BULK CARRIERS

164 KA01AG4079 K.P .KANDASAMY AMARJYOTHI TRANSPORT

165 KA01AG3539 P.KANDASAMY SML ROAD LINES

166 KA01AG3529 K.EGAMBARAM SML ROAD LINES

167 KA01AG3565 R.SEKAR SML ROAD LINES

168 KA01AG4044 P.MUTHUSAMY ESWAR TRANSPORTS I

169 KA01AD4627 K.NAVALADI NSMK TRANSPORTS

170 KA01AD4572 K.NAVALADI NSMK TRANSPORTS

171 KA01AG1067 N.RAJESH SHREE RAMA ROADWAYS




175 KA01AG2014 N.RAJESH SHREE RAMA ROADWAYS1






181 KA01AG2025 N.RAJESH SHREE RAMA ROADWAYS 1

182 KA01AG3465 P.NATARAJAN MAHALAKSHMI FREIGHT CARRIER

PERIOD OF INSURANCE 05/12/2016 TO 04/12/20!7

For THE ORIENTAL INSURANCE CO.LTr-

' " · ~"~

h•r So.:tl•crn l{cgion Uulk L.P.G. Tnui~JHtrl Uw:wrs Assnciution,

~ ~'----President.

(.._ '

. ATTACHED TO AND FORMING PART OF POLICY NUMBER 454700/48/2017/ ;;L:L_~q

183 KA01AG3467 P.NATARAJAN MAHALAKSHMI FREIGHT CARRIER 184 KA01AG3468 P.NATARAJAN MAHALAKSHMI FREIGHT CARRIER 185 KA01AG3470 P.NATARAJAN MAHALAKSHMI FREIGHT CARRIER 186 KA01AG3471 P.NATARAJAN MAHALAKSHMI FREIGHT CARRIER 187 KA01AG3472 P.NATARAJAN MAHALAKSHMI FREIGHT CARRIER







194 KA01AG3443 N.PALANIAMMAL MAHALAKSHMI FREIGHT CARRIER

195 KA01AG3481 N.PALANIAMMAL MAHALAKSHMI FREIGH""P CARRIER

196 KA01AG3486 N.PALANIAMMAL I

MAHALAKSHMI FREIGHT CARRIER

197 KA01AG3487 N.PALANIAMMAL MAHALAKSHMI FREIGHrf CARRIER


199 KA01AG3492 N. PALAN lAM MAL MAHALAKSHMI FREIGHT CARRIER



202 KA01AG3448 N.JAYAKARTHI MAHALAKSHMI FREIGHT CARRIER



205 KA01AG3451 N .JAY AKARTH I MAHALAKSHMI FREIGHT CARRIER

206 KA01AG3452 N.JAYAKARTHI MAHALAKSHMI FREIGHT ~ARRIER

207 KA01AG3457 N.RAJESH MAHALAKSHMI FREIGHT ~ARRIER



210 KA01AG3462 N.RAJESH MAHALAKSHMI FREIGHT CARRIER

211 KA01AG3463 N.RAJESH MAHALAKSHMI FREIGHT CARRIER

212 NL01QS205 L.RAJA SHRI THIRUMALESA ROA[J)LINES

213 NL01Q5206 L.RAJA SHRI THIRUMALESA ROAOLINES

214 NL01QS207 L.RAJA SHRI THIRUMALESA ROAOLINES

215 NL01Q5208 L.RAJA SHRI THIRUMALESA ROADLINES



218 NL01Q5218 L.RAVICHANDRAN SHRI THIRUMALESA ROADLINES

219 NL01Q5222 S.SHANTHI SHRI THIRUMALESA ROADLINES

220 NL01Q5223 S.SHANTHI SHRI THIRUMALESA ROAdLINES



223 NL01Q5226 S.SHANTHI SHRI TH IRUMALESA ROADLINES

224 NL01Q5227 S.SHANTHI SHRI TH IRUMALESA ROADLINES

225 NL01Q5229 R.CHITRA SHRI THIRUMALESA ROADpNES

226 NL01Q5230 R.CHITRA SHRI TH IRUMALESA ROAD]LINES




I or St~JIH"'n Rt·~ion flu II\ L.P.G. Tram-.plH·t Owncr·s Association,

President. · - ~lt.lt,....~ ..... . ······---

- ' ATTACHED TO AND FORMING PART OF POLICY NUMBER 454700/48/2017/ J-..:L'-t-'1

229 NL01Q5212 L.RAJA SHRI THIRUMALESA ROADLINES 230 NL01Q5213 L.RAJA SHRI THIRUMALESA ROADLINES 231 NL01Q5214 L.RAJA SHRI THIRUMALESA ROADLINES 232 NL01Q5215 L. RAVICHAN DRAN SHRI THIRUMALESA ROADLINES

233 NL01Q5216 L.RAVICHANDRAN SHRI THIRUMALESA ROADLINES 234 NL01Q5217 L RAVICHANDRAN SHRI THIRUMALESA ROADLINES

235 NL01Q5220 L.RAVICHANDRAN SHRI THIRUMALESA ROADLINES

236 NL01Q5221 L. RAVICHAN DRAN SHRI THIRUMALESA ROADLINES 237 KA01AG2121 L.RAVICHANDRAN PAVITHRA BULK CARRIE~ 238 KA01AG2122 L. RAVICHAN DRAN PAVITHRA BULK CARRIER

239 KA01AG2124 L.RAVICHANDRAN PAVITHRA BULK CARRIER

240 KA01AG2125 L.RAVICHANDRAN PAVITHRA BULK CARRIER

241 KA01AG2126 L.RAVICHANDRAN PAVITHRA BULK CARRIE~

242 KA01AG2127 L.RAJA PAVITHRA BULK CARRIER


244 KA01AG2129 L.RAJA PAVITHRA BULK CARRIE~



247 NL01Q5272 S.RAJADURAI SHRI THIRUMALESA ROADLINES

248 NL01Q5269 S.V.PANDIYAN SHRI THIRUMALESA ROADLINES

249 KA01AG3442 D.SREERAJ SHRI THIRUMALESA ROADLINES

250 KA01AG3511 S.V.PANDIYAN SHRI THIRUMALESA ROADLINES

251 KA01AG4525 P.MOHANKUMAR SAl VARSHITHA TRANSPqRTS


~or THE ORIENTAL INSURANCE COJID.

~ I Sr. DIVISIONAL MANAGER

For Southctln Region But~ L:P.G. Transport Owners Assnctatwn,

M }- c.-President.

3?•qqugc1 ''4.,fi:ct ~fliu the oriental insurance company...

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