Cover Note No.

Insured's Code

Insured's Name

Address

THE ORIENTAL INSURANCE COMPANY LIMITED Regd. & Head Office: A-25/27, Asaf Ali Road, New Delhi - 110002.

Cover Note Date

, 79232475 Issue Office code 454700 SOUTHERN REGION BULK Issue Office Name : DO NAMAKKAL (GSTIN: L,P,G,TRANSPORT OWNERS 33AAACT0627 R3Z4) ASSOCIATION A\c: Various Parties as per List attached (GSTIN: 33AAGAS5195R1Z0)

87,SALEM ROAD Address KVA COMPLEX, NAMAKKAL 637 001 90-A, THURAIYUR ROAD,

NAMAKKAL - 637001

NAMAKKAL TAMIL NADU 637001 NAMAKKAL TAMIL NADU 637001 Tel.lFax/Email I 19442177088 I Tel.lFax/Email 04286-220504 , 222504 I 04286-222104 I

srblpgtoa@yahoo,co,in 454700@orientalinsurance,co,in

AgenUBroker Details

Dev.Off.Code : NA0000002595 M SELVARAJU

Agent/Broker : BA0000118557 R.MOHAN M. SELVARAJU Address ; 1/38A, VAGURAMPATTY"VASANTHAPURAM,NAMAKKAL,SALEM,TAMIL NADu,637da~s jness ASSOciat~ Tel/Fax/Email : 9442227091/944222709111Nt The OnentallnsUfaNCe C II

Namakkal _Gell . g4 o. ld. , Period of Insurance ,FROM 00:00 ON 22/01/2018 TO MIDNIGHT OF 21/01/2019 • • 43251165. Collection No, & DL CHQ 8935005335 - 18/01/2018 GST INVOICE NO :331610116404

Gross Premium 81,160 GST 14608 Stamp Duty ,5 Total: 176,928

Co-insurance Details NIL

Nature of Business TRANSPORT OPERATIONS

Category of Industry GREEN Policy Purchaser Category: Handler

Indemnity Limit Rs, 5,00,00,000,00 Any One Accident

Aggregate during the Policy Period (Not exceeding three times Rs, of anyone accident of Indemnity LimiL) 15,00,00,000,00

Retroactive Date 11/01/2018

Contribution to the 81,160,00 (included in the Total Premium) Environmental Relief Fund

TERRITORY/JURISDICTION: INDIA I INDIA

The Insurance under this policy is subject to terms and conditions given in the policy attached here to,

spe~COnditiOnS if a~ SRBLPGTOA A\C:200 NUMBER OF LPG TANKERS AS PER LIST ATTACHED

Excess: Kttb..

Place' NAMAKKAL For and on behalf of 11 11!~ll llnl lllillll llllll lllllll ~i I IIIIII~II IIIIII itedDate 11/01/2018 IRDA-RE;GN0-55e

In case of any query regarding the Policy please ca l Free No, 1800118485 and 011 33208485,

CIN U66010DL 1947GOI007158 All the Amounts m Page 1 of2

Attached to and forming part of policy number 454700/48/2018/3618

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 (GSTIN: 33AAACT0627R3Z4) on 11TH DAY OF JANUARY 2018

For and on behalf of Entered By M. SELVARAJU The Oriental Insurance Company Limited

Examined By MR V. AADHITHIYANATHAN

Policy Printed By : 426865

Authorised Signatory ,.- Policy Printed On : 18-JAN-18 12:31:48

Place: NAMAKKAL For and on behalf ofI~~IIII~UIIII~ I~ Date: 11/01/2018 IROA·RE~;NO-!iSil

In case of any query regarding the Policy please call Toll Free No. 1800 11 8485 and 011 33208485. Authorised Signatory

CIN: U6601 ODL1947GOI007158 All the Amounts mentioned in this policy are in Indian Rupees Page 2 of 2

IRDA Regn. No. 556 - Now you can buy and renew selected policies online at www.orientalinsurance.org.in

PLiINSURANCE 2 ATIACHED TO AND FORMING PART OF POLICY NUM BER 454700/48/2018/ 3b IB­

1 TN28M2152 P.SRINIVASAN JP LORRY SERVICE

2 KA01AG8087 P.SRINIVASAN JP LORRY SERVICE

3 KA01C9608 P.VAIYAPURI ARULLAXIMI GAS TRANSPORTS

4 TN28AH9879 S.PALANIAPPAN SPN BULK CARRIERS

5 TN45AE1067 S.PALANIAPPAN SPN BULK CARRIERS

6 TN28AH7130 M .VADIVEL SPN BULK CARRIERS

7 TN48R7545 S.T.BABU SBT TRANSPORTS

8 TN88C2497 S.T.BABU SBT TRANSPORTS

9 TN45AJ4867 M .VADIVEL RPA TRANSPORTS

10 TN88C3801 K.VAIYAPURI VANGALAMMAN TRANSPORTS

11 TN88C3803 K.VAIYAPURI VANGALAMMAN TRANSPORTS

12 TN28AJ2097 P.NATARAJAN PSN TRANSPORT

13 TN28AJ3097 P.NATARAJAN PSN TRANSPORT

14 TN28AJ3785 P.PARTHIBAN SJP TRANSPORT

15 TN04AH8476 P.5ENTHIL KUMAR ARS GAS CARRIERS

16 KA01AG7039 P.SUBBRAMANIYAM SHAKTHI MURUGAN ROADWAYS

17 KA01AG6897 P.SUBBRAMANIYAM SHAKTHI MURUGAN ROADWAYS

18 KA01AF4097 P .SU BBRAMAN IYAM SHAKTH I MURUGAN ROADWAYS

19 MH09BC5997 P .SUBBRAMANIYAM SHAKTHI MURUGAN ROADWAYS

20 KA01AG7132 P.SUBBRAMAN IYAM SHAKTHI MURUGAN ROADWAYS

21 TN45BA6739 C.NATARAJAN THOTIIYATHAN LORRY SERVICE

22 TN45AJ4267 P.BUVANESWARI MONISH ROADLINES

23 TN88A9697 R.HEMACHAND RAN JAYALAKSHMI TRANSPORTS

24 KA01AA6275 R.HEMACHANDRAN KRS TRANSPORTS

25 KA05AC5807 R.5AKUNTH ALA KRS TRANSPORTS

26 TN28AC8629 R. H EMACHAN DRAN SIVASAKTHI ROAD WAYS

27 TN28AC8650 R.H EMACHAN DRAN SIVASAKTHI ROAD WAYS

28 KAOI AH1499 R.HEMACHANDRAN SIVASAKTHI ROAD WAYS

29 KA01AH4099 R.HEMACHANDRAN SIVASAKTHI ROAD WAYS

30 TN28AC4266 V.PERIASAMY RAM ROADWAYS

31 TN28AJ4349 V.PERIASAMY RAM ROADWAYS

32 TN 28BA9996 K.M.RAMASAMY RAM ROADWAYS

33 KA01AG6943 K.M.RAM ASAMY RAM ROADWAYS

34 TN28AH9671 K.P .SARAVANAN KPSARAVANAN TRANSPORTS

35 TN28AH2153 K.BALACHANDAR SELLAPPAA TRANSPORT

36 TN28AH2253 K. BALACH AN DAR SELLAPPAA TRANSPORT

37 TN28AC8494 B.JAYANTHI SELLAPPAA TRANSPORT

38 KA01AG9453 K.BALACHANDAR SELLAPPAA TRANSPORT

39 KA01AH0453 K. BALACHAN DAR SELLAPPAA TRANSPORT

40 KAOIAG7173 S.KARUPPAN NAN SELLAPPAA TRANSPORT

41 KAO~AD3252 S.KA RU PPAN NAN SELLAPPAA TRANSPORT

42 TN 28AJ0902 S.KAR UPPANNAN SELLAPPAA TRANSPORT

43 TN28AF7410 K. PRABAHAR SRI YOGI RAM ROADWAYS

44 TN28AF7510 K.PRABAHAR SRI YOGI RAM ROADWAYS

PERIOD OF INSURANCE 22/01/ 2018 TO 21/01/2019

,., Or Sourheru Rc I' Transport Own MI~n Hull. L.Il.G 1

c~ ASSOl'iu'~on,

ATTACHED TO AN D FORMING PART OF POLICY NUMBER 454700/48/2018/ 3(,' 8 45 TN28AF7610 K.PRABAHAR SRI YOGI RA M ROADWAYS

46 TN28AF7310 K.PRABAHAR JAYALAKSHMI TRANSPORTS

47 TN886217 P.BALAN VAISHALI BULK CARRIER

48 TI\J88C3895 P.BALAN VAISHALI BULK CARRIER

49 TN28AF7210 P.BALAN RAAJAM AGENCIES

50 TN28AJ3515 P.VEE RAPPAN VP TRANSPORT

51 KA01AE5698 P.VEE RAPPAN VP TRANSPORT

52 KA01AG7558 P. VE ERAPPAN VP TRANSPORT . 53 KA01AH1977 P.VEERAPPAN VP TRANSPORT

54 TN28AP9986 T.5IVAKUMAR PUSHPAVALLI LO RRY SERVICE

55 TN28AD4723 T.S IVAKUMAR PUSHPAVALLI LORRY SERVICE

56 TN46J4523 T.SIVAK UM AR PUSHPAVALLI LO RR Y SERVICE

57 KA01AD2719 T.SIVAKUMAR PU SHPAVALLI LORRY SERVICE

58 TN886196 R.SELVAM VEL TRANS PORT

59 TN28AH3283 S.MADHESWARAN VELAVAN LORRY SERVI CE I, 60 TN28AH3105 A. MADESWARA N PSA ROADLIN ES

61 KAOI AG6469 A. MADESWARAN PSA ROADLINES

62 KAOIAG6471 A.M ADESWARAN PSA ROADLINES

63 KAO IAG7494 C. SAKTHIVEL KRMS LORRY SE RVICE

64 KAOIAG7499 C.SAKTHIVEL KRMS LO RRY SERVIC E

65 KA01AG7519 C. SAKTHIVEL KR MS LORRY SE RVICE

66 KA21A1859 C.SAKTHIVEL KRMS LO RRY SERVICE

67 TN886359 C.SAKTHIVEL KR MS LO RRY SERVICE

68 KA51A1569 C. SAKTH IVEL KRMS LORRY SERVICE

69 KA51 A1575 C. SAKTHIVEL KRMS LORRY SERVICE

70 TN28AJ9355 C. SAKTHIVEL KR MS LORRY SERVICE

71 KA01AD3 450 C. SAKTHIVEL KRM S LORRY SERVICE

72 KAOIAF6359 C.SAKTHIVEL KRMS LORRY SERVICE

73 TN28AJ4159 K.SELVARAJU SHRI GANAPATHY GAS CARRIER

74 KAO IAG9967 C.SAKTH IVEL MAHA GANAPATHI GAS CARRIER

75 TN 884559 C.SAKTHIVEL MAHA GANAPATHI GAS CARRIER

76 TN28AJ2959 C.SAKTH IVEl MAHA GANAPATHI GAS CARRIER

77 TN28AJ4259 C.SAKTH IVEL MAHA GANAPATH I GAS CARRIER

78 TN20BS8263 M .THANGAVEL SRI SIVASAKTH I TRANSPORTS

79 TN20BX5612 M.THANGAVEL SRI SIVASAKTHI TRANSPORTS

80 TN28BB7683 M.MANIYARAN VEL BULK CARRIERS

81 TN28AJ 1861 N.GANESAN NG KRISHNAVENI TRANSPORTS

82 KA402274 D.SIVAKUMAR GOKUL ROADWAYS

83 TN28BB6959 D.5IVAKUMAR SIVA TRANSPORT

84 KL09AJ 9959 N.MUTHUSAMY PARI TRANSPORTS

85 TN28AJ5 7SS K.RAJA PARI TRANSP ORTS

86 KL09AM4759 K.RAJA PARI TRANSPORTS

87 TN 28AH9481 N.RAMASAMY VTC TRANSPORTS

88 KAOIAD2928 N.RAMASAMY VTC TRANSPORTS

89 TN28AC8736 R.BHARATHI KAMATCHI VILAS TRANSPORT

PERIOD OF INSURANCE 22/01/2018 TO 21/ 01/2019

tIll, .~ 'Ir' ' 1'1' 1.. · · : 1'I su n 'n Rcv,il'" null, L.P.G . laIl HE URI ElHAl N , . ~ For Southel rs Assm.' i11l inn,TrJlJU~J)orl own e

rv~~

ATTACHED TO AND FORMING PART OF POLICY NUMBER 454700/48/2018/3bI8 90 TN886013 M. SELVARAJU RMS TRANSPORTS

91 TN886014 M. SELVARAJU RMS TRANSPORTS

92 TN886015 M . SELVARAJU RMS TRANSPORTS

93 TN886016 M. SELVARAJU RMS TRANSPORTS

94 TN886017 M. SELVARAJU RMS TRANSPORTS

95 TN886018 M. SELVARAJU RMS TRANSPORTS 96 TN886019 M. SELVARAJU RMS TRANSPORTS

97 TN886021 M. SELVARAJU RMS TRANSPORTS

98 TN886022 M. SELVARAJU RMS TRANSPORTS

99 TN886023 M. SELVARAJU RMS TRANSPORTS

100 TN886024 M. SELVARAJU RMS TRANSPORTS

101 S. MALARKODI RMS TRANSPORTS

102

TN886025

RMS TRANSPORTS

103 TN886026 M. SELVARAJU

TN48Y1444 RMS TRANSPORTS

104

M. SELVARAJU

KA01C9544 RMS TRANSPORTS

105

M. SELVARAJU

KA01C9553 M . SELVARAJU RMS TRANSPORTS

106 M. SELVARAJU RMS TRANSPORTS

107

KA01C9554

RMS TRANSPORTS

108

M. SELVARAJUTN88C4929

RMS TRANSPORTS

109

KA01AE4879 NS. ASHOKRAJU

RMS TRANSPORTS

110

KAOlAE0897 M. SE LVARAJU

RMS TRANSPORTS

111

M. SELVARAJUKA01AE8996

RMS TRANSPORTS

112

NS. ASHOKRAJUTN88A8445

RMS TRANSPORTS

113

NS. ASHOKRAJUHR63C6685

ASHOK ROAD LINES

114

M . SELVARAJUKA01AF8097 ASHOK ROAD LINES

115

M . SELVARAJUTN88C4939

ASHOK ROAD LINES

116

M. SE LVARAJUTN88C4925 ASHOK ROAD LINES

117

M. SE LVARAJUTN88C4935 ASHOK ROAD LINES

118

M. SELVARAJUTN88C4928 ASHOK ROAD LINES

119

M. SELVARAJUTN88C4943 P.RAJU

120

P.RAJUKA01AG9713 P.RAJU

121

P.RAJUKA01AG9714 P.RAJU

122

P.RAJUKA01AF5632 P.RAJU

123

P.RAJUKA01AF5635 P.RAJU

124

P.RAJUKA01AF5636 P.RAJU

125

P.RAJUKA01AF5637 P.RAJU

126

P.RAJUKA01AF5638 P.RAJU

127

P.RAJUKA01AF5639 P.RAJU

128

P.RAJUKA01AF5644 P.RAJU

129

P.RAJ UKA01AF5645 P.RAJU

130

P.RAJUKA01AF5293 P.RAJU

131

P.RAJUKA01AF5296 P.RAJU

132

P.RAJUKA01AF5297 P.RAJU

133

P.RAJUKA01AF4893 P.RAJU

134

P.RAJU KA01AF4896 P.RAJUP.RAJUKA01AF4897

PERIOD OF INSURANCE 22/01/2018 TO 21/01/2019

For Southern nC:.!,itul BIII~ ":" :IorlH£O~ ;/(\~S tJR~~', Trnnsport Own~rs AssociatlOIl .COMPANY LlMlTffl, fJ.... ' ~ . (1\ W\~D.O _ u~

C') Presldeo\.

ATTACHED TO AND FORMING PART OF POLICY NUMBER 454700/48/2018/ 3> t.,\ 11 135 KA01AF4898 P.RAJU P.RAJU

136 P.RAJUKA01AF1693 P.RAJU

137 KA01AF1695 P.RAJU P.RAJU

138 KA01AF1696 P.RAJU P.RAJU

139 KA01AF1697 P.RAJU P.RAJU

140 P.RAJU P.RAJU

141

KA01AF1698

KA01AE4896 P.RAJU P.RAJU

142 KA01AF5292 P.RAJU P.RAJU

143 KA01C8929 MUKUNTH BULK CARRIERS

144

K.SELVI

K.SELVI MUKUNTH BULK CARRIERS

145

KA01C8930

C.BALASUBRAMANIAN SS TRANSPORTS

146

TN88C3125

SKM TRANSPORTS

147

KA01AD2382 P.SENTHIL KUMAR

SKM TRANSPORTS

148

P.SENTHIL KUMARTN05Y1903

ES TRANSPORTS

149

TN28AH0769 C.SURESH

GIRl ESHWAR TRANSPORTS

150

KA21A5055 K.ANNADURAI

GIRl ESHWAR TRANSPORTS

151

K.ANNADURAI KA01AA6905 GIRl ESHWAR TRANSPORTS

152

KA01AF8177 K.ANNADURAI SKV TRANSPORT

153

K.MUTHIYALU KA19AB2372 SKV TRANSPORT

154

K.MUTHIYALU MH06AQ5720 SHREE CHAKKRAA BULK CARRIER

155

N.GANESHKA21A4649 SHREE CHAKKRAA BULK CARRIER

156

N.GANESHTN28AH5347 SHREE CHAKKRAA BULK CARRIER

157

N.GMJESHKA01AG7611 SHREE CHAKKRAA BULK CARRIER

158

N.GANESHKA01AG3515 CHANDRASEKARAN IYER S

159

P.sENTHIL KUMARKA01AG3516 GIRl ESHWAR TRANSPORTS

160

K.ANNADURAIKA01AG3517 KAVI TRANSPORT

161

K.MUTHUKUMAR TN28AE9634 G.LOGAVANI TRANSPORT

162

P.GOVINDARAJTN28AH8389 G.LOGAVANI TRANSPORT

163

P.GOVINDARAJKA01AD2262 G.LOGAVANI TRANSPORT

164

P.GOVINDARAJKA01AG6486 SJP TRANSPORT

165

P.PARTHIBANTN59AJ2125 SJP TRANSPORT

PRAKASH TRANSPORT P.PARTHIBANKA01AG9367 V.PRAKASHKUMAR

ANNAMAR BULK CARRIERS TI\l88C4587166

M.REVATHI ANNAMAR BULK CARRIERS

TI\l28AC6376167 M.REVATHI

ESWARI TRANSPORT TI\l88C3541168

S.SENGUnUUVAN

170

TI\l28AJ6897169 VAT TRANSPORTS

171

V.sUBRAMANIANTN28AC8826 VAT TRANSPORTS

172

V.sU BRAMAN IANKA01C9772 VAT TRANSPORTS

VAT TRANSPORTS V.sUBRAMANIANKA21A4971 V.SUBRAMANIAN

VAT TRANSPORTS TN88B4487173

V.SUBRAMANIAN VAT TRANSPORTS

TN88C4487174 V.SUBRAMANIAN

VAT TRANSPORTS KA01AF5284175

V.SUBRAMANIAN VAT TRANSPORTS

KA01AG3715176 V.SUBRAMANIAN

SRI RAM TRANSPORT KA01AG7287177

K.THAALAMUTHU SRI RAM TRANSPORT

TN48K8734178 K.THAALAMUTHUTN28AJ3319179

PERIOD OF INSURANCE 22/ 01/ 2018 TO 21/01/2019

\"SURAJ G . ....~C' For Southern Region Bulk. L:P. Tr.nsport Owners Assocl.tlon

." •

kt1liEORlfN.A: '~C~. ! '" Uol ('") ~ . - • 0 (}.\~ .... . .... ., ~t :.

ATTACHED TO AND FORMING PART OF POLICY NUMBER 454700/48/2018/3bl g 180 KA01AG1932 K.THAALAMUTH U SRI RAM TRANSPORT

181 KA01C8557 K.THAALAMUTH U SRI RAM TRANSPORT

182 KA01AG9096 K.THAALAMUTH U SRI RAM TRANSPORT

183 KA01AG3057 K. THAALAM UTH U SRI RAM TRANSPORT

184 KA01AFS294 K.THAALAMUTH U SRI RAM TRANSPORT

185 TN88C4387 K.THAALAMUTH U SRI RAM TRANSPORT

186 KA01AE5809 ESWARAN EPR TRANSPORTS

187 KA01AG7909 ESWARAN EPR TRANSPORTS

188 TN28AH5969 S.SELVARAJ SRI RAMAJEYAM ROADWAYS

189 TN885969 S.SELVARAJ SRI RAMAJEYAM ROADWAYS

190 TN88C3157 R.VEERAPPAN VIBI ROAD LINES

191 TN88C3453 A.J.RAJA JAISHAKTHITRANSPORTS

192 TN88C3418 A.J .RAJA JAISHAKTHITRANSPORTS

193 KL09AA469 V.MAHESWARI VASANTHAM TRANSPORTS

194 KL09AA496 V.MAHESWARI VASANTHAM TRANSPORTS

195 KL09AA569 V.MAHESWARI VASANTHAM TRANSPORTS

196 KL09AA5902 V.MAHESWARI VASANTHAM TRANSPORTS

197 KL09AA5911 V.MAHESWARI VASANTHAM TRANSPORTS

198 KL09AL8595 V.MAHESWARI VASANTHAM TRANSPORTS

199 KL09AL5945 V.MAHESWARI VASANTHAM TRANSPORTS

200 KA01C8806 S.S UN DARARAJAN SS TANKER SERVICE

PERIOD OF INSURANCE 22/01/2018 TO 21/01/2019

For Southern Regiun Uulk L.P.r.. TrllnspoJ't Owners Assut:latiuu.

L\ \,-- l.--- •

PresidenL

-