State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy
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1 State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned. INSURED : Accounts Officer(Budget) SCHEDULE POLICY No.:GIF/81/GPA/11-12/15 Jodhpur Vidyut Vitran Nigam Ltd., Date : Jodhpur ADDRESS : COVER NOTE No.: DD No Dated Rs PREMIUM CHEQUE NO. DATED 500/ % S.T.) Prem. Rs /- + ST Rs /- + Ed.Cess Rs.9689/-+H.E.C.4845/- Total = / Employees RENEWAL OF POLICY NO /73 PERIOD OF INSURANCE SUM INSURED FROM To
2 INSURANCE COVER Group Personal Accident Insurance for 9689 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs SUBJECT TO CLAUSE : As per attached Policy Note: List of Employees not submitted fully by the Insured. Claims will be settled only after receiving the complete list of employees. 1 For THE GENERAL INSURANCE FUND State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned.
3 INSURED : Secretary Asstt.Accounts officer(cash), SCHEDULE POLICY No.:GIF/81/GPA/11-12/14 Rajasthan Rajya Vidyut Utpadan Nigam Ltd., Date : Jaipur ADDRESS : COVER NOTE No.: DD No Dated Rs PREMIUM CHEQUE NO. DATED Prem. Rs /- + ST Rs.83325/- + Ed.Cess Rs.1667/-+ H.E.Cess 833/ Employees INSURED PERSON LIST ENCLOSED RENEWAL OF POLICY NO /74 PERIOD OF INSURANCE SUM INSURED FROM To INSURANCE COVER Group Personal Accident Insurance for 3333 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs SUBJECT TO CLAUSE : As per attached Policy Note :- List of Employees has not submitted by the Insured. 2 For THE GENERAL INSURANCE FUND
4 State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned. INSURED : Secretary Accounts officer(estt. Cont.) SCHEDULE POLICY No.:GIF/81/GPA/11-12/12 Rajasthan Rajya Vidyut Prasaran Nigam Ltd., Date : Vidyut Bhawan, Janpath, Jaipur ADDRESS : COVER NOTE No.: DD No Dated Rs PREMIUM CHEQUE NO. DATED Prem. Rs /- + ST Rs /- + Ed.Cess Rs.3500/- +H.E. Cess Rs.1750/ Employees INSURED PERSON LIST ENCLOSED RENEWAL OF POLICY NO /70 PERIOD OF INSURANCE SUM INSURED
5 FROM To INSURANCE COVER Group Personal Accident Insurance for 7000 employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs SUBJECT TO CLAUSE : As per attached Policy 3 For THE GENERAL INSURANCE FUND
6 State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned. SCHEDULE INSURED : Accounts officer(cash) POLICY No.:GIF/81/GPA/11-12/13 Jaipur Vidyut Vitran Nigam Ltd., Date : Vidyut Bhawan, Janpath, Jaipur ADDRESS : COVER NOTE No.: DD No Dated Rs PREMIUM CHEQUE NO. DATED 500/ % S.T.) Prem. Rs /- + ST Rs /- + Ed.Cess Rs.15157/-+ H.EDU.Cess 7579/- Total Rs / Employees RENEWAL OF POLICY NO /71 PERIOD OF INSURANCE SUM INSURED
7 FROM To
8 INSURANCE COVER Group Personal Accident Insurance for employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs SUBJECT TO CLAUSE : As per attached Policy Note: List of Employees not submitted completely by Insured. Claims will be settled only after receiving the complete list of employees. 4 For THE GENERAL INSURANCE FUND State Insurance and Provident Fund Department (General Insurance Fund) Group Personal Accident Insurance Policy Whereas the insured named in the Schedule hereto has made or caused to be made to the General Insurance Fund a written proposal dated as stated, in the schedule hereto (warranting the truth of the statement contained therein) which is the basis of this contract and is deemed to be incorporated herein and has paid the General Insurance Fund the premium herein stated for the insurance of the risk hereinafter specified occuring during the period General Insurance Fund may accept payment for the renewal of this policy. Now this policy witnesseth that subject to the terms, exclusions, conditions and definitions contained herein or endorsed or otherwise expressed hereon the General Insurance Fund will indemnify the insured as hereinafter mentioned.
9 SCHEDULE INSURED : Secretary Sr. Accounts officer(ea & Cash) POLICY No.:GIF/81/GPA/11-12/17 Ajmer Vidyut Vitran Nigam Ltd., Date : Ajmer ADDRESS : City Power House, Hathibhata, Ajmer COVER NOTE No.: DD No Dated Rs PREMIUM CHEQUE NO Dated Rs DATED Dated Rs Dated Rs Dated Rs Dated Rs Dated Rs Dated Rs Prem. Rs /- + ST Rs /- + Ed.Cess Rs.12468/-+ H.E.C. 6234/ Employees INSURED PERSON LIST ENCLOSED RENEWAL OF POLICY NO /75 PERIOD OF INSURANCE SUM INSURED FROM To INSURANCE COVER Group Personal Accident Insurance for employees Sum assured for each employee Rs. 2,00,000/- Total Sum Assured Rs SUBJECT TO CLAUSE : As per attached Policy
10 Note:- List of Employees not Fully submitted by the Insured. For THE GENERAL INSURANCE FUND
STUDENT SAFETY ACCIDENTAL INSURANCE POLICY (CLASS 1 TO 8) Policy No. GIF/81/SSI/2011-12/10
GOVERNMENT OF RAJASTHAN STATE INSURANCE PROVIDENT FUND DEPARTMENT (GENERAL INSURANCE FUND) 2nd FLOOR,'D BLOCK,VITTA BHAWAN,JANPATH,JAIPUR. PHONE 2740219,2740292 STUDENT SAFETY ACCIDENTAL INSURANCE POLICY
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