Endorsement Schedule of Contractor All RiskEndorsement Schedule of Contractor All RiskEndorsement Schedule of Contractor All RiskEndorsement Schedule of Contractor All Risk

We value your relationship with ICICI Lombard. We thank you for preferring us as your

engineering insurance partner. We write to this on the basis of your request vide letter for

correction in respect of below subject matter.

Name : ARCHEE GROUP CONTRACTS PRIVATE ARCHEE GROUP CONTRACTS PRIVATE ARCHEE GROUP CONTRACTS PRIVATE ARCHEE GROUP CONTRACTS PRIVATE

LIMITED.LIMITED.LIMITED.LIMITED.

Address : Plot NoPlot NoPlot NoPlot No----BBBB----18 2 Nd Floor Sector18 2 Nd Floor Sector18 2 Nd Floor Sector18 2 Nd Floor Sector----32 32 32 32

Instituional Area N.HInstituional Area N.HInstituional Area N.HInstituional Area N.H----8 8 8 8 ---- Gurgaon Haryana Gurgaon Haryana Gurgaon Haryana Gurgaon Haryana

PinPinPinPin---- 122001 122001 122001 122001

Financier NameFinancier NameFinancier NameFinancier Name BranchBranchBranchBranchAgreement Agreement Agreement Agreement

TypeTypeTypeType

STATE BANK OF INDIA (30203),

SME CONNAUGHT CIRCUS, B-

39, MIDDLE CIRCLE, NEW

DELHI-110001

. Hypothecation

Office Name: GURGAON SECTOR GURGAON SECTOR GURGAON SECTOR GURGAON SECTOR

14141414

Policy Number : 5004/89981739/00/000 5004/89981739/00/000 5004/89981739/00/000 5004/89981739/00/000

(TRUE COPY)(TRUE COPY)(TRUE COPY)(TRUE COPY)

Period of

Insurance :

From: 23/04/2014 From: 23/04/2014 From: 23/04/2014 From: 23/04/2014

Time: 00:00 Hours Time: 00:00 Hours Time: 00:00 Hours Time: 00:00 Hours

To Midnight of To Midnight of To Midnight of To Midnight of

31/03/201531/03/201531/03/201531/03/2015

Non-Liable

Period :

From: 01/04/2015 From: 01/04/2015 From: 01/04/2015 From: 01/04/2015

Time:00:00 Hours Time:00:00 Hours Time:00:00 Hours Time:00:00 Hours

To Midnight of To Midnight of To Midnight of To Midnight of

13/04/201513/04/201513/04/201513/04/2015

Endorsement

No :

5004/89981739/00/004 5004/89981739/00/004 5004/89981739/00/004 5004/89981739/00/004

(TRUE COPY)(TRUE COPY)(TRUE COPY)(TRUE COPY)

Effective time

and date:

00:00 Hours 00:00 Hours 00:00 Hours 00:00 Hours ----

01/04/201501/04/201501/04/201501/04/2015

Date of issue : 18/04/201518/04/201518/04/201518/04/2015

Intermediary

Code :

200875708894200875708894200875708894200875708894

Endorsement wording :Endorsement wording :Endorsement wording :Endorsement wording :

Not withstanding anything to the contrary contained in the policy, it is hereby declared and Not withstanding anything to the contrary contained in the policy, it is hereby declared and Not withstanding anything to the contrary contained in the policy, it is hereby declared and Not withstanding anything to the contrary contained in the policy, it is hereby declared and

agreed that the policy stands amended for the reasons given below:agreed that the policy stands amended for the reasons given below:agreed that the policy stands amended for the reasons given below:agreed that the policy stands amended for the reasons given below:

The policy period stands extended by 03 months i.e. from 01/04/2015 to 30/06/2015.

Not Liable period: 01/04/2015 to 13/04/2015.

In lieu of above premium amount of Rs. 24,515/- stands charged to the insured.

All other terms & conditions of the Policy remain unaltered.

IDV Mentioned below is for the purpose of settlement of Total Loss and Theft claim

Endorsement PremiumEndorsement PremiumEndorsement PremiumEndorsement Premium 21,818.00

Endorsement Service TaxEndorsement Service TaxEndorsement Service TaxEndorsement Service Tax 2,618.16

Endorsement Edu.Cess And Higher Edu.Cess(3% on Service Tax)Endorsement Edu.Cess And Higher Edu.Cess(3% on Service Tax)Endorsement Edu.Cess And Higher Edu.Cess(3% on Service Tax)Endorsement Edu.Cess And Higher Edu.Cess(3% on Service Tax) 78.54

Endorsement Total PremiumEndorsement Total PremiumEndorsement Total PremiumEndorsement Total Premium 24,515.00

Service Tax Registration No. : GIS/MUMBAIService Tax Registration No. : GIS/MUMBAIService Tax Registration No. : GIS/MUMBAIService Tax Registration No. : GIS/MUMBAI----I/1528/2001I/1528/2001I/1528/2001I/1528/2001

Service Tax Code Number : AAACI7904GST001Service Tax Code Number : AAACI7904GST001Service Tax Code Number : AAACI7904GST001Service Tax Code Number : AAACI7904GST001

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Category: General Insurance Business Services 00440005.Category: General Insurance Business Services 00440005.Category: General Insurance Business Services 00440005.Category: General Insurance Business Services 00440005.

IRDA Registration no.115IRDA Registration no.115IRDA Registration no.115IRDA Registration no.115

Subject otherwise to the terms, conditions, exclusions, limitations and warranties attached to the

within mentioned policy.

All amounts are in Rs. Authorised SignatoryAuthorised SignatoryAuthorised SignatoryAuthorised Signatory

ICICI Lombard General Insurance Company Ltd

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