“Specimen- This draft is only to take language for
the purpose by Associate/consultant/company.”




This Indemnity Bond is made at ________on this _____ day of ________by Shri ____________ S/o  __________________Resident of ______________________________________________________, proprietor/partner/authorized signatory of ___________________in favour of M/s. PREMIER LPG LIMITED, 242, D-21 Corporate Park, Near Sec-8 Metro Station, Sector-21 Dwarka, New Delhi-110078.

WHEREAS I have obtained Associationship as “Customer Representative” from M/s. ___(Name of associate)___, of Premier LPG Limited vide authorization dated _________ for supply of cylinders in the areas _________.

AND WHEREAS I have been authorized for supply of the filled LPG cylinders and return empty gas cylinders to/from the customers to whom security vouchers have been issued by the _______________ of M/s. Premier LPG Limited.

AND WHEREAS I have accepted the terms of M/s__________________ vide my agreement with the distributor and followed the terms of the company for supply of cylinders as Customer Representative and I shall abide by the rules & regulations framed by the competent authority/central & state Govt. From time to time.

AND WHEREAS there is very likelihood of the dispute being raised by the consumer in respect of the defects in supply to the customers or complaints from any customers due to less weigh /leakage in cylinders.


  1. That I shall be fully responsible to the consumer in the event of their claim in respect of the refund vouchers or any other claim and M/s. Premier LPG Limited shall have no liability of any sort in respect of such claims.
  2. That I shall also be responsible and keep M/s. Premier LPG Limited harmless in the event of any claim arising out of any mishappening in view of non-return of empty gas cylinders or non return of security/service vouchers and in those circumstances, I shall be exclusively and solely responsible for such acts of the consumers. I shall also be personally liable in the process of mishappening due to natural factor or due to the negligency of the consumers or due to any other reasons and also responsible for any claim lodged against Premier LPG Limited. I undertake to indemnify M/s. Premier LPG Limited, in respect of all the claims including the cost of the litigations and also personally liable for the criminal cases(s) instituted, if any, by the consumers.
  3. That I undertake to Indemnify Premier LPG Limited in the event of any Claim, damages or mishappenings occurring on account, of the aforesaid factors as stated above and it shall be my exclusive responsibility and Premier LPG Limited have nothing to do with it and shall keep Premier LPG Limited, harmless and fully indemnified from all such claims, criminal cases etc.

IN WITNESS WHEREOF I have signed this Indemnity Bond on the day, month and year mentioned above in the presence of the following witnesses:-

WITNESS                                                                                                                                                                                                                (EXECUTANT)