Licence No.SLA74772 Office No. 7887513931 Valid Upto :06/06/2023 Mobile No. 9769319849 Amol Sawant Surveyor, Loss Assessor & Valuer Email Id :- amol6777@gmail.com C/103 New Ashish CHSL, CSC Road No.4, Dahisar East, Mumbai 400068 FINAL SURVEY BILL ReF. no. : AS/4148/2021 INSURER : BAJAJ ALLIANZ GENERAL INSURANCE CO. LTD. BILL NO : 2021/1022 BAGI Andheri Date : 13/03/2021 291, Xtrium, 2nd Floor, Next To Holy Family Church, Andheri-Kurla Road, Chakala, Andheri (E), Mumbai-400099. State : Maharashtra - 27 GSTIN No. : 27AABCB5730G1ZX INSURED : NIRAJ DHARAMRAJ DUBEY POLICY NO. : OG-20-3064-1828-00000711 CLAIM NO. : OC-21-1901-1828-00000312 VEHICLE NO. : MH03DM2899 SURVEYED AT : PILOT HONDA on Dt. : 24/12/2020 Details Amount Professional Fees SAC Code No. 997162 Rs. : 750.00 Photograph (@Rs. 10.00 x 0 Copy) Rs. : 0.00 Conveyance () Rs. : 250.00 KO PHOTO Rs. : 250.00 RI PHOTO Rs. : 250.00 Total Rs. : 1,500.00 CGST 9% On Rs. 1,500.00 Rs. : 135.00 SGST 9% On Rs. 1,500.00 Rs. : 135.00 Rounded to Nearest Rupees: Net Total Rs. : 1,770.00 Rupees : One Thousand Seven Hundred Seventy Only GST No. : 27BNAPS9753G1ZJ State : Maharashtra Code:27 PAN No. : BNAPS9753G 0 Amol Sawant SURVEYOR ---PAGE END---