Parikh Associates                                                                  mobile+919998100555
                                                                                                                   phone+912652481991
                                                                                                                   parikh.associates@yahoo.com
        chartered engineer.                                 INVOICE
       surveyor,
       loss assessor,                                                                                          21,Padmavatinagar,VIP.Road.
        valuer.                                                                                                  Karelibaug,Vadodara-39618
       risk management
 INVOICE'NO.:             211775                                                                    Date:       27.11.2020
 REPORT NO.:            BAG/PDP/2021/1713
                                                                                                                  License no.SLA/72618,valid upto Nov.2021
To,
 BAJAJ ALLIANZ GENERALINSURANCE CO LTD
 4TH FLOOR ATLANTIS HIGHTS
 NR SARABHAI CIRCLE
 VADODARA
 RECIPIENTID             24AABCB5730G1Z3

 INSURED:                 SUKHRAMBHAI R RATHWA                                            INTERESTGJ34A8013
                                                                                                                                    HF DELUX
 POLICY NO:             OG-21-2201-1802-00005943

 CLAIMNO:              OC-21-2201-1802-00000624

INSURER:                  BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.

APPOINTED BY:        BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.

SR.NO.    DESCRIPTION                                            HSN/SAC          RATEQty.         AMOUNT
                                                                                  Code
       1        PROFESSIONAL SURVEY CHARGES
                 FINAL                                                                            350.00               1       350.00
                 SPOT                                                                                                      0
       2       CONVEYANCE CHARGES                                                                        0
                 1VISIT AT CHHOTAUDEPUR 105*2=210KMS                          7.50           210    1,575.00
                                                                                                                                0
       3       PHOTOGRAPHS                                                                                       0
                 DIGITAL CD                                                                     40.00              1         40.00

       4        OUT OF POCKET EXPENSES                                                                       1
                 TOLLTAX/PHOTOCOPIES
                 HALTING                                                                                                 0
                                                                 SUB TOTAL                                                      1,965.00
                                                                        CGST                        9.00%                        176.85
                                                                         SGST                       9.00%                       176.85
                 ROUNDING OFF
                                                           GRAND TOTAL                                                            2,319

RUPEES     TWO THOUSAND THREE HUNDRED AND NINETEEN ONLY.

Our Bank Detail:
Bank        ICICI Bank Ltd.
Bank Br.Karelibaug                                                                              FOR PARIKH ASSOCIATES
C.A/c no.024805001738                                                                                                          H
IFSC CodeICIC0000248
PAN No.:AFTPP 4625 C                                                                                      PRAKASH PARIKH

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