DEEPAK RATHIBE.
                                                                       Surveyor and Loss Assessor & Valuer
  IIISLA Member Ship No.-Associate -A/W/04882                             Fire, Motor & Engineering)
  GSTIN :08ACUPR3734N1ZO                                                                       SLA-73076
  PAN ACUPR3734N                                                    Mobile :94149-14640,99822-14640


                                                  PRE RECEIPT
  Bill Number:DR/07-2020/145                                                 Date: 13-07-2020
  Insurer                                     Bajaj Allianz General Insurance Company Limited
                                                 2&3 Floor,4Hathroi Fort Gopal bariAjmer road, Jaipur
                                                 GSTIN-08AABCB5730G1ZX
  Claim Number                          OC-21-1401-1802-00000200
  Insured                                    Mr.Dashrath Meena
  Policy Number                          OG-20-1418-1802-00000123
  Report number                          DR/Motor/07-2020/145
  Place of inspection                     Barmer Bajaj-Barmer
  Vehicle Regd. Number               RJ-04-SN-4772
  Professional Fees                                                                                500.00/-
  Conveyance-For Final                                                                        3300.00/-
  Distance between Jodhpur & Barmer is 220.00 km.
  Total distance covered=220.00x2=440.00 km
  Conveyance @07.50/-=440.00x07.50/-=3300.00/-
  Photographs charges-CD                                                                       30.00-
 DA                                                                                                   175.00/-
  Regd Letters                                                                                         0.00/-
  TOTAL                                                                                          4005.00/-
  CGST @ 09.00% = 360.45/- & SGST @ 09.00% = 360.45/-                                720.90/-
  TOTAL Rs/-                                                                                    4726.00/-
(Rs/- Four Thousand Seven Hundred Twenty Six Only
      For NEFT Fund Transfer:-
      Bank Name:Union Bank of India
      IFSCUBIN 0550388
      A/C Number:503802010011146
      MICR Code:342026003
      GSTIN-08ACUPR3734N1ZO                              DEEPAKRATHI



           C/o. Annkoot Agro Food, T-2,Mandore Mandi, Jodhpur-342 006 Raj.)

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