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

                                                 PRE RECEIPT
  Bill Number:DR/01-2021/801                                                 Date: 16-01-2020
 Insurer                                    Bajaj Allianz General Insurance Company Limited
                                                2&3rd Floor, 4,Hathroi Fort,Gopal bari, Ajmer road, Jaipur
                                                GSTIN-08AABCB5730G1ZX
  Claim Number                          OC-21-1401-1801-00004014
  Insured                                   Mr.Raju Vaishnav
 Policy Number                         OG-21-3284-1801-00000217
  Report number                          DR/Motor/01-2021/801
  Place of inspection                     Local Workshop-Pali
  Vehicle Regd. Number               RJ-22-CA-5352
  Professional Fees                                                                              750.00/-
  Conveyance-For Final                                                                        1350.00/-
  Distance between Jodhpur & Pali is 90.00 km.
  Total distance covered=90.00 x 2=180.00 km
  Conveyance @ 07.50/- = 180.00 x 07.50/- = 1350.00/-
 Photographs charges-CD                                                                      30.00/
 DA                                                                                                 175.00/
  Regd Letters                                                                                        0.00/-
  TOTAL                                                                                         2305.00/-
 CGST @ 09.00% = 207.45/- & SGST @ 09.00% = 207.45/-                              414.90/-
  TOTAL Rs/-                                                                                  2720.00/-
(Rs/- Two Thousand Seven Hundred Twenty Only)
      For NEFT Fund Transfer:-
      Bank Name:Union Bank of India
      IFSCUBIN 0550388
      A/C Number: 503802010011146                                             SLA
      MICR Code:342026003
      GSTIN-08ACUPR3734N1ZO                              DEERAKRATHI



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

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