Yogesh Gupta
                           Surveyor & Loss Assessor
                           License No.                   120998                                                                                     Office:                            SCF-10,Sector-5
                           Valid upto                    20.01.2022                                                                                                   Bahadurgarh,Distt.Jhajjar
                           Deptt.                        :Motor                                                                                                                         Haryana-124507
                           PAN No.                       AIEPG3565C
                                                                                                                                                                                           M9728410038
                           Ref.No.YRK/Bajaj/21/Motor/043                                                                                                                                     June 20,2021
                                      Bajaj Allianz General Insurance Co.Ltd;
                                      Moti nagar
                                      Delhi.
                                                                                       Policy No.                    OG-21-1904-1802-00011736
                                                                                        Claim No.                    OC-22-1101-1802-00000420
                                                                                     Vehilce No.                     HR12AB4521
                                                                          Insured's Name                             : MR SARUP SINGH
                                                                                                                       SURVEY FEE BILL
                             A) Professional Fee for Spot survey                                                                                                                  :Rs.                        0.00
                             B)Professional Fee for Final survey                                                                                                                  Rs.                    450.00
                                      (Assessed loss amount Rs.)                                            5600.00
                            c)Professional Fee for others/Verification                                                                                                            Rs.                         0.00
                                      Conveyance Charges (Local)                                                   1                                                              :Rs.                   300.00
                                      Conveyance(Out Station)                                                                                                                     Rs.                         0.00
                                      Photographs-Digital                                                                       0                     0                            :Rs.                       0.00
                                                                                                                                                                                                         750.00
                                                    Total Rs.750.00
                                      (Rs.SEVEN HUNDRED FIFTY ONLY.)
                                            SLA
                                           120998
                                      (Yogesh Gupta)
                                      Surveyor and Loss Assessor
                                      NEFT Details:
                                     Name:                              YOGESH GUPTA
                                     Bank:                              INDUSIND BANK
                                     A/c No.                            159728410038
                                      IFSC Code:                        INDB0000360
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