NAGESH. S. DHUMAL
 Automobile Surveyor, Loss Assessor & Valuer                                             D.A.E., B.A.
                                                                                                         A-25, First Floor, Office No.6 ,Gurrukripa CHS,
 Licence No. : SLA - 74742               Valid Upto :22/03/2023                           Sector 03, Sanpada (E), Navi Mumbai - 400 705
                                                                                                         022-27753336,2775 3405,Mob No. 9833490051
                                                                                                         Email ID:surveyor.nsd@gmail.com
                                                                        FINAL SURVEY BILL
Bill No.       : BA-000087/2020-2021                                                                  Date        : 12/12/2020
                                     Bajaj Allianz General Insurance Company Ltd.
ISSUED TO
DIV./BRANCH                    MUMBAI
INSURED                        MR.DHANAJI JADHAV
VEHICLE NO.                     MH 14 EM 0676
POLICY NO.                                                                            CLAIM NO. :          OC-21-2001-1803-00000946
SURVEYED AT            :    Mumbai Pune Expressway on Dt. : 07/12/2020

             Professional Fees                                                                                               Rs.:                    750.00
             Photograph1(at Rs. 0.00 x 0 Copy)                                                              Rs.:                        0.00
             Traveling Expenses 140 km. 140kms to & fro @ Rs.7.50                                          Rs.:                   1050.00
             Toll Charges                                                                                                     Rs.:                     203.00
             Doc. Veri. Char.                                                                                                 Rs.:                        0.00
                                                                                                    Total                      Rs.:                   2003.00
             18.00% GST on Rs. 2003.00                                                                              Rs.:                    360.54
             Rounded to Nearest Rupees :                                              Net Total                      Rs.:                   2364.00
              Rupees :TWO THOUSAND THREE HUNDRED SIXTY FOUR  ONLY
GST No.                   : 27AOMPD6250M1ZM

BAGIC GST NO :           27AABCB5730G1ZX
                                                                                                                       NAGESH. S. DHUMAL
Advance Receipt

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