SAURABH JUNEJA                                                                              Phone(s)       : 011 - 42058194
Surveyor & Loss Assessor                                                                                  Mobile(s)       : 9899474475
SLA 73349, Valid up to : 08-04-2023                                                                  Address        : H No 107, Hargobind Enclave,
Email : srbh.juneja@gmail.com                                                                                                1st Floor, Vikas Marg Extn.,
IIISLA No. : A/N/5997                                                                                                             Delhi - 110092
                                                                                         Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                                           Bill. No : B-07/20/03506
       Block No-4, 7 Th Floor DLF Tower Shivaji Marg New Delhi-110015                                      Date     : 29/07/2020
       New Delhi-110015                                                                                                        Code     :
       GSTIN: 07AABCB5730G1ZZ                      State Code: Delhi (07)
                    Report Ref No                            SJ/BAGI/SCL0445/07-20/F/11764
                    Vehicle No.                         :     DL3SCL0445
                    Insured Name                    :     PRAMOD KUMAR RAY
                    Date Of Accident          :            11/07/2020
                    Policy/cover note no           :     OG-20-1104-1802-00005869
                    Claim No                           :    OC-21-1101-1802-00000589
    S No                                              Particulars                                                         HSN/SAC                                      Amount Z
       1     Final                                                                                                             997162                                                900.00
                       Professional Fee :             Assessed Amount  13,720.00                                                        750.00
                       Photos/CD Expenses :                                                                                                            0.00
                        0 Photographs , Charged for 0 @ Rs. 10.00
                       Conveyance Expenses :                                                                                                       150.00

                                                                                                                                                       Sub Total : %                   900.00
                                                                                                                                                    C GST @ 9.00 %                     81.00
                                                                                                                                                   S GST @ 9.00 %                      81.00
                 ADVANCE RECEIPT                                                                                                      Grand Total : %                 1,062.00
                                                                                                                                                       Round off :                  1,062.00
                                                                         In words : Rs. One Thousand Sixty Two Only
   GSTIN: 07AHGPJ3702K1ZG State : (07)
   PAN. : AHGPJ3702K
   Bank Name: AXIS BANK
   A/c No.                : 913020019916326
   MICR No              : 110211039                                                              SAURABH JUNEJA

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