HITESH R. RAVAL                                     TEL: (02836) 228544 Mo. 9825225844
D.A.E.,A.I.I.S.A(BOMBAY)                                                     G-8, B Green Park, PI. No. 113-114, Tagore Road,
SURVEYOR LOSS ASSESSOR & VALUER                                            Gandhidham - 370201, Dist - Kutchh.
LIC.NO.SLA/36625 up to 02.04.2023                              EMAIL :hird2007@gmail.com
                                                                  INVOICE


BAJAJ ALLIANZ GENERAL INSURANCE CO.LTD.              Invoice #           HIR/11336/2021
BARODA                                                                    Invoice Date       8-Mar-2021
GSTIN : 24AABCB5730G1Z3


Insured : GOKUL AGRO RESOURCES LTD                                Vehicle No.                 GJ 12 BV 7422
Policy # OG-20-2022-1803-00025969                                  Nature of Loss     Own Damage / External means
CLAIM NO. OC-21-2204-1803-00000311
Sr. NqDESCRIPTION                                                QTY.        UNIT       RATE          Rs. Ps.
 01.  Survey Fees -- Final                                            1           Per         1500             1500.00
 01.  Survey Fees -- Spot                                             0            Per            0                    0.00
 02.  Re Inspection Fees                                             0            Per            0                    0.00
 03.  Daily Allowance                                                0           Each         150                   0.00
 04.  Local Convence Charges                                      2           Each         250               500.00
         R. Inspection visits                                             1          Each         250               250.00
         Outstation Conveyance                                       0            km            6                    0.00
 05.  Photograph (CD) Charges No.                               1           Each          50                  50.00
 06.  Other Expense / Toll Taxes                                                                                         0.00
                                                                         Sub Total                                          2300.00
                                                                         CGST @                     9.00%                207.00
                                                                         SGST @                     9.00%                207.00
                                                                         Grand Total                                       2714.00
                                                                         Say                                                 2714.00
Rupees :      Two Thousand Seven Hundred Fourteen Only

E. and O.E.                                                                                   Bank Details
Subject to Gandhidham Jurisdiction                                                 ICICI BANK LTD.
GSTIN: 24AASPR2350N1Z6                                                          Account No.: 008601009859
PAN No. :AASPR2350N                                                                  IFSC Coad: ICIC0000259
                                                                                                 Micr. No.: 108214
             ESHRAT
               Lig.Nio.                                                                            Account Type: Savings
            9S-36625
              Surveyor

HITESH RAVAL

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