RAKESH KUMAR
                                                     SURVEYOR & LOSSASSESSOR
FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                         Mob.#9868110525/8836301125
                                         E-mail: majokarakesh61197@gmail.com
                                         License No. SLA-61197,Valid upto 07/10/2023
                                         Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
Ref:- BAJAJ/FINAL/2020/21/0638                                                                     Dated: 25/03/2021
                                                     HSN/SAC CODE:997162
Bajaj Allianz General Insurance Company Limited.
Block No.4, 7th Floor, DLF Tower-15, Shivaji Marg, 011-66278225, New Delhi-110001.
GST Number: 07AABCB5730GIZZ
VEHICLE NO.                           UP 12AW 8160
INSURED NAME           :        SONU KUMAR
CLAIM NO.                     :        OC-21-1103-1871-00000447
PolICY No.                               OG-21-1307-1871-00000076
ASSESSED LOSS              :        Rs. 3100/-


Professional
Professional Fee                                                                                                                                     400.00
Visit to workshop                                  Rohini To Baraut, UP 132*4                                                          528.00
RE-Inspection Charges                                                                                                                              0.00
Under repair                                                                                                                                              0.00
Spot inspection                                                                                                                                          0.00
TOTAL                                                                                                                                                 928.00
CGST@9%:                                                                                                                                                83.52
SGST@9%                                                                                                                                                 83.52
GROUND TOTAL                                                                                                                             1095.04


Thanks & Regards
Rakesh Kumar


(Authorized Signatory).

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