RAKESH KUMAR
                                                 SURVEYOR& LOSS ASSESSOR
 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/2020/21/0386                                                               Dated: 14/12/2020
                                                 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.                        DL 1LAE 1215
 INSURED NAME                   MR. IBRAIL RAJA
 CLAIM NO.                            OC-21-1101-1803-00000803
POLICY No.                             OG-21-1149-1803-00001105
ASSESSED LOSS                     Rs. 5925/-


Professional
Professional Fee                                                                                                                         550.00
Visit to workshop                                                                                                                        150.00
RE-Inspection Charges                                                                                                                   0.00
Under repair                                                                                                                                  0.00
Spot inspection Fee                                                                                                                        0.00
TOTAL                                                                                                                                     700.00
CGST@9%:                                                                                                                                    63.00
SGST@9%                                                                                                                                         63
GROUND TOTAL                                                                                                                    826.00


Thanks & Regards
Rakesh Kumar
Surveyors & LossAssessors.
                            KSND1187  6
(Authorized Signator

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