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/2020/21/0468                                                                      Dated: 06/01/2021

                                                      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 14BZ 0833
INSURED NAME            :        GOPAL DAS
CLAIM NO.                      :        OC-21-1101-1802-00002531
POLICY No.                                OG-21-9906-1802-00050252
                                            .
ASSESSED LOSS                        Rs. 1800/-


Professional
Professional Fee                                                                                                                                      400.00
Visit to workshop                                Rohini To Sahibabad,UP 75*4                                                         300.00
RE-Inspection Charges                                                                                                                                0.00
Under repair                                                                                                                                                0.00
In-Person verification Fee                                                                                                                           0.00
TOTAL                                                                                                                                                   700.00
CGST@9%:                                                                                                                                                  63.00
SGST@9%                                                                                                                                                        63
GROUND TOTAL                                                                                                                                826.00



Thanks & Regards
Rakesh Kumar
                    AKESHA
                                   Assessors.
                    SCNEVIOT 0
(Authorized

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