Licence No. SLA/22774                                                                                                    Mobile No. : 9829061788
Valid upto 8th March 2022                                                                                            Phone :2611275,2617371
Surveyor & Loss Assessore of Motor, Fire                                                                                  ASHWANI BERI
Marin Miscellaneous                                                                                                    SURVEYOR & LOSS ASSESSOR
                                                                                                                                                 B - 13, Govind Marg
                                                                                                                                            Near Sindhi Ice Factory
                                                                                                                                  Adarsh Nagar, Jaipur - 302 004
                                                              BILL
Bill No. :    3207
                                                                                    M/s.:E Bajaj Allianz General Insurance Co. Ltd.
Date           12-Jan-21                                                              2nd & 3rd floor, 4 Hathroi Fort, Gopalbari, Ajmer Road,
                                                                                               GST No- 08AABCB5730G1ZX
Claim No.         : OC-21-1401-1803-00000466
Policy No         :OG-21-3025-1803-00000051
Insured Property : RJ-14-GJ-3966
                                                                                           Date of Accident:                    26-12-2020
Insured Name :MR. SURESH KUMAR                               Date of Survey                        28-12-2020
                                                         PARTICULARS                                                                           AMOUNT

(a) Professional Fee                                                                                                                                 1,250.00
(b) Halting Allowance
cConveyance (Local)                                                                                3Visits @350/-                       1,050.00
(c) Photo Charges - CD                                                                                                                                 50.00
(d) Fare From
    By own
    Distance                             (3Visits)
                                                                                                                                                               2,350.00
GSTIN 08ABPPB2007A1ZE                                                       Add  : CGST @ 9%                                    211.50
PAN No.ABPPB2007 A                                                             Add. SGST@ 9%                                    211.50
                                                                                               Add. IGST  @ 18%
                                                                                                                  Total                                    2,773.00
PUNJAB NATIONAL BANK
247, MANISH MANSION, FRONTIER COLONY, ADARSH NAGAR, JAIPUR-302 004
A/c Name Mr. Ashwani Beri A/c No. 4079000100005077
                                                                                                                                                 A
IFS Code PUNB0407900, MICR No. 302024025
                                                                                                                                      S
                                                                                                                                      R              F

                                                                                                                                 ASHWANI BERI

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