Rajesh S. Thakker
                                                                                                                 C.A.E., D.A.E., A.I.S.A.
                                                                        SURVEYOR, LOSS ASSESSOR & VALUER
                                                                              Licence No. SLA 20725 Exp. Dt. 17-08-2021
                                            5, PATEL COLONY, ROAD NO. 1, OPP. DARSHAN APARTMENT, JAMNAGAR - 361 008, (GUJARAT)
                                                            MO. 98242 11549, 94274 45301 E-mail : rajesh_thakker@rediffmail.com
                                                                                           Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                                             Bill. No : RST/203049
       Rajkot                                                                                                                            Date     : 06/11/2020
       1st Floor, Hotel K Rose Building, In Front Of Shastri Medan, Limda Chowk,                            Code     :
       Rajkkot
       GSTIN: 24AABCB5730G1Z3                      State Code: Gujarat (24)
                    Report Ref No                     :     RST/203049
                    Vehicle No.                         :     GJ03KN0849
                    Insured Name                     :     Sonal Odich
                    Date of accident                  :     29-10-2020
                    Policy/cover note no            :     OG-21-1000-1802-00023455
                    Claim No                            :     OC-21-2204-1802-00000696

    S No                                               Particulars                                                           HSN/SAC                                       Amount /
      1      Final                                                                                                                 997162                                                1510.00
                       Professional Fee :              Assessed Amount  7600.00                                                             500.00
                       Photos/CD Expenses :                                                                                                              50.00
                        CD with digital photographs
                       Conveyance Expenses :       Visited total 120 Kms. No of visits 1 charged @28.00/ Km                                 960.00

                                                                                                                                                            Sub Total : 2                  1510.00
                                                                                                                                                        C GST @ 9.00 %                    135.90
                                                                                                                                                       S GST @ 9.00 %                     135.90
                 ADVANCE RECEIPT                                                                                                         Grand Total : 2                  1781.80
                                                                                                                                                           Round off :                  1,782.00
                                                              In words : Rs. One Thousand Seven Hundred Eighty Two Only
  GSTIN: 24AAUPT4514C1ZN State : (24)
   PAN. : AAUPT4514C
                                                                                                                                                                                               0
  Bank Name : HDFC Bank Ltd.,
                                                                                                                                                                              31MOeQ
  A/c No.                : 01771500003760                                                                                                                  RAJeshs ThaKKer
   MICR No              : 361240001                                                                                                                                  C.A.e.,D.Ae.A.I..S.A.
                                                                                                                                                                           SURVEYCR &LCES ASSESSOR

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