License No. SLA-73766
Valid Up to 05-10-2024		       Mobile(S : 9990929990
Pan card no. AHRPA8488Q		       E-Mail : msadhikari77@gmail.com
		     MANOHAR ADHIKARI
			    Surveyor & Loss Assessor
		  C/o Harinagar Nayak,Near DAV School, Haldwani Uttrakhand
			      Survey Fee Bill
To,
   Bajaj Allian General Insurance Co.Ltd Bill No.: B-02-24-02416
   NEW DELHI				   Date 15/02/2024
   NEW DELHI,WEST DELHI-110015		 Code  :
   GSTIN: 07AABCB5730G1ZZ State Code :NEW DELHI (07)
       Report Ref No  : M S/BAGI/6BH9009/02-24/F/02684
       Vehicle No. UK06BH9009
       Insured Name M/S CHEEMA HOSPITAL
       Date Of Accident 11-Feb-24	 Assessed :       22,371.00
       Policy/cover note no OG-24-1157-1825-00000036 Estimate :   0.00
       Claim No       : OC-24-1103-1825-00012149 IDV   : 1,962,510.00
 SNo	 Particulars		  HSN/SAC	   Amount t
   1 Final				 997162	    1,500.00
	Professional Fee : Assessed Amount  22,371.00 1,250.00
	Photos/CD Expenses :			   0.00
	0 Photographs ,Charged for 0@ Rs. 0.00
	Conveyance Expenses:			 250.00
   2 ReInspection			  997162	       250.00
	Professional Fee :			     0.00
	Photos/CD Expenses :			   0.00
	 0 Photographs , Charged for 0 @ Rs. 0.00
	Conveyance Expenses :			250.00
						    Sub Total: 1,750.00
						  CGST 9.00%    157.50
						  S GST @9.00 % 157.50
      ADVANCE RECEIPT		     Grand Total :      2,065.00
						    Round off : 2,065.00
		       In words :Rs. Two Thousand Sixty Five Only
 GSTIN:07AHRPA8488Q1Z9 State:(07)
 PAN.AHRPA8488Q
 Bank Name:HDFC BANK LTD
 A/c No. 50200085453100			 MANOHARADHIKARI
 MICR No 110240116

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