RAJEEV BATRA
                                                                      (Surveyor& Loss Assessor)
            No.SLA/72709 Valid upto 22/03/2022                                                                      Ph.(M)9810143600
         MEMBERSHIPNO.-A/N/05042                                                                                           (0) 8800174968
   30,3rd FLOOR(BACK SIDE)                                                                                                       (R) 011-27672404
MAHATMA GANDHI ROAD                                                                                                   Email: r.batra@yahoo.co.in
ADARSH NAGAR,DELHI-110033
                                                                              Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                         Bill.No B-10/20/06260
      7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date17/10/2020
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    CodeNil
       GSTIN:07AABCB5730G1ZZ               State Code : Delhi (07
                  Report Ref No                     RB/BAJ/20-21/06882
                  Vehicle No.                         HR 10AD 1480
                  Insured Name               :    MR.RAJESHWAR
                  Date Of Accident           :    10/09/2020
                  Policy/cover note no           og-20-1901-1802-00049847
                  Claim No                             OC-21-1103-1802-00001630

   S No                                        Particulars                                                HSN/SAC                                Amount
      1    Final                                                                                                 997162                                      1,170.00
                                                   1
                     Professional Fee:       Assessed Amount 2,963.00                                           450.00
                     Photos/CD Expenses:                                                                                            0.00
                     0 Photographs,Charged for 0@Rs.0.00
                     Conveyance Expenses:                                                                                      720.00
                     CONVEYANCE FOR 90 kMS.@RS.8/-
                                                                                                                                      Sub Total:            1,170.00
                                                                                                                                 C GST @9.00%                105.30
                                                                                                                                  S GST @ 9.00 %                105.30
               ADVANCE RECEIPT                                                                                   GrandTotal             1,380.60
                                                                                                                                     Roundoff             1,381.00
                                               In words : Rs. One Thousand Three Hundred Eighty One Only
  GSTIN:07AIGPB7033E1ZQ State :(07)                                          RAJEEV BATRA
  PAN.AIGPB7033E
  Bank Name:PUNJAB NATIONALBANK
  A/cNo.             0618000100079039
  MICR No          110024109                                                       SURVEYOR&LOSS ASSESSOR.

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