RAJEEV BATRA
                                                                     (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                     Ph.(M)9810143600
IISLA MEMBERSHIP NO.-A/N/05042                                                                                         (0)8800174968
B-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-10/20/06344
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                   Date29/10/2020
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                   CodeNil
       GSTIN:07AABCB5730G1ZZ              State Code Delhi (07)
                  Report Ref No                     RB/BAJ/20-21/06957
                  Vehicle No.                         DL 9CAC 5623
                  Insured Name                    MR.ASHOK KUMAR
                  Date Of Accident                28/10/2020
                  Policy/cover note no           OG-20-9906-1801-00098975
                  Claim No                            OC-21-1103-1801-00007112

    SNo                                       Particulars                                                HSN/SAC                               Amount
      1    Final                                                                                                997162                                     1,380.00
                     Professional Fee:       Assessed Amount 3,858.00                                           500.00
                     Photos/CD Expenses:                                                                                          0.00
                     0 Photographs,Charged for 0@Rs.0.00
                     Conveyance Expenses:                                                                                     880.00

                                                                                                                                     Sub Total:            1,380.00
                                                                                                                                C GST @9.00%                124.20
                                                                                                                                 S GST @9.00 %                124.20
               ADVANCE RECEIPT                                                                                  Grand Total            1,628.40
                                                                                                                                    Round off:            1,628.00
                                               In words : Rs. One Thousand Six Hundred Twenty Eight Only
   GSTIN:07AIGPB7033E1ZQ State :(07)                                         RAJEEV BATRA
   PAN.AIGPB7033E
   Bank Name:PUNJAB NATIONAL BANK
   A/c.No.            0618000100079039
   MICR No          110024109                                                       SURVEYOR&LOSS.ASSESSOR.

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