SURVEY FEE BILL
Ravinder Singh Yadav                                        License No.                  SLA / 85064
Surveyor & Loss Assessor                                                    Pan No.                        ADBPY7173L
H.No. 1043 P, UE-II, Hisar, Haryana-125001                      Mail ID                        rsyadav85064@gmail.com
81999-33977                                                                        GSTIN No.                    06ADBPY7173L1ZX
State:                                                           Haryana                 Bill No.                          RSY/M/BGIC/2198
Code :                                                          06                        Date of Bill :                    07.10.2020
                                        Bill to Party                                                        Insurance Claim Adjustment Services
To          Bajaj Allianz General Insurance Co. Ltd                                 Name:                Mr. Pawan Kumar
Address: 3rd Floor, JMD Regent Plaza, Sikanderpur, Mehrauli -Gurgaon     Address:             VPO- Naya Gaon, Barwala, Hisar(125121)
             road, Gurgaon-122002 , PH:4064501                                    Vehicle No.          HR 80 B 2237
GSTIN:    06AABCB5730G1Z1                                                         Make/Model      TVS MOTORS/ STAR CITY/ 2017
State:     Haryana                                          Code       06          Estimate Amt.       11304/-
Claim No.OC-21-1103-1802-00001741                                              Policy No.            OG-20-3029-1802-00000313
                                                                   HSN/SAC               Taxable         CGST              SGST               IGST
  Sr. No.                  Item Description                                Amount
                                                                      code                   Value
                                                                                                                9%   Amount   9%  Amount   0%  Amount
     1     Professional fee for final survey                997169      550        550            49.5               49.5                 0
     2     Photographs                                       997169       50         50             4.5                 4.5                  0
              Conveyance charges for final survey At
      3     Barwala                                             997169      150        150           13.5                13.5                 0
      4     Spot Location Survey Fee                        997169        0           0               0                   0                   0
      5     Coveyance charges for Spot Location          997169        0           0               0                   0                   0
      6     Re-Inspection Fee                                 997169        0           0               0                    0                   0
      7     Conveyance charges for Re-inspection        997169       0           0               0                   0                   0
      8     National Highways Authority of India         997169       0          0               0                   0                   0
      9     Speed Post                                         997169       0           0               0                    0                    0
                                  Total                                         750|       750|        67.5               67.5                 0
                                               Bank Details                                               Total Amount before Tax                      750
 Bank A/C:                                                     008201531249                    Add: CGST                                        67.5
 Bank Name                                                   ICICI Bank Ltd                       Add: SGST                                        67.5
Bank IFSC:                                                    ICIC0000082                        Add: IGST
                                                                                                                                                                     0
Pan No.                                                        ADBPY7173L                        Total Tax Amount                               135
                                                                                                             Total Amount after Tax:                       885
                                   Remark
                                                                                                                                             SW
                                                                                                                                           SU
                                                                                                                                     Ravindbr Singh Yadav

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