PRAVIN M. MUSALE Motor Surveyor, Loss Assessor and Valuer License No. : SLA - 73064 Exp.Dt. 08-02-2022 604 / Rilletta E / Casa Rio Gold, Kalyan-Shil Road, Dombivali East, Maharashtra - 421204 Mobile. : 9821681100 Final Survey Fees Bill BILL NO : BA/F/028 Date : 12/01/2021 INSURERS : BAJAJ ALLIANZ GENERAL INSURANCE CO. LT Div./Branch : Mumbai POLICY NO. : CLAIM NO. : OC-21-1901-1802-00001370 INSURED : PRAMOD NANDLAL YADAV VEHICLE NO. : MH04JA4202 SURVEYED AT: DIVA AGASEN ROAD on Dt. : 12/01/2021 Professional Fees Rs. 500.00 Photograph (at Rs. 10.00 x 0 Copy) Rs. 0.00 Traveling Expenses Rs. 600.00 Holting Allowance Rs. Out city Allowance Rs. Total Rs. 1,100.00 18.00% GST Rs. 1,100.00 Rs. 198.00 Net Total Rounded to Nearest Rupees : Rs. : 1,298.00 RupeeS :ONE THOUSAND TWO HUNDRED NINETY EIGHT ONLY Service Tax No. : GSTIN NO. - 27ALPPM7590M1Z3 PAN NO. : ALPPM7590M PRAVIN M. MUSALE Advance Receipt ---PAGE END---