mobile+919998100555
Parikh Associates                                                                         phone+912652481991
                                                                                                                       parikh.assoclates@yahoo.com
chartered engineer.
surveyor,                                                                                                         21,Padmavatinagar,VP.Road
loss assessor,                                                                                                    Karelibaug.Vadodara-390018.
valuer,
risk management
                                                                     INVOICE                                  License no.SLA/72618,valid upto Nov.2021

 INVOICENO.                  212429                                                              Date:    16.03.2021
 REPORT NO.:                 BAG/2021/2203
 To,
 BAJAJ ALLIANZ GENERALINSURANCE CO LTD
 4TH FLOOR ATLANTIS HIGHTS
 NR SARABHAI CIRCLE
 VADODARA
 RECIPIENTID                   24AABCB5730G1Z3                                STATE CODE:-24

 INSURED:                       AFSARALI KHALIL PATHAN                                       INTEREST GJO2Y4361
                                                                                                                               TATA1613
 POLICY NO:                   OG-21-2201-1803-00002654
 CLAIMNO:                    OC-21-2201-1803-00000314
INSURER:                       BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.

 APPOINTED BY:              BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.
SR.NO.      DESCRIPTION                                             HSN/SAC         RATEQty.      AMOUNT
                                                                                   Code
                   PROFESSIONAL SURVEY CHARGES
                   FINAL                                                                        2,500.00                           2,500.00
                   RE-INSPECTION
       2        CONVEYANCE CHARGES                                                                    o
                  2VISITS                                                                        450.00                             450.00
       3        PHOTOGRAPHS                                                                                  o
                   DIGITAL CD                                                                    40.00                               40.00
       4        OUT OF POCKET EXPENSES
                   TOLLTAX/PHOTOCOPIES
                  HALTING                                                                                            o
                                                                  SUB TOTAL|997162                                              2,990.00
                                                                         CGST|                     9.00%                            269.10
                                                                          SGST|                     9.00%                            269.10
                  ROUNDING OFF
                                                             GRAND TOTAL                                                              3,528
RUPEES       THREE THOUSAND FIVE HUNDREDA AND TWENTY EIGHT ONLY.
Our Bank Detail:
Bank         ICICI Bank Lta.
Bank Br.     Karelibaug                                                                                  FORRARIKH ASSOCIAYES
C.A/c no.24805001738                                                                                         Licprspiio.
IFSC Code:ICIC0000248                                                                                              72618
PAN No.:AFTPP 4625C                                                                                         PRAKASH PARIKHS

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