License No. SLA-73766
Valid Up to 05-10-2024		    Mobile(S)  : 990929990
Pan card no. AHRPA8488Q		     E-Mail :msadhikari77@gmail.com
		    MANOHAR ADHIKARI
			   Surveyor & Loss Assessor
		 C/ Harinagar Nayak,Near DAV School, HaldwaniUttrakhand
			     Survey Fee Bill
To,
  Bajaj Allianz General Insurance Co. Ltd. Bill No.: B-02-24-02558
  NEW DELHI				  Date 29/02/2024
  NEW DELHI,WEST DELHI -110015	       Code   :
  GSTIN: 07AABCB5730G1ZZ State Code :NEW DELHI 07
      Report Ref No  : M S/BAGI/6ER4450/02-24/F/02666
      Vehicle No.    : UK06ER4450
      Insured Name   : RATAN DHALI
      Date Of Accident : 06-Feb-24      Assessed : 	3,904.00
      Policy/cover note no : OG-24-1157-1803-00000864 Estimate  0.00
      Claim No       : OC-24-1103-1803-00002827 IDV  :    90,000.00
 SNo	Particulars		  HSN/SAC	  Amount t
  1 Final				 997162	    1,950.00
       Professional Fee : Assessed Amount  3,904.00 850.00
       Photos/CD Expenses:			    0.00
       0 Photographs  Charged for 0@Rs. 0.00
       ConveyncExensesVitd tl10KmsNo oft1harged10.00/K 1,100.00
	HALDWANI TO DINESHPUR 55*2 TOTAL 110KM
						  Sub Total : 1,950.00
						C GST @9.00%   175.50
						S GST 9.00%    175.50
     ADVANCE RECEIPT		      Grand Total :     2,301.00
						  Round off : 2,301.00
		   In words : Rs. Two Thousand Three Hundred One Only
GSTIN:07AHRPA8488Q1Z9 State :(07)
PAN.AHRPA8488Q
Bank Name:HDFC BANK LTD
A/cNo. 50200085453100			 MANOHAR ADHIKARI
MICR No 110240116

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