Gyan Rahash Twari
                                                 Surveyor & Loss Assessor
Licence No. SLA-38887                                                                                RESIDENCE:
Valid upto : 28-12-2020                                                                             MIG-55, Phase-II
                                                                                                           Kaushalpuri Colony
E-mail: gyan2500@gmail.com
                                                                                              Distt- Faizabad-224 001 (U.P.)
Pan No.ACVPT9594P                                                                              Mob.: 9415048094
GSTIN No- 09ACVPT9594P1ZT
     To,
      The Manager,
     Bajaj Allianj Genral Insurance Co. Ltd.
     4th floor, Habibulah estate, Halwasia commerce building, hazaratganj.
      Lucknow, Uttar Pradesh and mentioned below
      GST NO- 09AABCB5730G1ZV

     No.GPT/BAJAJ/(F)/20-21                                                              Date.12.10.2020
      Claim No. - OC-21-1301-1802-00001222
      Vehicle no.-UP45V8850
     Insured RAJU
       S1.                                           Particulars                                            Amount
       1     Final Survey Fee                                                                                750.00
       2    Conversion                                                                                            0.00
      3    T.A.(Faizabad to Ambedkar Nagar )                                              1650.00
       4     Photographs / C.D (Nos.)                                                                  0.00
       5     Other Expanses                                                                                     0.00
                                                                                   Total Amount Rs.      2400.00
                                                                                                        GST 0%          0.00
                                                                                                       Total Rs.    2400.00






                                                                                                (G.P. Tewari)

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