RAKESH KUMAR
                                                 SURVEYOR & LOSS ASSESSOR
FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                      Mob.#9868110525/8836301125
                                      E-mail: majokarakesh61197@gmail.com
                                      License No. SLA-61197, Valid upto 07/10/2023
                                      Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
Ref:- BAJAJ/FINAL/2020/21/0516                                                                Dated: 30/01/2021
                                                 HSN/SAC CODE:997162
Bajaj Allianz General Insurance Company Limited.
Block No.4, 7th Floor. DLF Tower-15, Shivaji Marg, 011-66278225, New Delhi-110001.
GST Number:07AABCB5730GIZZ
VEHICLE NO.               :       UP 17N 1576
INSURED NAME          :       MR. VINAY KUMAR
CLAIM NO.                    :       OC-21-1101-1802-00002740
POLICY No.                    :       OG-21-4058-1802-00000173
ASSESSED LOSS            :       Rs. 2000/-


Professional
Professional Fee                                                                                                                           400.00
Visit to workshop                           Rohini to Baraut, UP, 132*4                                                  528.00
RE-Inspection Charges                                                                                                                     0.00
Under repair                                                                                                                                    0.00
In-Person verification Fee                                                                                                                 0.00
TOTAL                                                                                                                                      928.00
CGST@9%:                                                                                                                                     83.52
SGST@9%                                                                                                                                      83.52
GROUND TOTAL                                                                                                                    1095.04


Thanks & Regards
Rakesh Kumar
Sunvenonska   Loss Assessors.
    SA'STT
  Lthorizedi Sigaatbry)

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