Chetan Mehta
                                                                                                                                                                                      Mobilc : 98250 52786
                                                                       D.A.E.                                                                                                                          02774241343
                  Surveyor, Valuer & Loss Assossor                                                                                                                                    Offico : Himatnagar
                  (Motor, Marino, Misc.)
                  S.L.A. 68278 (21-03-2022)                                                                                                                                           Resi.: Speed Post
                  c-mail: chetanmchtasurveyor@yahoo.com                                                                                                                               27, Panchjyot Socicty.
                                                                                                                                                                                      Modasa - 383315 (Guj)
                         Ref. No. CJ 43
                                                                                                                                                                                      Date: 16-05-2021
                                                                                                                          BILL
                       To
                       Bajaj Allianz General Insurance Co. Ltd.
                       Survey Fee
                                                                                                                                                                       Rs.           1250
                      Halting
                                                                                                                                                                       Rs.
                      Snaps
                                                                                                                                                                       Rs.
                       Conveyance
                                                                                                                                                                      Rs.              250
                                                                                                                                                                                     1500
                       Claim No.                                  : OC-22-2202-1801-00000805
                       Vehicle No.                                : GJ 09 BF 1731
                       Total                                      : One thousand five hundred only
                       P.A/C No                    : AIKPM7348D
                       Bank                         : Bank of Baroda, Modasa
                       A/C                         : 07210100011188
                       IFSC Code                   : BARBOMODASA
                                                                                                                                                                                                                     U.
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                                                                                                                                                                          ChetanJ. Mehta78
                                                                                                                                                                                  Surveyor^reyor
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