Licence No.SLA/120614                                                                                        Mot
Valid upto 10th May 2021                                                                                                        9799730029
                                                                                                                      djpudillp2i@amail.com
Surveyor & Loss Assessore of Motor                                                            DILIP KUMARPRAJAPAT
&Marin Cargo                                                                                               SURVEYOR&LOSS ASSESSOR
GSTIN-                                                                                                                        154.RabariVas
Reference N DKP/BGIC/01/2021/950                                                                               Amli Road Pindwae
                                                                                                                     Dist.Sirohi.Rajasthan-307022
                                                            BILL
Bill No.950
                                                                               M/s.: Bajaj Allianz General Insurance Co.Ltd
Date         20/02/2021                                                        2nd & 3rd floor, 4 Hathroi Fort, Gopalbari,
                                                                                       Ajmer Road, Jaipur-302001
                                                                                GSTI 
Claim No.              OC-21-1401-1801-00005116

Policy No              OG-20-1417-1801-00000079

Vehicle No.            RJ24CA0783
                                                                                Date of Accident:         10/02/2021
Insured Name       NURAL HAYAT KHAN                             Date of Survey 16/02/2021
            4h                                   PARTICULARS                                                             AMOUNT
a ProfessionalFee                                                                            Final                                500.00
              Nech
b Halting Allowance                                                                                                                  100.00
             HA
 Conveyance Local)
dFare From         Sirohi To Sumerpur                                                   Final                               640.00
    By Car
    Distance 80KM*8=640
eSpeed Post=40                                                                                                                      40.00

                                                                                                                                           1,280.00
                                                                                      Add: CGST @9%
PAN No. CZJPK1227R                                                          Add. : SGST @ 9%
                                                                                       Add.   IGST @ 18%                     GAT
                                                                                                      Total                             1,280.00
BANK -BANK OF BARODA
Address :-Shree Ji Plaza,Near Telephone Exchange,Pindwara-307022
A/c Name Mr.Dilip Kumar Prajapat A/c No.55318100005070                                 Aentas
IFS Code BARB0PINSIR Branch Code 307012027
                                                                                                                          lar
             11e
                                                                                                          DILIR KUMAR PRAJAPAT

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