RAKESH KUMAR
                                                    SURVEYOR&LOSSASSESSOR
 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/2020/21/0339                                                                   Dated: 26/11/2020
                                                    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.                 :       HR 10AB 1141
 INSURED NAME           :       MR. SOMPAL SO DARIYAO
 CLAIM NO.                     :       OC-21-1103-1802-00002145
 POLICY No.                               0G-21-1901-1802-00010429
 ASSESSED LOSS             :       Rs. 14500/-


 Professional
 Professional Fee                                                                                                                                 550.00
 Visit to workshop                                Rohini To Ganaur,HR 102*4                                                       408.00
RE-Inspection Charges                       Rohini To Ganaur, HR 102*4                                                       408.00
Under repair                                                                                                                                          0.00
Spot inspection Fee                                                                                                                                0.00
TOTAL                                                                                                                                           1366.00
CGST@9%:                                                                                                                                           122.94
SGST@9%                                                                                                                                            122.94
GROUND TOTAL                                                                                                                          1611.88

                                                     in

Thanks & Regards
Rakesh Kumar
Surveyor   &10s3Assessors.
                 SLA-61187 6
Authorie![tor

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