PRAVIN M. MUSALE
                                                    Motor Surveyor, Loss Assessor and Valuer
                                                   License No. : SLA - 73064 Exp.Dt. 08-02-2022
                                                               604 / Rilletta E / Casa Rio Gold,
                                            Kalyan-Shil Road, Dombivali East, Maharashtra - 421204
                                                                      Mobile. : 9821681100
                                                                     p_musale@yahoo.com

                                                                 Final Survey Fees Bill

BILL NO               : PM//BA/F/0235                                                                             Date : 04/12/2019

INSURERS           : BAJAJ ALLIANZ GENERAL INSURANCE CO. LT Div./Branch : Mumbai
POLICY NO.
CLAIM NO.           : OC-20-1901-1870-00000135
INSURED              : MR. MALHARI B PANDHARE
VEHICLE NO.        : MH 46 BK 0466
SURVEYED AT: EXCELL AUTOVISTA P. LTD.,TALOJA on Dt. : 03/12/2019

Professional Fees                                                                                           Rs.             1,250.00
Photograph (at Rs. 10.00 x 0 Copy)                                                            Rs.                   0.00
Traveling Expenses 80 km. Rs. 7.50                                                              Rs.                600.00
Holting Allowance                                                                                           Rs.
Out city Allowance                                                                                          Rs.
Total                                                                                                             Rs.             1,850.00
18.00% GST Rs. 1,850.00                                                                              Rs.                333.00
Net Total                 Rounded to Nearest Rupees :                                          Rs. :         2,183.00
RupeeS :TWO THOUSAND ONE HUNDRED EIGHTY THREE ONLY

Service Tax No.       : GSTIN NO. - 27ALPPM7590M1Z3
PAN No. :                    ALPPM7590M
                                                                                                                  PRAVIN M. MUSALE
Advance Receipt

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