SURVEY FEES BILL CUM RECEIPT DATE 13-Feb-21 SPARTANS INSURANCE SURVEYORS AND LOSS ASSESSORS PRIVATE LIMITED 98482 09966, 94400 14565 FELLOW MEMBER - FIRE, ENGINEERING, MOTOR # 3D SUSHO SAMRAT , 175, RANGARAJPURAM MAIN ROAD SLA IRDA/CORP/SLA-200055 EXPIRY June 24, 2022 KODAMBAKKAM GST NO 33AAZCS2907E1Z6 CHENNAI -600032 PAN NO AAZCS2907E TAMILNADU BILLING ADDRESS ; CLAIM NO OC-21-1501-1825-00000908 THE REGIONAL CLAIMS MANAGER POLICY NO OC-21-9910-1825-00082700 BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD INSURED NAME MR. VAMSEEDHARAN C V ANNA NAGAR VEHICLE NO TN22DT2878 CHENNAI WORKSHOP NAME GOKULAM MOTORS TAMILNADU ESTIMATE 24975 GST NO 33AABCB5730G1Z4 PLACE OF SUPPLY SURVEY FEELS BILL NO 18/BAJAJ/20-21 GST INVOICE NO 499BILL DATE 13-Feb-21 S. NO ITEM DESCRIPTION HSN CODE PROF FEE CONVEYANCE CGST SGST IGST INSURANCE CLAIMS ADJUSTMENT SERVICES MODE OF TRAVEL RATE % AMT RATE % AMT RATE % AMT DETAILS OF SURVEY FEES NO OF KM'S 1 PROFESSIONAL FEES - SPOT 997162 0 0 9% 0 9% 0 0% 0 2 PROFESSIONAL FEES - FINAL 997162 750 250 9% 90 9% 90 0% 0 3 REINSPECTION FEES 997162 0 0 9% 0 9% 0 0% 0 4 DAILY ALLOWANCE 997162 0 0 9% 0 9% 0 0% 0 5 PHOTO CHARGES CD/DVD 997162 0 0 9% 0 9% 0 0% 0 TOTAL 750 250 90 90 0 TOTAL INVOICE VALUE 1180 BANK CURRENT ACCOUNT NO 50200046343670 SWISS CODE BANK ADDRESS NO 6-3-891 & 892, RAJBHAVAN ROAD SOMAJIGUDA , HYDERABAD - 500015 MICR CODE NA IFSC CODE HDFC0000512 ---PAGE END---