Office: 42/3, Meera Society, Mahavir Shrishrimal Salisbury Park, Surveyors/Loss Assessor/Valuers Pune 411037. LICENCE N0: 73388 / 2007-2026 Mobile: 9923197858 VALID UPTO: 25-04-2026 Email: ssmahavir@gmail.com INVOICE NO. :: 17771 Date : 25/09/2023 To Surveyor Code : 73388 Bajaj Allianz General Insurance Co Ltd, 1ST FLOOR, TOWER 1,COMMERZONE, SAMRAT ASHOK PATH YERWADA Regional Office PUNE RO PUNE Name of the Insurer : Bajaj Allianz General Insurance Co Ltd, 1ST FLOOR, TOWER 1,COMMERZONE, SAMRAT ASHOK PATH YERWADA RegionaI Office PUNE MAHARASHTRA GST No. 27AABCB5730G1ZX Policy No. OG-23-9910-1825-00084240 Claim no. OC-24-2001-1825-00004775 Insured ASHIRVAD VERMA Vehicle No. MH12UW5600 Date of accident : Date of Survey: Sr.No DETAILS OF BILL Amount 1 Professional Fees : 1250.00 2 Travelling/Conveyance : z 500.00 3 Haltage : z 0.00 4 Digital Photographs No's @ Rs. 15.00 : 0.00 5 Others if any : 0.00 6 : 0.00 7 : 7 0.00 TOTAL : R 1750.00 Add CGST @ 9%: % 157.50 ADD SGST @ 9%: r 157.50 Pre Receipted Grand Total : 2065.00 RUPEES TWO THOUSAND SIXTY FIVE ONLY P.A.N NO: BPBPS7678H GSTIN : 27BPBPS7678H1Z8 HSN CODE:997162 Bank Details: HSBC A/C No. # 105515548006 IFSC code : # HSBC0411002 / MICR code # 411039002 ---PAGE END---