Manoj Jain                                                                  Pim               234845 (Resi.)
        Fire.Motor,Enginnering                                                                  Mobile       9425087045
        Surveyor & Loss Assessor                                                                     7693087045
       Investigator & Valuer                                                              Shreeji Nagar
       Email : manoj_jain_2001@yahoo.com                                                       Behind Vrandavan Colony
       GSTIN : 23AEDPJ2084E1ZZ                                                    Khargone - 451001
                                  Central Govt. Lic. No. SLA-40879 (Valid Up To 20th May 2021)
       Ref : Bajaj        244/020                                                                          Date:        04.01.2021
                                                                 Professional Fee Bill

      To
              The Manager
              Bajaj Allianz General Insurace Co. Ltd.
              Cust GSTIN/UIN :23AABCB5730G1Z5
     1     Particular                                                 GJ 16 DA 0472
     2     Policy ICovernote No.                              OG-21-2215-1826-00000881
                                                              :
     3      Claim No.                                                                                                                             boL
                                                             :              OC-21-2302-1826-00000114
    4     Place /Date of occurrence                       27.10.2020
                                                             :
    5     Insured                                    :              DEVDUTTA PURI
                             Particular                                                                     Amount

   1      Professional Fee                                           21856                           1000.00
            Reinspection Fee                                                                                350.00
   2      Photographs CD                                                                                   50.00
  4     Travelling Expanses                                                                            300.00
  5      Daily Allowance                       @5001-
  6      Misc Expanses
                                                                          Total                                  1700.00
                                           CGST @                            9%                            153.00
                                           SGST @                            9%                            153.00
                                          Total Tax                                                             306.00
                                                                         Total                                  2006.00

 Rs. Two Thousand & Six Only
                                                                                                               0
         Advance Receipt
                                                                                                                     (MabajVain)
                                                                                                         *             Sukveyor
                                                                                                           I               0
                                                                                                         S
Bank A/c No.0287000100070315
Bank Name : Punjab National Bank Khargone

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