mobile-919998100555
Parikh Associates                                                                           phone+912652481991
                                                                                                                         parikh.associates@yahoo.com
chartered engineer,
surveyor,                                                                                                           21.Padmavatinagar1P Road
loss assessor                                                                                                     Karelibaug.Vadodara-390a18
valuer.
risk management
                                                                                                                         License no.SLA/72618valid upto Nov2021


                                                                         INVOICE

    INVOICENO.                   212584                                                               Date:   30.03.2021
    REPORT NO.                  BAG/2021/2173
   Tor
    BAJAJ ALLIANZ GENERAL INSURANCE CO LTD
    4TH FLOOR ATLANTIS HIGHTS
    NR SARABHAI CIRCLE
    VADODARA
    RECIPIENTID                   24AABCB5730G1Z3
   INSURED:                       MOHSINKHAN AASHIKHUSSAIN SHEIKH                      INTEREST GJ34C6281
                                                                                                                                    SHINE
    POLICYNO:                   QG-21-3062-1802-00000064
   CLAIMNO:                     OC-21-2201-1802-00000951
   INSURER:                        BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.
   APPOINTED BY:               BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.
   SR.NO.      DESCRIPTION                                              HSN/SAC         RATEQty.      AMOUNT
                                                                                       Code
                      PROFESSIONALSURVEY CHARGES
                      FINAL                                                                            750.00            1               750.00
                      RE-INSPECTION                                                                                     1
          2        CONVEYANCE CHARGES                                                                      0
                      1VISITS NASVADI95*2==19OKM                                          7.50         190             1,425.00
          3        PHOTOGRAPHS                                                                                    o
                      DIGITAL CD                                                                     40.00                               40.00

          4        OUT OF POCKET EXPENSES
                      TOLLTAX/PHOTOCOPIES
                      HALTING                                                                                              0
                                                                       SUB TOTAL                                                          2,215.00
                                                                             CGST                      9.00%                             199.35
                                                                              SGST                      9.00%                             199.35
                     ROUNDING OFF
                                                                 GRAND TOTAL                                                               2,614
   RUPEES       TWO THOUSAND SIX HUNDRED AND FOURTEEN ONLY.
   Qur Bank Detail:
  Bank          ICICI Bank Ltd.                                                                                                  ASS
                                                                                                                        FOR PARIKH ASSOCIATES0
   Bank Br.     Karelibaug
   C.A/c no.024805001738                                                                                            p
  IFSC Code:ICIC0000248
  PAN NO.    AFTPP4625 C
                                                                                                                                           72618

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