RAKESH KUMAR
                                                     SURVEYOR&LOSS ASSESSOR
 FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                         Mob.#9868110525/8836301125
                                         E-mail: majokarakesh61197@gmail.com
                                         License No. SLA-61197, Valid upto 07/10/2023
                                         Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
 Ref:- BAJAJ/FINAL/2020/21/0588                                                                     Dated: 04/03/2021
                                                     HSN/SAC CODE:997162
 Bajaj Allianz General Insurance Company Limited.
Block No.4, 7th Floor, DLF Tower-15, Shivaji Marg, 011-66278225, New Delhi-110001.
 GST Number:07AABCB5730GIZZ
 VEHICLE NO.                 :       UP 17S 3139
 INSURED NAME            :        MR.RAJEEV
 CLAIM NO.                     :        OC-21-1103-1826-00001645
 POLICY No.                      :        OG-20-4058-1826-00000434
 ASSESSED LOSS              :        Rs. 5700/-


 Professional
Professional Fee                                                                                                                                    550.00
Visit to workshop                                 Rohini To Baraut,UP 140*4                                                         560.00
RE-Inspection Charges                                                                                                                             0.00
Under repair                                                                                                                                             0.00
Spot verification Fee                                                                                                                                 0.00
TOTAL                                                                                                                                              1110.00
CGST@9%:                                                                                                                                               99.90
SGST@9%                                                                                                                                                  99.9
GROUND TOTAL                                                                                                                            1309.80



Thanks & Regards
Rakesh Kumar.
Suryeyors & Loss Assessors.
          SLA-6119

(Authorized Signatory)

---PAGE END---