HIRAL S. PATEL
                                      SURVEYOR & LOSS ASSESSOR, VALUER
     Lic No        : 72693 / 19-22                                                                      417, Navrang Complex,
     Exp. Date    : 09-03-2022                                                                         Nr. Uttsav Hotel,
      Mobile No.  : 9879063617                                                                        Raopura,
     E-mail        : patelhiral66@yahoo.com                                                         Vadodara - 390 001.
OUR REF.                 : BAJAJ/HSP/20/1238                                                             30, MAR. 2021.
OUR BILL NO.           : BAJAJ/HSP/20/1238
                                                       BILL / ADV.RECEIPT.

To,
The Claim Manager,
Bajaj Allianz General Insurance Co. Ltd,
Branch Office, Baroda.

                                           Reg.:                  Final Survey of M/V No. GJ-06-AU-7124
                                                               A/c. Mr. Raj Quarry Works
                                                                      At, Savali, Vadodara.
                                                    Policy No.                    : OG-21-2201-1803-00001796
                                                    Claim No.                    : OC-21-2201-1803-00000260
                                                    Period                         : 13.10.2020 to 12.10.2021

SR NO.                                               PARTICULARS                                                   AMOUNT

   01.    PROFESSIONAL SURVEY CHARGES. : (SPOT )                                                Rs.   0750.00
   02.    PROFESSIONAL SURVEY CHARGES. : ( Final)                                                 Rs.   5000.00

   03.    CONVEYANCE EXPENSES : (Vadodara - Tulsi village - Vadodara)                  Rs.   1275.00
   04.    (85 kms x 2 x Rs. 7.5/km) (Spot)
   05.    CONVEYANCE EXPENSES : (Vadodara -- Sevaliya -- Vadodara)                        Rs.   2700.00
   06.    (90 kms x 2 x 2 Visit x Rs. 7.5/km) (Final)
   07    PHOTOGRAPH EXPENSES: Photo CD (Digital Photo)                                    Rs.   0040.00

   08.   HAULTING ALLOWANCE. :                                                                          Rs.    0000.00
                        SUB TOTAL.                                                                                    Rs.   9765.00

   09.  SGST 09%                                                                                                  Rs.    879.00
             CGST 09%                                                                                                 Rs.    879.00
       Rs. Eleven Thousand FIve Hundred Twenty Three Only.                                    Rs.   11523.00
                                                                                S.
OUR PAN NO.           : AKUPP7626D
OUR GST NO.           : 24AKUPP7626D1ZT              SURVEYOR
                                                                      H&LOSSASSESSORS
INSURER GST NO.    : 24AABCB5730G1Z3
                                                                              7283-19122
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                                                                                                              HIRAL PATEL

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