TAX INVOICE
 RAJ KUMAR SINGH
Surveyor & Loss Assessor                                                                          Mobile No.:9415126388
Licence No.SLA /29063 Valid Upto 06-08-2020                     116/47, Rawatpur,Kanpur-208019
GSTN.09AKUPS9618L1ZX                                                         E-mail : singhrk.knp@gmail.com
STATE BANK OF INDIA KAKADEO KANPUR A/C NO.10404792924 MICR NO.208002044 IFSC-SBIN0003467
Bill No.       506                                                                                Date:      31/01/2021
Insurer :       Bajaj Allianz General Insurance Co. Ltd
                                                                                  Vehicle No.        UP71AQ7837
                   11/9, Silver Line
 GSTN.         09AABCB5730G1ZV                                  Make               Bajaj Pulser
Insured :      Neha Singh
                   Tekari
Date of accident :    12/01/2021                                      Policy No.          OG-21-3327-1826-0000074
 Date of deputation :13/01/2021                                     Claim No.          OC-21-1302-1826-00002578
    Particulars OF Servies                                                                     SAC              Amount
1.    Final Survey                Estimate Amount                  0.00             997162                     750.00
                                         Assessed Amount                  0.00
 2.      Digital Photographs                          0   @   Rs.   0.00 each                                       0.00
3.     Local Conveyance                                                                                                       0.00
 4.     Re-Inspection Conveyance                                                                                           0.00
 5.      Fare from Kanpur to spot and back    270   kms.at Rs.0.00/Km.                              2,100.00
6.      Outstation allowance
7.     toll tax                                                                                                                    105.00
                                                                                         Taxable Value:                     2,955.00
                                                                                         C.G.S.T.@9.00%                     265.95
                                                                                         S.G.S.T.@ 9.00%                     265.95
                                                                                         Grand Total                             3,487
 Rs.in Words:THREE THOUSAND FOUR HUNDRED EIGHTY-SEVEN ONLY

E.&O.E                                                                                           (R K SINGH)
 REMARKS:                                                                               Surveyor & Loss Assessor


                                                     ACKNOWLEDGEMENT
Insurer:Bajaj Allianz General Insurance Co.Ltd                           Bill No.506           31/01/2021

Insured : Neha Singh                                                               Veh.No. UP71AQ7837

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