RAJEEV BATRA
                                                                      (Surveyor & Loss Assessor)
      nce No.SLA/72709 Valid upto 22/03/2022                                                                      Ph. M9810143600
     A MEMBERSHIP NO.-A/N/05042                                                                                           (0)8800174968
   30,3rd FLOOR (BACK SIDE)                                                                                                       (R) 011-27672404
 MAHATMA GANDHI ROAD                                                                                                    Email: r.batra@yahoo.co.in
ADARSH NAGAR,DELHI-110033
                                                                              Survey Fee Bill
To,
      Bajaj Allianz General Insurance Co. Ltd.                                                         Bill. No :B-12/20/06650
      7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date23/12/2020
      7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    CodeNiI
      GSTIN:07AABCB5730G1ZZ               State Code : Delhi (07
                  Report Ref No                     RB/BAJ/20-21/07289
                  Vehicle No.                         DL1CC 2361
                  Insured Name                    MS.LAVISHA
                  Date Of Accident           :    08/12/2020
                  Policy/cover note no           OG-20-9910-1825-00040332
                  Claim No                      :    OC-21-1103-1825-00004093

   S No                                        Particulars                                                HSN/SAC                                Amount
      1    Final                                                                                                 997162                                      1,150.00
                     Professional Fee:       Assessed Amount  21,692.00                                      1,000.00
                     Photos/CD Expenses:                                                                                            0.00
                     0 Photographs.,Charged for 0@Rs.0.00
                     Conveyance Expenses :                                                                                      150.00

                                                                                                                                      Sub Total:             1,150.00
                                                                                                                                  C GST @9.00 %               103.50
                                                                                                                                  S GST @ 9.00 %                103.50
               ADVANCE RECEIPT                                                                                   Grand Total            1,357.00
                                                                                                                                      Round off:            1,357.00
                                               In words : Rs. One Thousand Three Hundred Fifty Seven Only
                                                                                                                          CATRA
  GSTIN:07AIGPB7033E1ZQ State :(07)                                          RAJEEV/BATRA
  PAN.AIGPB7033E
   Bank Name:PUNJAB NATIONAL BANK
                                                                                                                         1-72709
  A/c No.             0618000100079039
  MICR No          110024109                                                        SURVEYOR&LOSSASSESSOR.

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