SURVEY FEE BILL
                                                                           JAVED ALI CHAUAHAN
                                                                                surveyor& Loss Assessor
                                                                         Licence No.-SLA75199(23-03-2022)
Ref.No.3480                                                                                                                      Date:                    15/09/2020
PAN:       AHRPA4504H
SAC:       917162
Insurance Auxillary Service
State &State Code:Uttar Pradesh,09)

INSURER DETAILS
Name                                    M/S-Bajaj Allianz General Insurance company Limited
Addresh                                 C-31,Sector-2,2nd floor,Near Nirulas,NoidaU.P.-201301
GSTIN                                    :09AABCB5730G1ZV
State                                        UTTAR PRADESH
State Code                                9

CLAIM DETAILS
Claim No.                                  OC-21-1103-1802-00001228
Policy-No.                               0G-21-2991-1892-00004101
Vehicle No.                                UP 19 9925
Insured                                     MRIKHLAK
Date Of Loss                              22-Aug-20
DESCRIPTION OF SERVICES
PROFESSIONAL FEE                                                                                                                                            550
 CONVYENCE                             MEEROT TOSHAMLI                           140*7:5=1050                                                   600
Photos                                                                     100@      1
Others
                                                                                                            Total Amount                                          1150

Account Detail
Account No.                              50100120988818
IFSC Code                                  HDFC0000655
Bank Name                             HDFCBANK LTD.MEERUT
                                                                                                                                     JAVED ALI CHAUAHAN)
                                                                                                                                         SurveyorLoss Asg
                                                             Ho.No 70,Sector 105hastri Nagar Meerut-250001U.                  SLA
                                                                                                                                           XX
                                                         Mob.-9719999792,01212703392,Email-jachauhan73@gmail.com
                                                                                                                                                       75199

---PAGE END---