PARESH KOTHARI
                                        Approved Consulting Automobile and Engineering Surveyor, Loss Assessor & Valuer
S.L. NO. SLA -66761                                                                                                               2C SONAL APRTMENT,
Dt. Exp. : 29-11-2021                                                                                                              2 MARUTINAGAR,
Mobile :9825072771                                                                                                             NEAR AIRPORT, RAJKOT -360001
pareshkothari1@gmail.com
                                                                           Survey Fee Bill
To,
      Bajaj Allianz General Insurance Co. Ltd.                                                       Bill. No : B-02-21-04307
      VADODARA                                                                                                Date : 18/02/2021
      401,ATLANTIS HERITAGE,OPP.SWAGAT PETROL PUMP,SARABHAI MAIN    Code
      ROAD, NEAR GENDA CIRCLE
      GSTIN: 24AABCB5730G1Z3              State Code : Gujarat (24)
                 Report Ref No                    VKP/BAGI/AT-172-/02-21/F/04358
                 Vehicle No.                        GJ 3 AT 172
                 Insured Name              :   Mr. Shahnavaz S Jalyawala
                 Date Of Accident          :    01-Feb-21
                  Policy/cover note no     :    OG-21-2204-1803-00003266
                 Claim No                     :   OC-21-2204-1803-00000425

   S No                                      Particulars                                              HSN/SAC                              Amount 
      1    Final                                                                                             997162                                    2,800.00
                    Professional Fee :       Assessed Amount & 153,300.00                                   2,500.00
                    Photos/CD Expenses :                                                                                      50.00
                    1 Photographs , Charged for 1 @ Rs. 50.00
                    Conveyance Expenses :                                                                                  250.00

                                                                                                                                Sub Total :            2,800.00
                                                                                                                            C GST @ 9.00 %               252.00
                                                                                                                            S GST @ 9.00 %               252.00
              ADVANCE RECEIPT                                                                                Grand Total :            3,304.00
                                                                                                                                Round off :            3,304.00
                                                In words : Rs. Three Thousand Three Hundred Four Only
  GSTIN: 24ADNPK4533G1ZM State : (24)                                                                      Advance Receipt
  PAN.: ADNPK4533G                                                                                                   Paresh Kothari
                                                                                                       PARESH KOTHARI
  Bank Name : Bank of Baroda                                                                                                   hotuun
  A/c No.            : 7460100005184                                                                                  SurveyAr and Assessor
  MICR No           360012006

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