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/20/1122                                                             08 March 2021
OUR BILL NO.           : BAJAJ/HSP/20/1122
                                                       BILL / ADV. RECEIPT.

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

                                           Reg.:            Final + Ri Survey of M/V No. GJ-06-NA-7648
                                                               A/c. Mr Rameshbhai G Parekh
                                                                      Vadodara
                                                   Policy No.                    : OG-21-2201-1826-00000476
                                                    Claim No.                    : OC-21-2201-1826-00000950
                                                   Period                        : 24.06.2020 T0 23.06.2021

SR NO.                                               PARTICULARS                                                   AMOUNT

   01.   PROFESSIONAL SURVEY CHARGES. : ( FINAL )                                               Rs.   0450.00

   02.    CONVEYANCE EXPENSES : (Vadodara - Padra - Vadodara)                            Rs.   0510.00
             (17kms x 2 x 2 x Rs. 7.5/km) (Final + Ri= Two visit)
   03.   PHOTOGRAPH EXPENSES: Photo CD (Digital Photo)                                     Rs.   0040.00
   04.   HAULTING ALLOWANCE. :                                                                          Rs.   0000.00
                       SUB TOTAL.                                                                                    Rs.   1000.00
   05.   SGST 09%                                                                                                 Rs.     90.00
             CGST 09%                                                                                                 Rs.     90.00
       Rs. One Thousand One Hundred Eighty Only.                                                            1180.00
                                                                               S.
OUR PAN NO.           : AKUPP7626D
OUR GST NO.           : 24AKUPP7626D1ZT              SURVEYOR
                                                                      H &LOSS ASSESSORS
INSURER GST NO. : 24AABCB5730G1Z3
                                                                              7283-19/22
                                                                           BA
                                                                                                              HIRAL PATEL

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