RAKESH KUMAR
                                                     SURVEYOR &LOSS ASSESSOR
 FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                         Mob.#9868110525/8836301125
                                         E-mail: majokarakesh61197@gmail.com
                                         License No. SLA-61197, Valid upto 07/10/2023
                                         Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
 Ref:- BAJAJ/FINAL/2020/21/0407                                                                      Dated: 18/12/2020
                                                     HSN/SAC CODE:997162
Bajaj Allianz General Insurance Company Limited.
Block No.4, 7th Floor, DLF Tower-15, Shivaji Marg, 011-66278225, New Delhi-110001.
GST Number:07AABCB5730GIZZ
VEHICLE NO.                 :       UP 14EF 5967
INSURED NAME            :        RADHEY SHYAM PAL
CLAIM NO.                      :        OC-21-1103-1828-00000333
POLICY No.                               OG-20-1149-1828-00004819
ASSESSED LOSS                       Rs. 16800/-


Professional
Professional Fee                                                                                                                                     750.00
Visit to workshop                               Rohini To Arya Nagar, UP 80*4                                                       320.00
RE-Inspection Charges                      Rohini To Arya Nagar, UP 80*4                                                       320.00
Under repair                                       Rohini To Arya Nagar, UP 80*4                                                       320.00
DLverification Fee                                                                                                                               1000.00
TOTAL                                                                                                                                               2710.00
CGST@9%:                                                                                                                                              243.90
SGST@9%                                                                                                                                                  243.9
GROUND TOTAL                                                                                                                             3197.80



Thanks & Regards
Rakesh Kumar

                                      ssessors.
              S4NY
                  WOR&
                       PLOSS.AAS

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