RAJEEV BATRA
                                                                     (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                    Ph.M9810143600
IISLA MEMBERSHIP NO.-A/N/05042                                                                                         (0) 8800174968
B-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-01/21/06783
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                   Date14/01/2021
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                   CodeNil
       GSTIN:07AABCB5730G1ZZ              State Code : Delhi07)
                  Report Ref No                     RB/BAJ/20-21/07372
                  Vehicle No.                         DL 8SCC 0970
                  Insured Name              :    MR. SURENDER SINGH
                  Date Of Accident           :    19/12/2020
                  Policy/cover note no           OG-21-1104-1802-00001233
                  Claim No                      :    OC-21-1101-180200002423

   SNo                                       Particulars                                                HSN/SAC                               Amount
      1    Final                                                                                               997162                                        650.00
                    Professional Fee:       Assessed Amount  4,875.00                                          500.00
                    Photos/CD Expenses:                                                                                          0.00
                     0 Photographs, Charged for 0 @ Rs.0.00
                    Conveyance Expenses:                                                                                    150.00

                                                                                                                                    Sub Total:               650.00
                                                                                                                               C GST @9.00 %                 58.50
                                                                                                                               S GST @ 9.00 %                 58.50
               ADVANCE RECEIPT                                                                                  Grand Total               767.00
                                                                                                                                   Round off               767.00
                                                         In words: Rs. Seven Hundred Sixty Seven Only
   GSTIN:07AIGPB7033E1ZQ State :(07)                                         RAJEEVBATRA
   PAN.AIGPB7033E
                                                                                                                    EEV
   Bank Name:PUNJAB NATIONAL'BANK
  A/c No.            0618000100079039
  MICR No          110024109                                                      SURVEYOR&LOSS ASSESSOR.

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