HEMANT R.PANCHAL
                                     SurveyorLoss Assesor
            A203,2nd flor,Rushi Complex,Beside Hari Om Petrol Pump.LP.Savani Road
                               Adajan, Surat -394510.Mobile98244-75769.
                                    Lic.No.58125Valid upto 30/01/2023.
                                            SURVEY BILL
To,
Bajaj Alianz GenIns. Co.Ltd
Gujarat
GST No.24AABCB5730G1Z3

Bill/ Ref. No.:                          HP/098/150/2020           Date:                  07/08/2020
Policy No                               [OG-20-2203-1803-00005004
laim No.                               OC-21-2203-1803-00000069
Insured                                 MR SATYAVIRSINGH MUNSHI
Vehicle no.                               GJ05/YY/7527
                                                                                                Amount
                                                                                                 Rs.Rs.
01.Survey Fees                                                                                      5,000

02.Out Station Allowance

03.Travelling&Conveyance charges                                                                  450

04.Photographs Charges                                                                                40
05.Other Exps.
                                                                                                        5,490
AddGST                                  CGST                    09%                        494
GST No.24AIWPP4714A1ZA           SGST                    09%                        494
PAN no.AIWPP4714A                   IGST                    00%
                                               ADVANCE RECEIPT   Total Rs.                6,478
                                                                                                    CHEMANT
                                                                   HEMANTAPANCHAL
                                                               SURVEYOR&OSSASSESSOR

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