SAURABH JUNEJA
                                                     SURVEYOR& LOSSASSESSOR
                                   H.No. 107, Hargobind Enclave, Ist Floor, Vikas Marg Extn. Delhi-110092
License No.: SLA 73349                                                                Mobile No.:9899 474 475
Valid Up to : 08-04-2023                                                                E-Mail          : .srbh.juneja@gmail.com
IIISLA No.: A/N/5997                                                                   Phone(s)       011 -42058194

                                                                          Survey Fee Bill
To,
      Bajaj Allianz General Insurance Co. Ltd.                                                      Bill.No : B-11/20/04299
      Block No-4,7 Th Floor DLF Tower Shivaji Marg New Delhi-110015                Date26/11/2020
      New Delhi-110015                                                                                    Code:
      GSTIN:07AABCB5730G1ZZ              State Code : Delhi (07)
                 Report Ref No                    SJ/BAGI/6BE6846/11-20/F/12452
                 Vehicle No.                        UP16BE6846
                 Insured Name                    HUKAM SINGH
                 Date Of Accident                16/10/2020
                 Policy/cover note no          OG-21-9910-1801-00003727
                 Claim No                     :    OC-21-1103-1801-00006872
    SNo                                     Particulars                                             HSN/SAC                              Amount 
      1    Final                                                                                           997162                                       900.00
                    Professional Fee:       Assessed Amount  15,989.00                                       750.00
                    Photos/CD Expenses:                                                                                      0.00
                     0 Photographs , Charged for 0 @ Rs. 0.00
                    Conveyance Expenses :                                                                                150.00

       2               Under Repair                                                                      997162                                       150.00
       3               Re-Inspection                                                                     997162                                       150.00
                                                                                                                               Sub Total:            1,200.00
                                                                                                                          C GST @ 9.00 %               108.00
                                                                                                                          S GST @ 9.00 %               108.00
                ADVANCE RECEIPT                                                                              Grand Total :            1,416.00
                                                                                                                              Round off :            1,416.00
                                                In words : Rs. One Thousand Four Hundred Sixteen Only
   GSTIN: 07AHGPJ3702K1ZG State : (07)
                                                                                                        BH
    PAN.AHGPJ3702K
   Bank Name :AXIS BANK
   A/c No.            913020019916326                                                             S
   MICR No          110211039                                                         RABH JUNEJA

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