RAJEEV BATRA
                                                                       (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                       Ph.(M)9810143600
IIISLA 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-08/20/06044
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date    26/08/2020
       7THFLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Code   Nil
       GSTIN:07AABCB5730G1ZZ               State Code : Delhi (07)
                   Report Ref No                     RB/BAJ/20-21/06625
                   Vehicle No.                    :    UP-14-EB-0453
                   Insured Name               :    MR KUMAR KAPILESH
                   Date Of Accident           :    14/08/2020
                   Policy/cover note no     :    OG-21-1103-1871-00000218
                   Claim No                       :    OC-21-1103-181-00000067

    S No                                         Particulars                                                 HSN/SAC                                Amount
      1    Final                                                                                                  997162                                          550.00
                      Professional Fee:       Assessed Amount 4,900.00                                            400.00
                     Photos/CD Expenses:                                                                                             0.00
                      0 PhotographsCharged for 0@ Rs.0.00
                     Conveyance Expenses:                                                                                       150.00
                                                                                               5
                                                                                                                                         Sub Total:                550.00
                                                                                                                                    C GST @9.00%                  49.50
                                                                                                                                    S GST @9.00 %                  49.50
                ADVANCE RECEIPT                                                                                     Grand Total:                649.00
                                                                                                                                        Roundoff:                649.00
                                                              In words : Rs. Six Hundred Forty Nine Only
   GSTIN:07AIGPB7033E1ZQ State:(07)                                          RAJEEV BATRA
   PAN.AIGPB7033E
   Bank Name:PUNJAB NATIONAL BANK
   A/c No.             0618000100079039
   MICR No          110024109                                                        SURVEYQR&LOSSASSESSOR.

---PAGE END---