PRAVIN M. MUSALE
                                                    Motor Surveyor, Loss Assessor and Valuer
                                                   License No. : SLA - 73064 Exp.Dt. 08-02-2022
                                                               604 / Rilletta E / Casa Rio Gold,
                                            Kalyan-Shil Road, Dombivali East, Maharashtra - 421204
                                                                      Mobile. : 9821681100
                                                                     p_musale@yahoo.com

                                                                 Final Survey Fees Bill

BILL NO               : PM//BA/F/0094                                                                             Date : 05/09/2019

INSURERS           : BAJAJ ALLIANZ GENERAL INSURANCE CO. LT Div./Branch : Mumbai
POLICY NO.
CLAIM NO.           : OC-20-1901-1802-00001695
INSURED              : Mr ANWAR ABUBAKAR TAMBOLI
VEHICLE NO.        : MH 04 HL 9665
SURVEYED AT: SAI POINT AUTOMOBILES PVT.LTD.,MUMBRA On Dt. : 05/09/2019

Professional Fees                                                                                           Rs.                750.00
Photograph (at Rs. 10.00 x 0 Copy)                                                             Rs.                   0.00
Traveling Expenses                                                                                         Rs.                300.00
Holting Allowance                                                                                           Rs.
Out city Allowance                                                                                           Rs.
Total                                                                                                              Rs.             1,050.00
18.00% GST Rs. 1,050.00                                                                               Rs.                189.00
Net Total                 Rounded to Nearest Rupees :                                          Rs. :         1,239.00
RupeeS :ONE THOUSAND TWO HUNDRED THIRTY NINE ONLY

Service Tax No.       : GSTIN NO. - 27ALPPM7590M1Z3
PAN No. :                    ALPPM7590M
                                                                                                                   PRAVIN M. MUSALE
Advance Receipt

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