RAKESH KUMAR
                                               SURVEYOR & LOSS ASSESSOR
FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                        Mob.#9868110525/8836301125
                                        E-mail: majokarakesh61197@gmail.com
                                        License No. SLA-61197, Valid upto 07/10/2020
                                        Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
Ref:- BAJAJ/FINAL/2020/21/0014                                                              Dated: 13/06/2020

Bajaj Allianz General Insurance Company Limited.
Block No.4, 7th Floor, DLF Tower-15, Shivaji Marg, 011-66278225, New Delhi-110001.
GST Number:07AABCB5730GIZZ
VEHICLE NO.                       UP 14ED 4043
INSURED NAME                  MS. RAKHI
CLAIM NO.                           0C-21-1101-1826-00000090
POLICY No.                            0G-20-1105-1826-00000722
ASSESSED LOSS                    Rs. 3600/-


Professional
Professional Fee                                                                                                                     450.00
Visit to workshop                                                                                                                    150.00
RE-Inspection Charges                                                                                                               0.00
Under Repair             1 VISIT                                                                                                      0.00
Spot Inspection fess                                                                                                                    0.00
TOTAL                                                                                                                                600.00
CGST@9%:                                                                                                                               54.00
SGST@9%                                                                                                                                     54
GROUND TOTAL                                                                                                                708.00


Thanks & Regards
Rakesh Kumar.
Sy            Kumoss Assessors.
           ars
       (StA-W9E)*
    ithorizediSignatory)
             LOSS A

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