SOUMEN KUMAR MAITY                                          GSTIN No. :    19AGRPM4779K2ZB
Surveyor  Loss Assessor                                                         Bill No. :          48            2020
SLA-54973, Exp. 23-04-2022                                                      Date               03.08.2020
Mobile No. - 9434007542                                                     Report No. :        BAJAJ-48-2020
                                                                   INVOICE
To
BAJAJ ALLIANZ GENERALINSURANCE CO.LTD.
KOLKATA.R.O,KOLKATA
GSTIN NO:-19AABCB5730G1ZU
Nature of Claim:                  MOTOR                    Claim No. :           OC-21-2401-1871-00000065
Insured                       SERAJULMALLICK            Policy No. :          OG-21-2401-1871-00000224
                                                                                                                            Amount
SI. No.                                          Description
                                                                                                                            (in Rupees)
            Survey Fees (As per schedule) Professional fees for final survey of
            WB50P 8857(Assessment Amount Rs.-14,000.00)                                                          750.00



    2     Travelling : From Kharagpur to Popular auto Garage and back by
                           own car X 1 by WB36B 9598 (60km.X 2 X 7.5)                                              900.00





                                                                                 Total Taxable Value                      1,650.00
                                                                                        Add : CGST @ 9%                        148.50
                                                                                        Add : SGST @ 9%                        148.50
                                                                                             Total Value                     1,947.00
       Amount in words :       Rupees One Thousand Nine Hundred Forty Seven Only.
BANK DETAILS
Bank Name            AXIS BANK LTD.
Branch Name :      KHARAGPUR
A/C Number :       190010100108430                                                          SLA-$4973E
IFS Code                UTIB0000190                                                              6
                                                                                                                            O

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