Gursharan Singh Modi
               B.E Mech                                                                                                                            5 B/B Gandhi Nagar
               Surveyors & Loss Assessors                                                                                                  Jammu (J&K)
               SLA 39309 Validity : 11/04/2021                                                                                           Mob.: 9419192514
               E-Mail : gsmodijmu@gmail.com
                                                                                         Tax Invoice
To,
      Bajaj Allianz General Insurance Co. Ltd.                                                                         Bill. No : B-03-21-03693
      Paloura, Jammu                                                                                                         Date     : 05/03/2021
                                                                                                                                      Code     :
      GSTIN: 01AABCB5730G1ZB                     State Code : (01)
                   Report Ref No                    :     GS/BAGI/8H-3164/01-21/F/03927
                   Vehicle No.                        :     JK08H-3164
                   Insured Name                    :    Sandeep Bhadwal
                   Date Of Accident         :            30/01/2021
                   Policy/cover note no           :     OG-21-1204-1811-00000313
                   Claim No                           :    OC-21-1204-1811-00000063

    S No                                             Particulars                                                        HSN/SAC                                     Amount Z
      1     Spot                                                                                                            997162                                              3380.00
                      Professional Fee :                                                                                                             500.00
                      Photos/CD Expenses :                                                                                                           0.00
                       0 Photographs , Charged for 0 @ Rs. 10.00
                      Conveyance Expenses :      Visited total 288 Kms. No of visits 1 charged @210.00/ Km                            2880.00
                       144 Kms one side for Punkhari Kelri Teh. Mahanpur.
      2     Final                                                                                                            997162                                              2200.00
                      Professional Fee :             Assessed Amount  10868.00                                                      1000.00
                      Photos/CD Expenses :                                                                                                           0.00
                       0 Photographs , Charged for 0 @ Rs. 10.00
                      Conveyance Expenses :      Visited total 120 Kms. No of visits 1 charged @210.00/ Km                            1200.00
                        60 kms one side for Chadwal Kathua.
      3                  Tol charges for spot                                                                              997162                                               105.00
      4                  Tol charges for final                                                                              997162                                                105.00
      5                  Outstation allowance for        1 day  @ Rs.450/day    visit                        997162                                                450.00
                           for spot survey at Punkhari Kelri
      6                  Outstation allowance for        0.3 day  @ Rs.450/day  visit                        997162                                               150.00
                           for final at Chadwal
                                                                                                                                                    Sub Total : 2                 6390.00
                                                                                                                                                 C GST @ 9.00 %                   575.10
                                                                                                                                                S GST @ 9.00 %                    575.10
                ADVANCE RECEIPT                                                                                                    Grand Total :                  7540.20
                                                                                                                                                    Round off :                 7,540.00
                                                               In words : Rs. Seven Thousand Five Hundred Forty Only
  GSTIN: 01AAXPM3914C1ZX State : (01)
  PAN. : AAXPM3914C
  Bank Name : Union Bank Of India
                                                                                                             GURSHARAN SINGH MODI
  A/c No.                : 437902010004521
  MICR No              : 180026003                                                               Surveyor and Loss Assessor

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