HITESH R. RAVAL                                          TEL: (02836) 228544 Mo. 9825225844
D.A.E.,A.I.I.S.A(BOMBAY)                                                         G-8, B Green Park, PI. No. 113-114, Tagore Road,
SURVEYOR LOSS ASSESSOR & VALUER                                               Gandhidham - 370201, Dist - Kutchh.
LIC.NO.SLA/36625 up to 02.04.2023                              EMAIL :hird2007@gmail.com
                                                                    INVOICE

Bajaj Allianz General Insurance Co. Ltd.                         Invoice #            HIR/11126/2020
RAJKOT                                                                     Invoice Date        25-12-20
GSTIN : 24AABCB5730G1Z3

Insured : KIRITSINH RANA                                                  Vehicle No.                   GJ 12 BV 3766
Policy# OCG-21-2219-1803-00000053                               Nature of Loss      Own Damage / External means
         OC-21-2204-1803-00000324
Sr. NqDESCRIPTION                                            SAC Coad      Qty.      Rate / Qty       Rs. Ps.
  01.  Survey Fees -- Final                                        997162          1            1500              1500.00
  01.  Survey Fees -- Spot                                         997162          0            750                   0.00
  02.  Re Inspection Fees                                         997162          0            750                   0.00
  03.  Daily Allowance                                             997162          0            150                   0.00
  04.  Local Convence Charges                                  997162          2            250                500.00
         R. Inspection visits                                         997162          1            250                250.00
         Outstation Conveyance                                     997162          0              8                     0.00
  05.  Photograph (CD) Charges No.                           997162          1             50                  50.00
 06.  Other Expense / Toll Taxes                              997162          0              0                     0.00
                                                                        Sub Total                                              2300.00
                                                                        CGST @                      9.00%                   207.00
                                                                        SGST @                      9.00%                   207.00
                                                                        Grand Total                                           2714.00
                                                                        Say                                                    2714.00
Rupees :      Two Thousand Seven Hundred Fourteen Only

E. and O.E.                                                                                    Bank Details
Subject to Gandhidham Jurisdiction                                                  ICICI BANK LTD
GSTIN: 24AASPR2350N1Z6                                                           Account No.: 008601009859
PAN No. :AASPR2350N                                                                   IFSC Coad: ICIC0000259
                                                                                                  Micr. No.: 108214
                LigNo                                                                           Account Type: Savings
             31SA-36625
                Surveyor

HITESH RAVAL

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