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 07/10/2023
                                          Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
Ref:- BAJAJ/FINAL/2020/21/0252                                                                  Dated: 24/10/2020
                                                 HSN/SAC CODE:997162
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 14CE 2843
INSURED NAME           :       AMIT KUMAR JAIN
ClaIM no.                    :       OC-21-1103-1802-00001935
Policy No.                    :       OG-20-1607-1802-00000396
ASSESSED LOSS             :       Rs. 4850/-


Professional
Professional Fee                                                                                                                             400.00
Visit to workshop                           Rohini To Kirana Mandi, Gzb 75*4                                                 300.00
RE-Inspection Charges                                         :                                                                           0.00
Under repair                                                         :                                                                           0.00
Spot inspection Fee                                                                                                                            0.00
TOTAL                                                                                                                                        700.00
CGST@9%:                                                                                                                                        63.00
SGST@9%                                                                                                                                             63
GROUND TOTAL                                                                                                                       826.00


Thanks & Regards
Rakesh Kumar
Surveyors & Loss Assessors.

(Authorized Signatory)

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