Mobile - 9422375437                                 Vinayak D.Mali                           Phone No.02145 - 224581
                                      AUTOMOBILE ENGINEER,INSURANCE SURVEYOR,
Lic.No.SLA 62459/98-21                   VALUATOR AND LOSS ASSESSORS                  Lic.Exp. date 14-01-2021


      Report No. BAGI/1251                                                 Date :06/03/2021
                                                                                        Claim No.
      To,
      Bajaj Allianz General Insurance Co. Ltd.
      Mumbai

      Policy Number               OG-193782184300000135
      Insured                         VISHAL MISHRA
      Vehicle No.                    MH06BZ5774
      Inspection/                    03/03/2021
      Survey Held on
      Held at                     :RAJ MOTORS

      Professional Fees                                                                      Rs.          850.00
      Travelling                                                                                 Rs.           350.00
      Local Conveyance                                                                     Rs.              0.00
      Photograph                                                                               Rs.           100.00
      Outstation allowance                                                                  Rs.              0.00
      TOTAL                                                                                     Rs.        1,300.00
       Service Tax No.AGVPM5685NST001
      Pan No.AGVPM5685N

                                                                                               V.D.MALI
                                                                                        VINAYAKA D.MALI
                                                                                                 SURVEYOR

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