UMESH CHANDRA                                                                     Office
Surveyor & Loss Assessor                               UUISLA                                        739-B Akansha Bhawan
Consultant &Engineers                                                                                       D.M.ColonyBulandshahr
Valuer                                            Licence No-SLA-35346                                  Pin-203001 [U.P.]
Investigatior                                    Date of Expiry-01-12-2022                               M-9012540068
Insurance Inspection                                                                                          M-9412610836
GSTIN-09ABIPC2285L1ZF                                        Email ld:Umeshsurveyor@ gmail.com
 Indian Institute of Insurance Surveyor and Loss Assessor Membership No-A-2999
                                                    SURVEY FEE BILL
Ref-BAJAJ/SEP/2020                                                                                  Bill No- SEP-20-138
                                                                                                                   Bill Date:- 26-09-2020
To,                                                         Insured-      MR.PRABHAS KUMAR
Bajaj Allianz General Ins.Co.Ltd.        Vehicle No-UP13BC2032
Block No.04,7th F!oor                          Policy No-OG-21-1901-1802-00003400
DLF Tower 15,Shivaji Marg                 Claim No-OC-21-1103-1802-00001595
New Delhi-110015
GSTIN-07AABCB5730G1ZZ              Place of Service-Bulandshahr,State Code-09
                                                               Reverse Charge:-No
Particulars of Scrvices                                                                             HSN CODE    Amount
PROFESSIONAL CHARGES:-                                                                        997162
Final Survey.                                                                                                                     400.00

Daily Allowance:-
For One Day                                                                                                                       0.00
Out Station Conveyance:-
BSR to Bugrasi Total Km 50x2=100 @ Rs.7.5 PerKm                                                      750.00
Re-Inspection                                                                                                                     0.00
Photograph Charges:-
 Photograph No-0 @10 per sanp                                                                                             0.00

 Document Verification:-
 Total Document No.0 @Rs-50 Per Document                                                                    0.00
Misc-Expenses                (Incidental Espenses                         Courier                             0.00
                                                                                    Taxable Value:-                         1150.00
                                                                                    C.G.S.T.@9.00%                          0.00
                                                                                    S.G.S.T @9.00%                          0.00
                                                                                    I.G.S.T@18.00%                       207.00
 Rupees:-One Thousand Three Hundred Fifty Seven        Grand Total :-                          1357.00

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