Gyan Rahash Twvari
                                                 Surveyor & Loss Assessor
Licence No. SLA-38887                                                                                 RESIDENCE:
Valid upto : 28-12-2020                                                                              MIG-55, Phase-II
                                                                                                            Kaushalpuri Colony
E-mail: gyan2500@gmail.com
                                                                                               Distt- Faizabad-224 001 (U.P.)
Pan No.ACVPT9594P                                                                               Mob.: 9415048094
GSTIN No- 09ACVPT9594P1ZT
     To,
      The Manager,
      Bajaj Allianj Genral Insurance Co. Ltd.
      4th floor, Habibulah estate, Halwasia commerce building, hazaratganj.
      Lucknow, Uttar Pradesh and mentioned below
      GST NO- 09AABCB5730G1ZV

      No.GPT/BAJAJ/(F)/19-20                                                               Date.09.06.2020
      Claim No. - OC-21-1301-1870-00000020
      Vehicle no.-MH02EZ3144
      InsuredI BABLU GUPTA
       S1.                                           Particulars                                            Amount
       1     Final Survey Fee                                                                                850.00
       2     Conversion                                                                                             0.00
      3    T.A.(Faizabad to Ambedkar Nagar )                                                  950.00
       4     Photographs / C.D (Nos.)                                                                  0.00
       5     Other Expanses                                                                                 1800.00
                                                                                    Total Amount Rs.      1800.00
                                                                                                         GST 0%          0.00
                                                                                                        Total Rs.    1800.00






                                                                                                 (G.P. Tewari)

---PAGE END---