SAURABH JUNEJA
                                                       SURVEYOR & LOSSASSESSOR
                                    H.No. 107, Hargobind Enclave, 1st Floor, Vikas Marg Extn. Delhi-110092
License No. : SLA 73349                                                                 Mobile No. :9899 474 475
Valid Up to : 08-04-2023                                                                 E-Mail          : srbh.juneja@gmail.com
IIISLA No. : A/N/5997                                                                    Phone(s)        011 -42058194

                                                                            Survey Fee Bill
To,
      Bajaj Allianz General Insurance Co. Ltd.                                                       Bill. No : B-01/21/04786
      Block No-4, 7 Th Floor DLF Tower Shivaji Marg New Delhi-110015                 Date : 31/01/2021
      New Delhi-110015                                                                                      Code:
      GSTIN:07AABCB5730G1ZZ              State Code : Delhi (07)
                  Report Ref No                    SJ/BAGI/SCF2542/01-21/F/13124
                 Vehicle No.                         DL7SCF2542
                 Insured Name                    HARISH SHARMA
                 Date Of Accident           :    15/01/2021
                 Policy/cover note no     :    OG-21-9906-1802-00024767
                 Claim No                      :    OC-21-1103-1802-00003059
   S No                                       Particulars                                               HSN/SAC                                Amount 
     1    Final                                                                                               997162                                         650.00
                   Professional Fee :       Assessed Amount  7,878.00                                           500.00
                    Photos/CD Expenses :                                                                                          0.00
                    0 Photographs , Charged for 0 @ Rs. 0.00
                    Conveyance Expenses :                                                                                     150.00

     2                Re-Inspection                                                                         997162                                         150.00
                                                                                                                                   Sub Total :                800.00
                                                                                                                               C GST @ 9.00 %                  72.00
                                                                                                                               S GST @ 9.00 %                  72.00
              ADVANCE RECEIPT                                                                                  Grand Total :                 944.00
                                                                                                                                   Round off :               944.00
                                                          In words : Rs. Nine Hundred Forty Four Only
  GSTIN: 07AHGPJ3702K1ZG State : (07)
  PAN.:AHGPJ3702K
 Bank Name : AXIS BANK
                                                                                                                         N
 A/c No.             913020019916326                                              S
 MICR No          110211039                                                      SAURABHJUNEJA

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