SAURABHJUNEJA
                                                       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-02/21/04834
       Block No-4, 7 Th Floor DLF Tower Shivaji Marg New Delhi-110015                Date : 08/02/2021
       New Delhi-110015                                                                                      Code
       GSTIN:07AABCB5730G1ZZ              State Code : Delhi (07)
                  Report Ref No                     SJ/BAGI/SDB9896/02-21/F/13123
                  Vehicle No.                   :    DL4SDB9896
                  Insured Name              :    ANKIT KAUSHIK
                  Date Of Accident          :    15/01/2021
                  Policy/cover note no     :    OG-21-1104-1802-00017520
                  Claim No                      :    OC-21-1103-1802-00003097

    S No                                       Particulars                                               HSN/SAC                               Amount
       1     Final                                                                                              997162                                        650.00
                     Professional Fee :       Assessed Amount  4,307.00                                          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
   A/c No.            913020019916326
                                                                                                   SAURABHJUNEJA
    MICR No          110211039

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