Yogesh Gupta
                             Surveyor& Loss Assessor
                             License No.                  120998                                                                                  Office:
                            Valid upto                                                                                                                                                             SCF-10,Sector-6
                                                          20.01.2022                                                                                                               Bahadurgarh,Distt.Jhajjar
                            Deptt.                       :Motor
                            PAN NO.                                                                                                                                                                 Haryana-124507
                                                         AIEPG3565C
                                                                                                                                                                                                      M9728410038
                            Ref.No.YRK/Bajaj/20/Motor/094
                                                                                                                                                                                              September 5,2020
                                       Bajaj Allianz General Insurance Co.Ltd;
                                       Moti nagar
                                      Delhi.
                                                                                      Policy No.                  OG-20-1901-1802-00077795
                                                                                       Claim No.                  OC-21-1103-1802-00001258
                                                                                   Vehilce No.                    HR13M0663
                                                                         Insured's Name                           :KAJAL
                                                                                                                     SURVEY FEE BILL
                             AProfessional Fee for Spot survey
                                                                                                                                                                             :Rs.                                       0.00
                            B Professional Fee for Final survey
                                                                                                                                                                             :Rs.                                  550.00
                                     (Assessed loss amount Rs.)                                          10212.00
                            c Professionai Fee for Re-inspection survey
                                                                                                                                                                             Rs.                                       0.00
                                     Conveyance Charges (Local)                                                             2                                                :Rs.
                                                                                                                                                                                                                  300.00
                                     Conveyance(Out Station)                                                                0                     0                          :Rs.
                                     Photographs-Digital                                                                                                                                                               0.00
                                                                                                                            0                     0                           :Rs.                                     0.00
                                                                                                                                                                                                                  850.00
                                                   Total Rs.850.00
                                    (Rs.EIGHT HUNDRED FIFTY ONLY.)
                                                              Gupta
                                                       1SLA               *B
                                                     120996
                                    (Yogesh Gupta)
                                    Surveyor and Loss Assessor
                                    NEFT Details:
                                   Name:                             YOGESH GUPTA
                                   Bank:                             INDUSIND BANK
                                   A/cNo.                            159728410038
                                   IFSC Code:                        INDB0000360
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