Yogesh Gupta
                                       Surveyor & Loss Assessor
                                      License No.                 : 120998                                                                            Office:                            SCF-10, Sector-6
                                      Valid upto                  : 20.01.2022                                                                                           Bahadurgarh, Distt. Jhajjar
                                      Deptt.                     :Motor                                                                                                                  Haryana-124507
                                      PAN No.                     : AIEPG3565C
                                                                                                                                                                                           M9728410038
                                      Ref. No. YRK/Bajaj/21/Motor/180                                                                                                                   October 30, 2021
                                                Bajaj Allianz General Insurance Co.Ltd;
                                                Moti nagar
                                                Delhi.
                                                                                            Policy No.                 : OG-21-1701-1802-00063069
                                                                                             Claim No.                 : OC-22-1103-1802-00001804
                                                                                          Vehilce No.                  : HR12AF4100
                                                                                Insured's Name                         : GAUTAM
                                                                                                                          SURVEY FEE BILL
                                       (A) Professional Fee for Spot survey                                                                                                     :Rs.                         0.00
                                       (B) Professional Fee for Finai survey                                                                                                    :Rs.                     400.00
                                                (Assessed loss amount Rs.)                                     2906.00
                                       (c) Professional Fee for Reinspection                                                                                                   : Rs.                         0.00
                                                Conveyance Charges (Local)                                           1         RTK                                              : Rs.                    450.00
                                               Conveyance(Out Station)                                                                                                          :Rs.                         0.00
                                               Photographs-Digital                                                                0                    0                         :Rs.                        0.00
                                                                                                                                                                                                         850.00
                                                             Total Rs. 850.00
                                               (Rs. EIGHT HUNDRED FIFTY ONLY.)
                                                                        G
                                               (Yogesh Gupta)
                                               Surveyor andEosSAssessor
                                               NEFT Details:
                                               Name:                          YOGESH GUPTA
                                              Bank:                           INDUSIND BANK
                                              A/c No.:                        159728410038
                                              IFSC Code:                     INDB0000360
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