License No. SLA-73766
Valid Up to :05-10-2024			 Mobile(S :9990929990
Pan card no. :AHRPA8488Q			 E-Mail : msadhikari77@gmail.com
		      MANOHAR ADHIKARI
			     Surveyor & Loss Assessor
		   C/o Harinagar Nayak, Near DAV School, Haldwani,Uttrakhand
				Survey Fee Bill
To,
  Bajaj Allianz General Insurance Co. Ltd. Bill No. : B-02-24-02558
  NEW DELHI				       Date 29/02/2024
   NEW DELHI, WEST DELHI -110015		  Code
   GSTIN: 07AABCB5730G1ZZ State Code :NEW DELHI (07)
       Report Ref No M S/BAGI/6ER4450/02-24/F/02666
       Vehicle No.     : UK06ER4450
       Insured Name RATAN DHALI
       Date Of Accident : 06-Feb-24	  Assessed : 	 3,904.00
       Policy/cover note no OG-24-1157-1803-00000864 Estimate :	0.00
		      :
       Claim No	: OC-24-1103-1803-00002827 IDV     :     90,000.00
 SNO	  Particulars		    HSN/SAC	     Amount 
  1 Final				     997162	      1,950.00
	Professional Fee : Assessed Amount  3,904.00    850.00
	Photos/CD Expenses :			       0.00
	0 Photographs , Charged for 0 @ Rs. 0.00
	Conveyance Expenses : Visited total 110 Kms. No of visits 1 charged @10.00/Km 1,100.00
	HALDWANI TO DINESHPUR 55*2 TOTAL 110KM
						       Sub Total: 1,950.00
						     C GST @ 9.00 %  175.50
						     S GST @ 9.00 %  175.50
     ADVANCE RECEIPT			   Grand Total :      2,301.00
						      Round off :  2,301.00
		     In words : Rs. Two Thousand Three Hundred One Only
GSTIN: 07AHRPA8488Q1Z9 State : (07)
PAN.AHRPA8488Q
Bank Name :HDFC BANK LTD
A/cNo.  50200085453100			     MANOHAR ADHIKARI
MICR No 110240116
IFS Code : HDFC0000932

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