NAGESH. S. DHUMAL
                        Automobile Surveyor, Loss Assessor & Valuer                                                                                         D.A.E., B.A.
                                                                                                                                                            A-25, First Floor, Office No.6 ,Gurrukripa CHS,
                        Licence No. : SLA - 74742                                   Valid Upto :22/03/2023                                                  Sector 03, Sanpada (E), Navi Mumbai - 400 705
                                                                                                                                                            022-27753336,2775 3405,Mob No. 9833490051
                                                                                                                                                            Email ID:surveyor.nsd@gmail.com
                                                                                                                  FINAL SURVEY BILL
                      Bill No.              : BA-000042/2020-2021                                                                                                           Date               : 29/10/2020
                                                                      Bajaj Allianz General Insurance Company Ltd.
                      ISSUED TO
                      DIV./BRANCH                                    MUMBAI
                      INSURED                                         M/S RAJ ENTERPRISES
                      VEHICLE NO.                                     MH46BB0084
                      POLICY NO.                              :                                                                             CLAIM NO. :                        OC-21-1901-1811-00000013
                      SURVEYED AT                                     M/S KOHINOOR AUTO GARAGE                                        on Dt. : --
                                        Professional Fees                             SPOT + SURVEY (750 + 750)                                                                             Rs.:                            1500.00
                                       Photograph        1(at Rs. 0.00 x 0 Copy)                                                                                                            Rs.:                                   0.00
                                        Traveling Expenses 0 km.SPOT (60 KM TO AND FRO) 450 + 2 VISIT                                                                                       Rs.:                               750.00
                                       Toll Charges                                                                                                                                         Rs.:                                   0.00
                                       Doc. Veri. Char.                                                                                                                                     Rs.:                                   0.00
                                                                                                                                                      Total                                 Rs. :                           2250.00
                                       18.00% GST on Rs. 2250.00                                                                                                                            Rs. :                              405.00
                                       Rounded to Nearest Rupees :                                                                              Net Total                                  Rs.:                             2655.00
                                        Rupees :TWO THOUSAND SIX HUNDRED FIFTY FIVE                                                   ONLY
                      GST             No.                     : 27AOMPD6250M1ZM
                      BAGIC GST NO :                          27AABCB5730G1ZX
                                                                                                                                                                              NAGESH. S. DHUMAL
                      Advance Receipt