Salahuddin & Associates Govt. Approved Engineers, Values, Investigators, Surveyors & Loss Assessors License No, SLA/12232 Valid Up to 09-01-2025 Address: D-322, 2nd Floor, FM Tower, Vibhuti Khand, Gomti Nagar Lucknow 226 010 Phone No. 0522-4009370. Cell Nos.-9839118322 & 9984995544 Pan No. AOJPS0386L & GST NO 09AOJPS0386L1Z9 HSN/SAC 997162 Ref: 2324BAJAJ1513 Dated: 23-12-2023 1. Claim No. OC-24-1302-1826-00009201 2. Policy No. OG-24-3262-1826-00000358 3. Bill to Insurance Company Bajaj Allianz General Insurance Company 4. Insurance Company GST No 09AABCBS730G1ZV 5. Insurance Company Address 3rd Floor, Narain Automobiles, 4, Shahnajaf Road, Hazratganj, Lucknow, Uttar Pradesh - 226001 6. Insured MR. VINEETKUMAR 7. Registration No. UP30BR6441 Sl No. Description Amount (Rs) 1. Professional fee Rs 850.00 2. Conveyance Rs 250.00 Rs 1,100.00 Add: CGST @ 9.00% Rs 99.00 Add: SGST @ 9.00% Rs 99.00 TOTAL Rs 1,298.00 (RUPEES ONE THOUSAND TWO HUNDRED AND NINETY EIGHT ONLY) A3.S SIM BORS LCSS For, Salatuddir& Associates ---PAGE END---