PARESH KOTHARI
                                          Approved Consulting Automobile and Engineering Surveyor, Loss Assessor & Valuer
S.L. NO. SLA -66761                                                                                                                     2C SONAL APRTMENT,
Dt. Exp. : 29-11-2021                                                                                                                   2 MARUTINAGAR,
Mobile : 9825072771                                                                                                                   NEAR AIRPORT, RAJKOT -360001
pareshkothari1@gmail.com
                                                                               Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                          Bill. No : B-09-20-03951
       VADODARA                                                                                                     Date   29/09/2020
       401,ATLANTIS HERITAGE,OPP.SWAGAT PETROL PUMP,SARABHAI MAIN     Code   :
       ROAD, NEAR GENDA CIRCLE
       GSTIN:24AABCB5730G1Z3               State Code : Gujarat (24)
                  Report Ref No               :    VKP/BAGI/BV-108-/09-20/F/03997
                  Vehicie No.                   :    GJ 3 BV 108
                  Insured Name               :    Mr. Jaydeepsinh B Rajput
                  Date Of Accident          :    02-Sep-20
                   Policy/cover note no     :    OG-20-2204-1803-00004456
                  Claim No                       :    OC-21-2204-1803-00000179

   S No                                        Particulars                                                 HSN/SAC                                Amount 
      1    Final                                                                                                  997162                                      1,800.00
                     Professional Fee :       Assessed Amount  100,000.00                                    1,500.00
                     Photos/CD Expenses :                                                                                          50.00
                      1 Photographs , Charged for 1 @ Rs. 50.00
                     Conveyance Expenses :                                                                                      250.00

                                                                                                                                       Sub Total:            1,800.00
                                                                                                                                  C GST @ 9.00 %                162.00
                                                                                                                                   S GST @ 9.00 %                162.00
               ADVANCE RECEIPT                                                                                   Grand Total :             2,124.00
                                                                                                                                      Round off:            2,124.00
                                                In words : Rs. Two Thousand One Hundred Twenty Four Only
   GSTIN: 24ADNPK4533G1ZM State : (24)                                                                             Aev
   PAN.:ADNPK4533G                                                                                                           Paresh Mt
                                                                                                            PARESH KOTHARI
   Bank Name : Bank of Baroda
   A/c No.             7460100005184                                                                                                     yofeu
   MICR No           360012006

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