RAKESH KUMAR
                                                 SURVEYOR & LOSS ASSESSOR
FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                          Mob.#9868110525/8836301125
                                          E-mail: majokarakesh61197@gmail.com
                                          License No. SLA-61197, Valid upto 07/10/2020
                                          Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
Ref:- BAJAJ/FINAL/2020/21/0210                                                                Dated: 28/09/2020
                                                 HSN/SAC CODE:997162
Bajaj Allianz General Insurance Company Limited.
Block No.4, 7th Floor. DLF Tower-15, Shivaji Marg. 011-66278225, New Delhi-110001.
GST Number:07AABCB5730GIZZ
VEHICLE NO.                :       UP 14EB 5831
INSURED NAME                   MR.PRAVEEN
CLAIM NO.                             0C-21-1103-1828-00000228
POLICY No.                     :       0G-20-1149-1828-00002128
ASSESSED LOSS                     Rs. 10100/-


Professional
Professional Fee                                                                                                                           500.00
Visit to workshop                           Rohini to Bhopura, UP 78*4                                                  312.00
RE-Inspection Charges                                         :                                                                          0.00
Under repair                                  Rohini to Bhopura, UP 78*4                                                 312.00
Visi to Insured place                                                                                                                         0.00
TOTAL                                                                                                                                    1124.00
CGST@9%:                                                                                                                                    101.16
SGST@9%                                                                                                                                      101.16
GROUND TOTAL                                                                                                                    1326.32


Thanks & Regards
Rakesh Kumar
Suryeyors & Loss Assessors.

 Autherizep Sighatory)

---PAGE END---