SURVEY FEE BILL


SHYAM & CO.                                                                                                                  Address-:
SURVEYOR & LOSS ASSESSOR - LICENSE NO -27416, VALID TILL -24-03-2023                            MMIG-14,SEC-A, Sitapur Road Scheme, Aliganj , Lucknow
GSTIN NO-09AEZPP7123A1Z7                                                                                             09919280888, 09829833399
PAN NO -AEZPP7123A                                                                                                   radheyrspandey9@rediffmail.com

Billing Address
Bajaj Allianz General Insurance Co. Ltd.
GSTIN NO 09AABCB5730G1ZV
15/54-B,2nd Floor,Virendra Smrati Complex, Civil Lines, Kanpur-208001, (U.P.)

Place of Supply                   Lucknow
INVOICE NO         SC-21-01-125                                                                             INVOICE DATE                                 14-01-21

                                                                               HSN                    CONV.    TAXABLE
SNO      ITEM DESCRIPTION                                       CODE     FEE      CHARGE VALUE             CGST                  SGST                  IGST
             INSURANCE CLAIMS ADJUSTMENT
             SERVICES                                                                                                        RATE %    AMT    RATE %    AMT    RATE %    AMT
                                  DETAIL OF CLAIM
             CLAIM NO        -OC-21-1302-1826-00002477
             INSURED-        -Sanjay Kumar
             VEHICLE NO    -UP-72-BF-0885
             ESTIMATE       -7072.00
             ASSESSED      -3099.00
             REMARK -SULTANPUR TO PRATAPGARH =46X2X11.5=1058.00
             PROFESSIONAL FEE                                         9971]       500      1058|      1558|        9%    140.22        9%|   140.22          0          1
             REINSPECTION FEE                                          9971           o          0           o        9%|          0        9%           o          0          0
             PROFESSIONAL FEE FOR SPOT                         9971          0          0           0        9%          0        9%           0          0
             TOTAL                                                                            500|     1058|     1558|                140.22|                140.22]                        0

              TOTAL INVOICE VALUE IN FIGURES                                                      1838.44
             TOTAL INVOICE VALUE IN WORDS


                                                                                                                                                                               Shy
                                                                                                                                                                                   KNQW-21

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