Mobile No. :9782773649
Licence No. SLA/120614
                                                                                                                                       9799730029
Valid upto 10th May 2021
                                                                                                                       dipu.dilip2@gmail.com
                                                                                                         DILIP KUMAR PRAJAPAT
Surveyor &Loss Assessore of Motor
                                                                                                                  SURVEYOR& LOSS ASSESSOR
&Marin Cargo
GSTIN-                                                                                                                            154,Rabari Vas,
Reference N DKP/BGIC/01/2021/929                                                                                  Amli Road,Pindwara
                                                                                                                      Dist.Sirohi,Rajasthan-307022
                                                            BILL
Bill No.    929
                                                                               M/s.: Bajaj Allianz General Insurance Co. Ltd
Date   :    12/02/2021                                                        2nd & 3rd floor, 4 Hathroi Fort, Gopalbari,
                                                                                       Ajmer Road, Jaipur-302001
                                                                                 GSTI :

Claim No.               OC-21-1401-1802-00001195
Policy No               OG-21-1701-1802-00106607

Vehicle No.            GJ27BP9767
                                                                                 Date of Accident:         27/01/2021
Insured Name         PANCHAL PRANAV                                Date of Survey 02/01/2021

                                                        PARTICULARS                                                              AMOUNT

a Professional Fee                                                                             Final                                500.00
                                                                                                       Re-Inspection
b Halting Allowance
ConveyanceLocal
d)Fare From         Sirohi To Bagoda                                                      Final                             1,520.00
    By Car                                                                                          Re-Inspection                   1,520.00
    Distance 190KM*8=1520
e)Speed Post=40

                                                                                                                                            3,540.00
                                                                                       Add  : CGST @ 9%
PAN No. CZJPK1227R                                                          Add.   SGST @ 9%
                                                                                       Add. IGST@ 18%
                                                                                                       Total                             3,540.00
 BANK -BANK OF BARODA
Address :- Shree Ji Plaza, Near Telephone Exchange,Pindwara-307022
 A/c Name Mr.Dilip Kumar Prajapat A/c No.55318100005070                                         Prke
IFS Code BARB0PINSIR Branch Code 307012027                                                        Tar
                                                                                                            DILIP KUMARPRAJAPAT

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