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-11-20-04122
       VADODARA                                                                                                      Date   23/11/2020
       4O1,ATLANTIS HERITAGE,OPP.SWAGAT PETROL PUMP,SARABHAI MAIN    Code  :
       ROAD, NEAR GENDA CIRCLE
       GSTIN: 24AABCB5730G1Z3               State Code : Gujarat (24)
                   Report Ref No               :    VKP/BAGI/AW-7317/09-20/F/03949
                   Vehicle No.                          GJ 4 AW 7317
                   Insured Name                     Mr. Dinkarrai M Pandit
                   Date Of Accident                30-Aug-20
                   Policy/cover note no           OG-20-1911-1803-00002901
                   Claim No                       :    OC-21-2204-1803-00000174

    S No                                         Particulars                                                 HSN/SAC                                Amount
      1    Final                                                                                                   997162                                      2,800.00
                      Professional Fee :       Assessed Amount & 130,000.00                                     2,500.00
                     Photos/CD Expenses :                                                                                           50.00
                       1 Photographs , Charged for 1 @ Rs. 50.00
                      Conveyance Expenses :                                                                                       250.00

                                                                                                                                         Sub Total :            2,800.00
                                                                                                                                    C GST @9.00 %                252.00
                                                                                                                                     S GST @ 9.00 %                252.00
                ADVANCE RECEIPT                                                                                    Grand Total:             3,304.00
                                                                                                                                         Round off :            3,304,00
                                                    In words : Rs. Three Thousand Three Hundred Four Only
   GSTIN: 24ADNPK4533G1ZM State : (24)                                                                          MvaRuFe
   PAN.ADNPK4533G                                                                                                          FwomLoteri
                                                                                                              PARESH KOTHARI
   Bank Name : Bank of Baroda
   A/c No.             7460100005184
   MICR No           360012006                                                                                               RASveYOr  d As

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