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-20-11-55                                                                              INVOICE DATE                                09-11-2020

                                                                                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-21-1301-1826-00001443
             INSURED-        - MAYA RAM
             VEHICLE NO    - UP-30-AY-4963
             ESTIMATE      - 15500/-/-
             ASESSED       - 4773/-
             REMARK -CONVEYANCE CHARGES 45X2X11.5=1035
             PROFESSIONAL FEE                                         9971]       750[      1035|      1785|        9%    160.65        9%|   160.65          0          1
             REINSPECTION FEE                                          9971           o          0           o        9%|          0        9%|          o          0          0
             PROFESSIONAL FEE FOR SPOT                        9971                                     0        9%          0        9%           0          0
             TOTAL                                                                             750|     1035     1785|                160.65|                160.65|                        0

              TOTAL INVOICE VALUE IN FIGURES                                                        2106.3
             TOTAL INVOICE VALUE IN WORDS                                                       TWO THOUSAND ONE HUNDERED SIX ONLY


                                                                                                                                                                                Shy
                                                                                                                                                                                    KNQW-21

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