DEEPAK RATHIBE.
                                                                      Surveyor and Loss Assessor & Valuer
  IIISLA Member Ship No.-Associate-A/W/04882                             Fire,Motor Engineering)
  GSTIN:08ACUPR3734N1ZO                                                                     SLA-73076
  PAN ACUPR3734N                                                   Mobile :94149-14640, 99822-14640
                                                  PRE RECEIPT
  Bill Number: DR/06-2020/042                                                  Date: 12-06-2020
 Insurer                                     Bajaj Allianz General Insurance Company Limited
                                                 2&3 Floor,4Hathroi Fort,Gopal bari Ajmer road, Jaipur
                                                  GSTIN-08AABCB5730G1ZX
  Claim Number                          OC-21-1401-1802-00000046
  Insured                                    Mr.Bharat Kumar
  Policy Number                          OG-20-3023-1802-00000203
  Report number                          DR/Motor/06-2020/042
  Place of inspection                     Mahesh Automobiles-Balotra
  Vehicle Regd. Number               GJ-05-SD-4057
  Professional Fees                                                                                500.00/-
  Conveyance-For Final                                                                         1800.00/-
  Distance between Jodhpur & Balotra is 120.00 km.
  Total distance covered= 120.00x 2=240.00 km
  Conveyance @07.50/-=240.00 07.50/-=1800.00/-
  Photographs charges-CD                                                                        30.00/-
 DA                                                                                                   175.00/-
  Regd Letters                                                                                          0.00/-
  TOTAL                                                                                          2505.00/-
  CGST @ 09.00% =225.45/- & SGST @ 09.00% =225.45/-                                 450.90/-
  TOTAL Rs/-                                                                                    2956.00/-
(Rs/- Two Thousand Nine Hundred Fifty Six Only)
      For NEFT Fund Transfer:-
      Bank Name:Union Bank of India
      IFSCUBIN 0550388
      A/C Number:503802010011146
      MICR Code342026003
      GSTIN-08ACUPR3734N1ZO                              DEEPAKRATHI



            C/o. Annkoot Agro Food,T-2,Mandore Mandi, Jodhpur-342 006Raj.)

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