DEEPAK RATHIBE.
                                                                      Surveyor and Loss Assessor & Valuer
 IIISLA Member Ship No.-Associate -A/W/04882                              Fire,MotorEngineering)
 GSTIN 08ACUPR3734N1ZO                                                                       SLA-73076
 PAN :ACUPR3734N                                                    Mobile :94149-14640,99822-14640


                                                  PRE RECEIPT
  Bill Number:DR/08-2020/317                                                  Date: 29-08-2020
 In'surer                                     Bajaj Allianz General Insurance Company Limited
                                                 23 Floor, 4,Hathroi Fort,Gopal bari Ajmer road, Jaipur
                                                  GSTIN-08AABCB5730G1ZX
 Claim Number                          OC-21-1401-1802-00000246
 Insured                                    Mr.Saina Ram
 Policy Number                          OG-19-1901-1802-00024927
  Report number                           DR/Motor/08-2020/317
 Place of inspection                     Mahadev Motors-Pipar City
  Vehicle Regd. Number               RJ-19-BK-3822
 Professional Fees                                                                                 750.00/-
  Conveyance- For Final                                                                         1050.00/-
  Distance between Jodhpur & Pipar City is 70.00 km.
  Total distance covered=70.00 x 2=140.00 km
 Conveyance @07.50/-=140.00 x 07.50/- = 1050.00/-
  Photographs charges-CD                                                                        30.00/-
 DA                                                                                                    175.00/-
 Regd Letters                                                                                          0.00/-
  TOTAL                                                                                           2005.00/-
 CGST @ 09.00%= 180.45/- & SGST @ 09.00% = 180.45/-                                360.90/-
  TOTAL Rs/-                                                                                   2366.00/-
(Rs/- Two Thousand Three Hundred Sixty Six Only)
      For NEFT-Fund Transfer:-
      Bank Name:Union Bank of India
      IFSCUBIN 0550388
      A/C Number: 503802010011146
      MICR Code:342026003
      GSTIN-08ACUPR3734N1ZO                               DEEPAKRATHI



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

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