Rajesh S. Thakker
                                                                                                               C.A.E., D.A.E., A.I.S.A.
                                                                       SURVEYOR, LOSS ASSESSOR & VALUER
                                                                             Licence No. SLA 20725 Exp. Dt. 17-08-2021
                                           5, PATEL COLONY, ROAD NO. 1, OPP. DARSHAN APARTMENT, JAMNAGAR - 361 008, (GUJARAT)
                                                           MO. 98242 11549, 94274 45301 E-mail : rajesh_thakker@rediffmail.com
                                                                                         Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                                            Bill. No : RST/203159
       Rajkot                                                                                                                          Date     : 18/12/2020
       1st Floor, Hotel K Rose Building, In Front Of Shastri Medan, Limda Chowk,                           Code     :
       Rajkkot
       GSTIN: 24AABCB5730G1Z3                      State Code: Gujarat (24)
                    Report Ref No                     :     RST/203159
                    Vehicle No.                         :     GJ10TW5238
                    Insured Name                     :     Hiteshbhai L. Ramavat
                    Date of accident                  :     08-12-2020
                    Policy/cover note no           :     OG-21-1904-1803-00001832
                    Claim No                            :     OC-21-2204-1803-00000331

    S No                                               Particulars                                                          HSN/SAC                                      Amount /
      1     Final                                                                                                               997162                                               1050.00
                       Professional Fee :              Assessed Amount  18554.00                                                          750.00
                       Photos/CD Expenses :                                                                                                             50.00
                        CD with digital photographs
                       Conveyance Expenses :                                                                                                         250.00

                                                                                                                                                         Sub Total : %                  1050.00
                                                                                                                                                     C GST @ 9.00 %                      94.50
                                                                                                                                                     S GST @ 9.00 %                      94.50
                ADVANCE RECEIPT                                                                                                       Grand Total : %                  1239.00
                                                                                                                                                         Round off : %                 1,239.00
                                                              In words : Rs. One Thousand Two Hundred Thirty Nine Only
  GSTIN: 24AAUPT4514C1ZN State : (24)
   PAN. : AAUPT4514C
  Bank Name : HDFC Bank Ltd.,                                                                                                                            31N0I
  A/c No.                : 01771500003760                                                                                                                 RAJesh S ThaKKer
                                                                                                                                                                                C.A.E., D.Ae.A.I.S.A.
   MICR No              : 361240001                                                                                                                           SURVEYCR &LCES ASSESSOR

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