RAJEEVBATRA
                                                                      (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                     Ph.(M)9810143600
IIISLA MEMBERSHIP NO.-A/N/05042                                                                                          (0) 8800174968
B-30,3rd FLOOR (BACK SIDE)                                                                                                      (R) 011-27672404
MAHATMA GANDHI ROAD                                                                                                   Email:r.batra@yahoo.co.in
ADARSH NAGAR,DELHI-110033
                                                                              Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                         Bill.No : B-02-21-06964
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date 22/02/2021
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    CodeNil
       GSTIN:07AABCB5730G1ZZ               State Code : Delhi (07
                  Report Ref No                     RB/BAJ/20-21/07621
                  Vehicle No.                    :    DL 1LAE 4187
                  Insured Name               :    MR.TABREj
                  Date Of Accident          :    14-Feb-21
                  Policy/cover note no     :    OG-21-1149-1803-00001916
                  Claim No                       :    OC-21-1103-1803-00001261

   SNo                                       'Particulars                                                HSN/SAC                               Amount
      1    Final                                                                                                997162                                         650.00
                     Professional Fee:       Assessed Amount  6,472.00                                           500.00
                     Photos/CD Expenses:                                                                                           0.00
                     0 Photographs,Charged for 0 @ Rs. 0.00
                     Conveyance Expenses :                                                                                     150.00

                                                                                                                                      Sub Total:                650.00
                                                                                                                                 C GST @9.00 %                 58.50
                                                                                                                                 S GST @9.00 %                  58.50
               ADVANCE RECEIPT                                                                                   Grand Total                767.00
                                                                                                                                     Roundoff:                767.00
                                                         In words : Rs. Seven Hundred Sixty Seven Only
   GSTIN:07AIGPB7033E1ZQ State :(07)                                         RAJEEV BATRA
   PAN.AIGPB7033E
   Bank Name:PUNJAB NATIONAL BANK
   A/c No.             0618000100079039
  MICR No          110024109                                                       SURVEYOR&LOSSASSESSOR.

---PAGE END---