PARESH KOTHARI
                                           Approved Consulting Automobile and Engineering Surveyor, Loss Assessor &Valuer
S.L.NO.SLA-66761                                                                                                                      2C SONAL APRTMENT,
Dt. Exp. : 29-11-2021                                                                                                                     2 MARUTINAGAR,
Mobile 9825072771                                                                                                                   NEAR AIRPORT,RAJKOT -360001
pareshkothari1@gmail.com
                                                                               Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                          Bill. No : B-07-20-03735
       VADODARA                                                                                                     Date13/07/2020
       401,ATLANTIS HERITAGE,OPP.SWAGAT PETROL PUMP,SARABHAI MAIN     Code  :
       ROAD, NEAR GENDA CIRCLE
       GSTIN:24AABCB5730G1Z3               State Code : Gujarat (24)
                  Report Ref No               :    VKP/BAGI/AX-5488/06-20/F/03707
                  Vehicle No.                    :    GJ 3 AX 5488
                  Insured Name               :    Mr. Asifbhai A Lingadiya
                  Date Of Accident          :    20-May-20
                  Policy/cover note no     :    OG-21-2204-1803-00000187
                  Claim No                       :    OC-21-2204-1803-00000029

   S No                                        Particulars                                                 HSN/SAC                                Amount 
      1    Final                                                                                                  997162                                      2,800.00
                     Professional Fee :       Assessed Amount  110,000.00                                     2,500.00
                     Photos/CD Expenses :                                                                                          50.00
                      1 Photographs , Charged for 1 @ Rs. 50.00
                     Conveyance Expenses :                                                                                       250.00

                                                                                                                                       Sub Total:            2,800,00
                                                                                                                                   C GST @ 9.00 %                252.00
                                                                                                                                   S GST @ 9.00 %                252.00
               ADVANCE RECEIPT                                                                                    Grand Total :             3,304.00
                                                                                                                                       Round off:             3,304.00
                                                   In words : Rs. Three Thousand Three Hundred Four Only
  GSTIN: 24ADNPK4533G1ZM State: (24)
  PAN. : ADNPK4533G                                                                                                        Faresh KAar
                                                                                                            PARESH KOTHARI
   Bank Name : Bank of Baroda
  A/c No.             7460100005184                                                                                                     Kehui
  MICR No          360012006                                                                                                          or Rnd Assesse

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