Gyan Rahash Tuvari
                                                 Surveyor & Loss Assessor
Licence No. SLA-38887                                                                               RESIDENCE:
Valid upto : 28-12-2020                                                                             MIG-55, Phase-II
                                                                                                          Kaushalpuri Colony
E-mail: gyan2500@gmail.com
                                                                                              Distt- Faizabad-224 001 (U.P.)
Pan No.ACVPT9594P                                                                              Mob.: 9415048094
GSTIN No- 09ACVPT9594P1ZT
     To,
      The Manager,
     Bajaj Allianj Genral Insurance Co. Ltd.
     4th floor, Habibulah estate, Halwasia commerce building, hazaratganj.
      Lucknow, Uttar Pradesh and mentioned below
      GST NO- 09AABCB5730G1ZV

     No.GPT/BAJAJ/(F)/19-20                                                              Date.13.08.2020
      Claim No. - OC-21-1301-1826-00000598
      Vehicle no.-UP42AZ 3316
     Insured Ajay Kumar Singh
       S1.                                           Particulars                                            Amount
       1     Final Survey Fee                                                                               850.00
       2    Conversion                                                                                           0.00
      3    T.A.(Faizabad to Patranga )                                                             1250.00
       4     Photographs / C.D (Nos.)                                                                  0.00
       5     Other Expanses                                                                                     0.00
                                                                                   Total Amount Rs.      2100.00
                                                                                                       GST 0%          0.00
                                                                                                       Total Rs.    2100.00






                                                                                               (G.P. Tewari)

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