MANOJ KUMAR SAINI (Surveyor & Loss Assessor), 225 -A, Block-P, Narayan Vihar, Jaipur. 302038. sla.manojsaini@gmail.com, 7300214555 GSTIN: 08FDZPS0455Q1Z9, License No. : SLA-85202 / Date of Exp. : 05-NOV-2026 Survey Fees Bill Bill To: Invoice No Date BAJAJ ALLIANZ GENERAL INSURANCE CO. LTD MS/23-24/1706 30-03-2024 2nd and 3rd Floor, 4, Hathroi Fort, Gopal Bari, Ref. No. Ajmer Road, Jaipur Vehicle No. Policy No. / Claim No. Jaipur, Rajasthan RJ 14 HK 9302 OC-24-1401-1802- India 00000759 Insured Name 302001 VINOD KUMAR MEENA GSTIN: 08AABCB5730G1ZX Place Of Supply: 08-Rajasthan Sr. Taxable CGST CGST SGST SGST Description HSN/SAC Rate Per Amount No. Value RateAmount[Rate|Amount 1 Final Survey 850.00 |nos 850.00 9% 76.50 9% 76.50 1,003.00 Professional Fees Conveyance Charges (Charged for 160x2=320Kms 3,200.00 |nos3,200.00 9% 288.00 9% 288.00 3,776.00 @ Rs. 10/-PKM) Subtotal 4,779.00 Total 4,050.00 INR4,779.00 Paid INR0.00 Balance|INR4,779.00 Amount (in words) : INR Four Thousand Seven Hundred Seventy Nine Only CGST: 364.50 SGST: 364.50 Total Tax: 729.00 PAN No. : FDZPS0455Q Komar Saini Bank Name : HDFC Bank + I 0 A/c No. : 50100225869585 MICR No : 302240002 MADQIUMAR SAINI IFS Code : HDFC0000554 (Surveyor & Loss Assessor) ---PAGE END---