NAGESH. S. DHUMAL
 Automobile Surveyor, Loss Assessor & Valuer                                             D.A.E., B.A.
                                                                                                        A-25, First Floor, Office No.6 ,Gurrukripa CHS,
 Licence No. : SLA - 74742               Valid Upto :22/03/2020                          Sector 03, Sanpada (E), Navi Mumbai - 400 705
                                                                                                        022-27753336,2775 3405,Mob No. 9833490051
                                                                                                        Email ID:surveyor.nsd@gmail.com
                                                                       FINAL SURVEY BILL
Bill No.      : BA-0000738/2019-2020                                                                Date       : 05/05/2020
                                     Bajaj Allianz General Insurance Company Ltd.
ISSUED TO
DIV./BRANCH                    MUMBAI
INSURED                        OM SAI TRANSPORT
VEHICLE NO.                   MH04HD9046
POLICY NO.               :                                                           CLAIM NO. :          OC-20-1901-1803-00005166
SURVEYED AT            :    KHANDALA on Dt. : --

             Professional Fees                                                                                              Rs.:                    750.00
             Photograph (at Rs. 0.00 x 0 Copy)                                                                        Rs. :                        0.00
             Traveling Expenses 120 km. @ Rs. 7.50                                                                  Rs.:                    900.00
             Toll Charges                                                                                                    Rs.:                        0.00
             Doc. Veri. Char.                                                                                                Rs. :                       0.00
                                                                                                   Total                      Rs. :                   1650.00
              18.00% GST on Rs. 1650.00                                                                                  Rs.:                    297.00
             Rounded to Nearest Rupees :                                              Net Total                      Rs.:                   1947.00
             RuPeeS :ONE THOUSAND NINE HUNDRED AND FOURTY SEVEN ONLY
GST No.                 : 27AOMPD6250M1ZM

BAGIC GST NO :    27AABCB5730G1ZX
                                                                                                                       NAGESH. S. DHUMAL
Advance Receipt

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