Manoj Jain                                                                A               234845 (Resi.)
   Fire,Motor. Enginnering                                                                Mobile       9425087045
   Surveyor & Loss Assessor                                                                   7693087045
   Investigator&Valuer                                                            Shreeji Nagar
   Email : manoj_jain_2001@yahoo.com                                                     Behind Vrandavan Colony
   GSTIN :23AEDPJ2084E1ZZ                                                   Khargone - 451001
                             Central Govt. Lic. No. SLA-40879 (Valid Up To 20th May 2021)
  Ref :Bajaj        324/020                                                                        Date :        05.03.2021
                                                           Professional Fee Bill

  To
          The Manager
          Bajaj Allianz General Insurace Co. Ltd.
          Cust GSTIN/UIN :23AABCB5730G1Z5
  1     Particular                                               MP 10 MP 4430
  2     Policy ICovernote No.              :             OG-20-1901-1802-00091141
  3     Claim No.                                :             OC-21-2302-1802-00000393
  4     Place/Date of occurrence       :             17.01.2021
  5     Insured                                   :             DILIP VERMA
                         Particular                                                                    Amount

  1     Professional Fee                                            4164                             750.00
          Reinspection Fee
  2     Photographs CD                                                                                  50.00
  4     Travelling Expanses                                                                           300.00
  5     Daily Allowance                      @500/-
 6     Misc Expanses
                                                                       Total                                  1100.00
                                        CGST @                           9%                              99.00
                                        SGST @                            9%                              99.00
                                        Total Tax                                                             198.00
                                                                       Total                                  1298.00
 Rs. One Thousand Two Hundred & Ninety Eight Only
                                                                                                                   JAIM
        Advance Receipt
                                                                                                                   Manoj Jain)
                                                                                                                       Sufveyor
Bank A/c No.0287000100070315
                                                                                                                J870
Bank Name : Punjab National Bank Khargone

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