Mobile No. : 9829061788
Licence No. SLA/22774
                                                                                                                                   Phone : 2611275,2617371
Valid upto 8th March 2022
                                                                                                                                               ASHWANI BERI
Surveyor & Loss Assessore of Motor, Fire
Marin Miscellaneous                                                                                                      SURVEYOR & LOSS ASSESSOR
                                                                                                                                                     B - 13, Govind Marg
                                                                                                                                                Near Sindhi Ice Factory
                                                                                                                                     Adarsh Nagar, Jaipur - 302 004
Reference No. : AB/Bajaj/01/2020/11309
                                                                BILL

Bill No. :    2789
                                                                                      M/s. :  Bajaj Allianz General Insurance Co. Ltd.
Date    :     3-Jul-20                                                                  2nd & 3rd floor, 4 Hathroi Fort, Gopalbari, Ajmer Road,
                                                                                                 GST No- 08AABCB5730G1ZX
Claim No.        : OC-20-1401-1803-00001092

Policy No         :OG-20-1717-1803-00000759
Insured Property : NL-01-AC-0263
                                                                                             Date of Accident:                   29-12-2019
Insured Name :: : M/s Shree Shyam Road Carriers                  Date of Survey                      13-01-2020
                                                           PARTICULARS                                                                             AMOUNT

(a) Professional Fee                                                                                                                                    5,000.00

(b) Toll Tax                                                                                                                                                  285.00

 cConveyance (Local)
(c) Photo Charges - CD                                                                                                                                    50.00
 (d) Fare From Jaipur to Kotputli & Back                     (3-Visits)                                                                      5,610.00
     By my own Vehicle RJ-14-VC-0788
     Distance 660KM @8.5/-
                                                                                                                                                                 10,945.00
 GSTIN 08ABPPB2007A1ZE                                                        Add: CGST @ 9%                                     985.05
 PAN No.ABPPB2007 A                                                              Add. : SGST @ 9%                                     985.05
                                                                                                 Add.: IGST @ 18%
                                                                                                                     Total                                   12,915.00

 PUNJAB NATIONAL BANK
 247, MANISH MANSION, FRONTIER COLONY, ADARSH NAGAR, JAIPUR-302 004                  AN
 A/c Name Mr. Ashwani Beri A/c No.4079000100005077
                                                                                                                                                        O
 IFS Code PUNB0407900, MICR No. 302024025
                                                                                                                                        4


                                                                                                                                     ASHWANI BERI

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