DEEPAK RATHIBE
                                                                       Surveyor and Loss Assessor & Valuer
   IIISLA Member Ship No.-Associate -A/W/04882                             Fire,Motor Engineering
   GSTIN :08ACUPR3734N1ZO                                                                       SLA-73076
  PAN:ACUPR3734N                                                    Mobile 94149-14640,99822-14640

                                                 PRE RECEIPT
  Bill Number: DR/10-2020/492                                                 Date: 24-10-2020
  Insurer                                     Bajaj Allianz General Insurance Company Limited
                                                 23r Floor, 4,Hathroi Fort,Gopal bari Ajmer road,Jaipur
                                                 GSTIN-08AABCB5730G1ZX
  Claim Number                          OC-21-1401-1826-00000172
  Insured                                    Mr.Dungar Singh
  Policy Number                          OG-21-3023-1826-00000032
  Report number                          DR/Motor/10-2020/492
 Place of inspection                     Kirti Motors-Barmer
  Vehicle Regd.Number               RJ-04-SR-2613
  Professional Fees                                                                                500.00/-
  Conveyance-For Final                                                                        3300.00/-
  Distance between Jodhpur & Barmer is 220.00 km.
  Total distance covered=220.00x2=440.00 km
  Conveyance @07.50/-=440.00 x 07.50/-=3300.00/-
  Photographs charges-CD                                                                       30.00/-
 DA                                                                                                   175.00/-
  Regd Letters                                                                                         0.00/-
  TOTAL                                                                                          4005.00/-
  CGST @09.00% =360.45/- SGST @09.00%=360.45/-                                720.90/-
  TOTAL Rs/-                                                                                  4726.00/-
(Rs/- Four Thousand Seven Hundred Twnety Six Only)
      For NEFT Fund Transfer:-
      Bank Name:Union Bank of India
      IFSC:UBIN 0550388
      A/C Number:503802010011146
      MICR Code:342026003                                                           SLN
      GSTIN-08ACUPR3734N1ZO                              DEEPAKRATHI



            C/o. Annkoot Agro Food, T-2, Mandore Mandi, Jodhpur-342 006 (Raj.)

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