SOUMEN KUMAR MAITY                                             GSTIN No. :    19AGRPM4779K2ZB
Surveyor  Loss Assessor                                                            Bill No.:          39             2020
SLA-54973, Exp. 23-04-2022                                                        Date                24.06.2020
Mobile No. - 9434007542                                                        Report No. :        BAJAJ-39-2020
                                                                      INVOICE
To
BAJAJ ALLIANZ GENERAL INSURANCE CO.LTD.
KOLKATA.R.O,KOLKATA
GSTIN NO:-19AABCB5730G1ZU
Nature of Claim:                   MOTOR                      Claim No. :           OC-21-2401-1828-00000075
Insured                                                                    Policy No. :          OG-20-3042-1828-00001199
                                  SK.ANISUR RAHAMAN MONDAL
                                                                                                                                  Amount
SI. No.                                            Description
                                                                                                                                  (in Rupees)
            Survey Fees (As per schedule) Professional fees for final survey of
             WB30AF 3153(Assessment Amount Rs.-7,450.00)                                                             500.00



    2     Travelling : From Kharagpur to Khadinan More Garage and back by
                            own car X 1 by WB36B 9598 (76km.X 2 X 7.5)                                              1.140.00






                                                                                    Total Taxable Value                       1,640.00
                                                                                            Add : CGST @ 9%                          147.60
                                                                                            Add : SGST @ 9%                          147.60
                                                                                                  Total Value                       1,935.20
       Amount in words :       Rupees One Thousand Nine HundredThirty Five Only.
BANK DETAILS
Bank Name             AXIS BANK LTD.
Branch Name :       KHARAGPUR
A/C Number :       190010100108430                                                                    4973
                                                                                                                      SLt0a    .
IFS Code                UTIB0000190
                      :

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