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/01-2021/837                                                Date: 27-01-2020
  Insurer                                    Bajaj Allianz General Insurance Company Limited
                                                23r Floor,4Hathroi Fort,Gopal bari Ajmer road, Jaipur
                                                GSTIN-08AABCB5730G1ZX
  Claim Number                         OC-21-1401-1843-00000123
  Insured                                   Mrs.Chetana Verma
  Policy Number                         OG-21-3322-1843-00000005
  Report number                         DR/Motor/01-2021/837
  Place of inspection                    Shekawati Honda-Balotra
  Vehicle Regd. Number              RJ-37-SW-3966
 Professional Fees                                                                             500.00/-
  Conveyance-For Final                                                                       1800.00/-
  Distance between Jodhpur & Balotra is 120.00 km.
  Total distance covered=120.00'x 2=240.00 km
  Conveyance @07.50/-=240.00x 07.50/-=1800.00/-
  Photographs charges-CD                                                                     30.00/-
 DA                                                                                                175.00/-
  Regd Letters                                                                                       0.00/-
  TOTAL                                                                                        2505.00/-
  CGST @09.00%=225.45/-& SGST @ 09.00%=225.45/-                              450.90/-
  TOTAL Rs/-                                                                                 2956.00/-
(Rs/- Two Thousand Nine Hundred Fifty Six Only)
      For NEFT Fund Transfer:-
      Bank Name:Union Bank of India
      IFSC:UBIN 0550388
      A/C Number:503802010011146                                            SLH
      MICR Code:342026003
      GSTIN-08ACUPR3734N1ZO                              DEEPAKRATHI



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

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