Rajesh S. Thakker
                                                                                                             C.A.E., D.A.E., A.I.S.A.
                                                                      SURVEYOR, LOSS ASSESSOR & VALUER
                                                                            Licence No. SLA 20725 Exp. Dt. 17-08-2021
                                          5, PATEL COLONY, ROAD NO. 1, OPP. DARSHAN APARTMENT, JAMNAGAR - 361 008, (GUJARAT)
                                                          MO. 98242 11549, 94274 45301 E-mail : rajesh_thakker@rediffmail.com
                                                                                        Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                                           Bill. No : RST/203191
      Rajkot                                                                                                                         Date     : 25/12/2020
       1st Floor, Hotel K Rose Building, In Front Of Shastri Medan, Limda Chowk,                           Code     :
       Rajkkot
       GSTIN: 24AABCB5730G1Z3                      State Code: Gujarat (24)
                   Report Ref No                     :     RST/203191
                   Vehicle No.                         :     GJ10TT8022
                   Insured Name                     :     Jay Murlidhar Transport
                    Date of accident                  :     22-12-2020
                   Policy/cover note no           :     OG-20-4379-1803-00000107
                   Claim No                           :    OC-21-2204-1803-00000351

    S No                                              Particulars                                                         HSN/SAC                                      Amount /
      1     Spot                                                                                                              997162                                              2420.00
                      Professional Fee :                                                                                                               850.00
                      Photos/CD Expenses :                                                                                                           50.00
                       0 Photographs , Charged for 0 @ Rs. 50.00
                       Conveyance Expenses :      Visited total 190 Kms. No of visits 1 charged @28.00/ Km                              1520.00

                                                                                                                                                       Sub Total : 2                  2420.00
                                                                                                                                                   C GST @ 9.00 %                    217.80
                                                                                                                                                   S GST @ 9.00 %                    217.80
                ADVANCE RECEIPT                                                                                                      Grand Total : %                  2855.60
                                                                                                                                                       Round off : %                 2,856.00
                                                               In words : Rs. Two Thousand Eight Hundred Fifty Six Only
  GSTIN: 24AAUPT4514C1ZN State : (24)
   PAN. : AAUPT4514C
  Bank Name : HDFC Bank Ltd.,
                                                                                                                                                                       RAjesh s Thakker
  A/c No.                : 01771500003760                                                                                                                       C.A.e..D.Ae.A..I.S.A.
                                                                                                                                                                       SURVEYCR & LCES ASSESSOR
   MICR No              : 361240001

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