RAJEEV BATRA
                                                                      (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                     Ph.(M)9810143600
IISLA MEMBERSHIPNO.-A/N/05042                                                                                          (0) 8800174968
B-30,3rd FLOOR (BACK SIDE)                                                                                                      (R) 011-27672404
MAHATMA GANDHI ROAD                                                                                                   Email: r.batra@yahoo.co.in
ADARSH NAGAR,DELHI-110033
                                                                              Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                         Bill.No:B-11/20/06440
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date   16/11/2020
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                   Code  Nil
       GSTIN:07AABCB5730G1ZZ              State Code : Delhi (07)
                  Report Ref No                     RB/BAJ/20-21/07099
                  Vehicle No.                         HR 10AC2585
                  Insured Name                    MR. SATISH SHYAM LAL
                  Date Of Accident           :    20/10/2020
                  Policy/cover note no     :    OG-21-1901-1802-00029743
                  Claim No                       :    OC-21-1103-1802-00002058

    S No                                        Particulars                                                HSN/SAC                               Amount
      1    Final                                                                                                997162                                     1,332.00
                     Professional Fee:       Assessed Amount 5,624.00                                           500.00
                     Photos/CD Expenses:                                                                                           0.00
                      0 Photographs, Charged for 0@ Rs.0.00
                     Conveyance Expenses:                                                                                     832.00

                                                                                                                                     SubTotal            1,332.00
                                                                                                                                 C GST @9.00 %                119.88
                                                                                                                                 S GST @9.00 %                119.88
               ADVANCE RECEIPT                                                                                   Grand Total:             1,571.76
                                                                                                                                     Roundoff:             1,572.00
                                               In words : Rs. One Thousand Five Hundred Seventy Two Only
   GSTIN:07AIGPB7033E1ZQ State:(07)                                         RAJEEVBATRA
   PAN.AIGPB7033E
   Bank Name:PUNJAB NATIONAL BANK
                                                                                                                             309
   A/c No.            0618000100079039                                                        RLAY
   MICR No          110024109                                                       SURVEYOR&LOSSASSESSOR.

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