SURVEY FEE BILL


SHYAM & CO.                                                                                                                 Address-:
SURVEYOR & LOSS ASSESSOR - LICENSE NO -27416, VALID TILL -24-03-2023                            MMIG-14,SEC-A, Sitapur Road Scheme, Aliganj , Lucknow
GSTIN NO-09AEZPP7123A1Z7                                                                                             09919280888, 09829833399
PAN NO -AEZPP7123A                                                                                                  radheyrspandey9@rediffmail.com

Billing Address
Bajaj Allianz General Insurance Co. Ltd.
GSTIN NO 09AABCB5730G1ZV
15/54-B,2nd Floor,Virendra Smrati Complex, Civil Lines, Kanpur-208001, (U.P.)

Place of Supply                   Lucknow
INVOICE NO         SC-21-01-374                                                                            INVOICE DATE                                 15-03-21

                                                                               HSN                    CONV.    TAXABLE
SNO      ITEM DESCRIPTION                                       CODE     FEE      CHARGE VALUE             CGST                  SGST                  IGST
             INSURANCE CLAIMS ADJUSTMENT
             SERVICES                                                                                                        RATE %    AMT    RATE %    AMT    RATE %    AMT
                                  DETAIL OF CLAIM
             CLAIM NO        -OC-21-1302-1843-00000417
             INSURED-        -Mohd Irfan
             VEHICLE NO    - UP-73-W-7778
             ESTIMATE       - 36711.00
             ASESSED       - 15593.00
             REMARK- PRAYAGRAJ TO KAUSHAMBI 72X2X11.50= 1656.00
             PROFESSIONAL FEE                                         9971]       750[      1656|      2406|        9%|   216.54        9%|   216.54          0          1
             REINSPECTION FEE                                          9971       350|       250       600|        9%|         54        9%|         54          0          0
             PROFESSIONAL FEE FOR SPOT                        9971          0          0          0        9%          0        9%           0          0
             TOTAL                                                                          1100|     1906     3006|               270.54|                270.54                       0

             TOTAL INVOICE VALUE IN FIGURES                                                     3547.08
             TOTAL INVOICE VALUE IN WORDS


                                                                                                                                                                              Shy
                                                                                                                                                                                  EKNQW-21

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