HEMANT R. PANCHAL
			   Surveyor & Loss Assesor
	A-203, 2nd floor, Rushi Complex, Beside Hari Om Petrol Pump, L.P. Savani Road,
		      Adajan, Surat - 394510. Mobile: 98244 -75769.
			  Lic. No. 58125 Valid upto 30/01/2026.
				    SURVEY BILL
To,
Bajaj Alianz Gen. Ins. Co. Ltd.
Gujarat
GST No. 24AABCB5730G1Z3
Bill / Ref. No. :	 1369 /23-24		Date:	   26-03-2024
Policy No     OG-24-9910-1825-00044063
Claim No      OC-24-2203-1825-00002371
Insured	  DIPAK AVCHITRAO PATIL
Vehicle no.	    GJ15CN4967
								      Amount
								      Rs. Rs.
01. Survey Fees							    2,500
02. Out Station Allowance
03. Travelling & Conveyance charges					   250
04. Photographs Charges							40
05. Other Exps.
									     2,790
Add: GST			 CGST		  09%		    251
GST No. 24AIWPP4714A1ZA	  SGST		  09%		    251
PAN no. AIWPP4714A	       IGST		  00%		     -
				  ADVANCE RECEIPT  Total Rs.	       3,292
							 &VAL
						 HEMANT R. PANCHAL

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