RAJEEV BATRA
                                                                     (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                     Ph.(M9810143600
IISLA MEMBERSHIP NO.-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-01/21/06806
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date    16/01/2021
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Code   Nil
       GSTIN:07AABCB5730G1ZZ               State Code : Delhi 07
                  Report Ref No                     RB/BAJ/20-21/07481
                  Vehicle No.                         HR 60G 1322
                  Insured Name                    MR.VINOD KUMAR
                  Date Of Accident          :    08/01/2021
                  Policy/cover note no     :    OG-21-1901-1802-00043234
                  Claim No                            OC-21-1103-1802-00002970

    SNo                                       Particulars                                                HSN/SAC                               Amount
      1    Final                                                                                                997162                                        650.00
                     Professional Fee:       Assessed Amount 3,812.00                                           500.00
                     Photos/CD Expenses :                                                                                           0.00
                     0 Photographs,Charged for 0@ Rs.0.00
                     Conveyance Expenses:                                                                                     150.00

                                                                                                                                     Sub Total:                650.00
                                                                                                                                C GST @9.00 %                  58.50
                                                                                                                                 S GST @9.00%                  58.50
               ADVANCE RECEIPT                                                                                  Grand Total                767.00
                                                                                                                                    Round off               767.00
                                                         In words : Rs. Seven Hundred Sixty Seven Only
                                                                                                                  RATEEV
   GSTIN:07AIGPB7033E1ZQ State :(07)                                         RAJEEV BATRA
   PAN.AIGPB7033E
                                                                                                                 81
   Bank Name:PUNJAB NATIONAL BANK
   A/c No.             0618000100079039
   MICR No          110024109                                                       SURVEYOR&LOSSASSESSOR.

---PAGE END---