Shubhrajit Paul
                 Surveyor & Loss Assessor                                                                                                                       Shankarpur, Burdwan
                 IRDA/IND/SLA-73951 [Validity upto 23r March 2022]                                                                                              MQbile No.(0)9734296806
                 PermanantA/c No.:BBNPP7824G
                                                                                                                                                                E-shubhrajitpaul19@gmail.com
                 S.B.I.A/c. No.20017313041
                 Ref.No.SP-BajajF)21-22-110                                                                                                                                                   Date: 28/09/2021
                                                                                                             BILL
                 To: The Claims Department,
                           Bajaj AllianzGICLtd.,
                          Kolkata.
                  Insured                                      :Mr.Tarik Anwar.
                  Polici No.                                   : OG-22-9910-1870-00059408.
                  Claim No.                                    : OC-22-2401-1870-00001799.
                  Vehicle No.                                  :WB-54-X-7558.
                   SL. No.                                                              Partic                                           rs                                                               Amount in Rs.
                                                                                                                                    a
                                                                                  a) Spot                                                                                                                                 0.00
                       01.        Survey / Professional Fees:                     b) Fiml                                                                                                                           1250.00
                                                                                   (c) Re-inspection                                                                                                                      0.00
                                  Travelling :                                                                                                                                                                            0.00
                                 a) Spot
                                  Travelling :                    Visit to the survey spot at the repairer workshop 'Panchanath Automobiles',
                       02.                                        Suri, Birbhum and back                                                                                                                            3200.00
                                  b Finl                          200 kms.x 2 times =400 kms.@Rs.8.00 per km
                                  Travelling :                                                                                                                                                                             0.00
                                  (c) Re-inspection
                       05.        Postage/Others :                                                                                                                                                                         0.00
                                                                                                                                                                                             Total                     4450.00
                                                                                                                                                                                Shubhrajit Paul
                                                                                                                                                                                              SLA-73951
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