SAURABH JUNEJA
                                                      SURVEYOR & LOSS ASSESSOR
License No. : SLA 73349
                                                                                                          Mobile No.: 9899 474 475
Valid Up to : 08-04-2023
                                                                                                           E-Mail         : srbh.juneja@gmail.com
IIISLA No.: A/N/5997
                                                                                                           Phone(s)       011 -42058194

                                                                           Survey Fee Bill
 To,
       Bajaj Allianz General Insurance Co. Ltd.                                                     Bill. No : B-02/21/04875
       Block No-4, 7 Th Floor DLF Tower Shivaji Marg New Delhi-110015                Date12/02/2021
       New Delhi-110015                                                                                   Code
       GSTIN:07AABCB5730G1ZZ              State Code : Delhi (07)
                  Report Ref No                    SJ/BAGI/6TR0783/02-21/F/13214
                  Vehicle No.                        UP16TR0783
                  Insured Name                    SURENDER NAGAR
                                                      :
                  Date Of Accident          :    22/01/2021
                  Policy/cover note no     :    OG-21-9910-1825-00089507
                  Claim No                      :    OC-21-1103-1825-00005472

    S No                                      Particulars                                              HSN/SAC                              Amount 
      1    Final                                                                                            997162                                       900.00
                    Professional Fee :       Assessed Amount 18,223.00                                       750.00
                    Photos/CD Expenses :                                                                                       0.00
                     0 Photographs , Charged for 0 @ Rs. 0.00
                    Conveyance Expenses:                                                                                  150.00

     2                Re-Inspection                                                                       997162                                        150.00
                                                                                                                                 Sub Total:            1,050.00
                                                                                                                             C GST @ 9.00 %                 94.50
                                                                                                                             S GST @ 9.00 %                 94.50
             ADVANCE RECEIPT                                                                                 Grand Total:            1,239.00
                                                                                                                                 Round off:            1,239.00
                                              In words : Rs. One Thousand Two Hundred Thirty Nine Only
GSTIN: 07AHGPJ3702K1ZG State : (07)
PAN.AHGPJ3702K                                                                                     S
Bank Name:AXIS BANK
A/c No.             913020019916326
                        110211039                                                     SAURABHJUNEJA
MICR No
                        UTIB0000372                                                  Surveyor and Loss Assessor

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