mobile+919998100555
Parikh Associates                                                                          phone+912652481991
                                                                                                                       parikh.associates@yahoo.com
chartered engineer,
                                                                                                                       2i.Padmavatinagar,VI.P.Road
surveyor,
loss assessor,                                                                                                    Karelibaug.Vadodara-390018.
valuer,
risk management
                                                                       INVOICE                                License no.SLA/72618,valid upto Nov.2021

   INVOICENO. :                    211296                                                            Date:    14.08.2020
   REPORT NO.:                  BAG/2021/1273
   To,
   BAJAJ ALLIANZ GENERAL INSURANCE CO LTD
   4TH FLOOR ATLANTIS HIGHTS
   NR SARABHAI CIRCLE
   VADODARA
   RECIPIENT ID                   24AABCB5730G1Z3                                STATE CODE:-24

   INSURED:                       KANUBHAI MOHANBLAL PATEL                                 INTEREST GJ06YY7149
                                                                                                                                 TATA ACE
   POLICY NO:                  OG-20-2228-1803-00000220

   CLAIM NO :                    OC-21-2201-1803-00000083

  INSURER :                        BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.

   APPOINTED BY :              BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.
  SR. NO.      DESCRIPTION                                             HSN/SAC         RATE[Qty.      AMOUNT
                                                                                     Code
                     PROFESSIONAL SURVEY CHARGES
                     FINAL                                                                           500.00            1              500.00
                     RE-INSPECTION                                                                                   1
         2        CONVEYANCE CHARGES                                                                    o
                    1 VISITS AT DABHOI 52*2=104KMS                                       7.50        104              780.00
         3        PHOTOGRAPHS                                                                                  o
                     DIGITAL CD                                                                    40.00            1                40.00

          4        OUT OF POCKET EXPENSES                                                                   1
                    TOLL-TAX /PHOTOCOPIES
                    HALTING                                                                                            o
                                                                    SUB TOTAL                                                         1,320.00
                                                                           CGST                     9.00%                            118.80
                                                                            SGST                      9.00%                            118.80
                    ROUNDING OFF
                                                               GRAND TOTAL                                                              1,558
  RUPEES       ONE THOUSAND FIVE HUNDRED AND FIFTY EIGHT ONLY.

  Our Bank Detail:
                                                                                                                          RIKH
  Bank         ICICI Bank Lta.
  Bank Br.     Karelibaug
  C.A/c no.  24805001738                                                                                       PoiP      H
  IFSC Code:ICIC0000248
  PAN NO.:    AFTPP 4625 C                                                                                         PRAKASH PARIKH

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