PARESH KOTHARI
                                         Approved Consulting Automobile and Engineering Surveyor, Loss AssessorValuer
S.L. NO. SLA -66761                                                                                                                2C SONAL APRTMENT,
Dt. Exp. : 29-11-2021                                                                                                              2 MARUTINAGAR,
Mobile 9825072771                                                                                                             NEAR AIRPORT,RAJKOT -360001
pareshkothari1@gmail.com
                                                                           Survey Fee Bill
To,
      Bajaj Allianz General Insurance Co. Ltd.                                                       Bill. No : B-06-20-03621
      VADODARA                                                                                                Date  02/06/2020
      401,ATLANTIS HERITAGE,OPP.SWAGAT PETROL PUMP,SARABHAI MAIN    Code:
       ROAD,NEAR GENDA CIRCLE
       GSTIN: 24AABCB5730G1Z3              State Code : Gujarat (24)
                 Report Ref No                    VKP/BAGI/T-5892-/05-20/F/03697
                 Vehicle No.                        GJ 13 AT 5892
                 Insured Name                    Mr. Ashvinbhai V Tamaliya
                  Date Of Accident          :    08-May-20
                 Policy/cover note no     :    OG-20-2236-1803-00000417
                 Claim No                     :   OC-21-2204-1803-00000014

   S No                                      Particulars                                               HSN/SAC                              Amount 
      1    Final                                                                                             997162                                    2,800.00
                    Professional Fee :       Assessed Amount & 122,940.00                                   2,500.00
                    Photos/CD Expenses :                                                                                     50.00
                     1 Photographs , Charged for 1 @ Rs. 50.00
                    Conveyance Expenses :                                                                                  250.00

                                                                                                                                 Sub Total:            2,800.00
                                                                                                                            C GST @ 9.00 %               252.00
                                                                                                                            S GST @ 9.00 %               252.00
              ADVANCE RECEIPT                                                                               Grand Total:            3,304.00
                                                                                                                                Round off :            3,304.00
                                                In words : Rs. Three Thousand Three Hundred Four Only
  GSTIN: 24ADNPK4533G1ZM State : (24)
                                                                                                                                         v
  PAN. : ADNPK4533G
                                                                                                       PARESH KOTHARI      Paresh Koty
  Bank Name : Bank of Baroda
  A/c No.            7460100005184                                                                                                  Meri
  MICR No          360012006

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