Rajesh S. Thakker
                                                                                                             C.A.E., D.A.E., A.I.S.A.
                                                                      SURVEYOR, LOSS ASSESSOR & VALUER
                                                                            Licence No. SLA 20725 Exp. Dt. 17-08-2021
                                          5, PATEL COLONY, ROAD NO. 1, OPP. DARSHAN APARTMENT, JAMNAGAR - 361 008, (GUJARAT)
                                                          MO. 98242 11549, 94274 45301 E-mail : rajesh_thakker@rediffmail.com
                                                                                        Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                                           Bill. No : RST/203148
       Rajkot                                                                                                                         Date     : 14/12/2020
       1st Floor, Hotel K Rose Building, In Front Of Shastri Medan, Limda Chowk,                           Code     :
       Rajkkot
       GSTIN: 24AABCB5730G1Z3                      State Code: Gujarat (24)
                    Report Ref No                     :     RST/203148
                   Vehicle No.                         :     MH48AG2831
                    Insured Name                     :     Jay Virchand Soni
                    Date of accident                  :     14-11-2020
                    Policy/cover note no           :     OC-21-1934-1803-00000292
                    Claim No                           :     OC-21-2204-1803-00000291

    S No                                              Particulars                                                         HSN/SAC                                      Amount /
      1     Final                                                                                                              997162                                              1650.00
                      Professional Fee :             Assessed Amount  45475.00                                                       1250.00
                      Photos/CD Expenses :                                                                                                           50.00
                       0 Photographs , Charged for 0 @ Rs. 50.00
                       Conveyance Expenses :                                                                                                        350.00

                                                                                                                                                       Sub Total : 2                  1650.00
                                                                                                                                                    C GST @ 9.00 %                    148.50
                                                                                                                                                   S GST @ 9.00 %                     148.50
                ADVANCE RECEIPT                                                                                                      Grand Total : %                  1947.00
                                                                                                                                                       Round off : %                 1,947.00
                                                             In words : Rs. One Thousand Nine Hundred Forty Seven Only
  GSTIN: 24AAUPT4514C1ZN State : (24)
   PAN. : AAUPT4514C
  Bank Name : HDFC Bank Ltd.,
                                                                                                                                                                    RAjesh s.ThAKker
  A/c No.                : 01771500003760                                                                                                                   C.A.e.DAe.ALI.S.A.
                                                                                                                                                                    SURVEYCR &LCES ASSESSOR
   MICR No              : 361240001

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