RAJEEV BATRA
                                                                       (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                      Ph.(M)9810143600
IISLA MEMBERSHIPNO.-A/N/05042                                                                                            (0) 8800174968
B-30,3rd FLOOR(BACK SIDE)                                                                                                        (R) 011-27672404
MAHATMA GANDHI ROAD                                                                                                     Email: r.batra@yahoo.co.in
ADARSH NAGAR,DELHI-110033
                                                                                Survey Fee Bill
To,
       Bajai Allianz General Insurance Co.Ltd.                                                          Bill.NoB-06/20/05885
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date30/06/2020
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    CodeNiI
       GSTIN:07AABCB5730G1ZZ               State Code : Delhi (07)
                   Report Ref No                     RB/BAJ/20-21/06441
                   Vehicle No.                    :    UP-14-DF-0178
                   Insured Name               :    MR DALVIR SINGH
                   Date Of Accident           :    23/06/2020
                   Policy/cover note no i        OG-20-1101-1801-00004659
                   Claim No                       :    OC-21-1103-1801-00001692

    S No                                        Particulars                                                 HSN/SAC                                Amount
       1    Final                                                                                                  997162                                         650.00
                     Professional Fee:       Assessed Amount 9,627.00                                            500.00
                     Photos/CD Expenses                                                                                             0.00
                      0.Photographs,Charged for 0@ Rs.0.00
                     Conveyance Expenses                                                                                       150.00

                                                                                                                                        Sub Total                650.00
                                                                                                                                   C GST @9.00 %                  58.50
                                                                                                                                   SGST @9.00 %                  58.50
               ADVANCE RECEIPT                                                                                    Grand Total:                767.00
                                                                                                                                       Roundoff:                767.00
                                                           In words : Rs. Seven Hundred Sixty Seven Only
   GSTIN:07AIGPB7033E1ZQ State :(07)                                          RAJEEVBATRA
   PAN.AIGPB7033E
   Bank Name:PUNJAB NATIONAL BANK
   A/c.No.             0618000100079039
   MICR NO           110024109                                                        SURVEYOR&LOSS ASSESSOR.

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