PARESH KOTHARI
                                           Approved Consulting Automobile and Engineering Surveyor, Loss Assessor  Valuer
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-07-20-03725
       VADODARA                                                                                                      Date    09/07/2020
       4O1,ATLANTIS HERITAGE,OPP.SWAGAT PETROL PUMP,SARABHAI MAIN     Code   :
       ROAD, NEAR GENDA CIRCLE
       GSTIN:24AABCB5730G1Z3               State Code : Gujarat (24)
                   Report Ref No                     VKP/BAGI/V-2255-/06-20/F/03767
                  Vehicle No.                          GJ 3 BV 2255
                  Insured Name                     Mr. Debasis Gupta
                  Date Of Accident           :    04-Jun-20
                   Policy/cover note no     :    OG-20-2204-1803-00003644
                  Claim No                       :    OC-21-2204-1803-00000069

   SNo                                        Particulars                                                 HSN/SAC                                Amount
      1    Final                                                                                                   997162                                          800.00
                     Professional Fee :       Assessed Amount & 7,495.00                                            500.00
                     Photos/CD Expenses :                                                                                           50.00
                      1 Photographs , Charged for 1 @ Rs. 50.00
                     Conveyance Expenses :                                                                                       250.00

                                                                                                                                        Sub Total:                800:00
                                                                                                                                    C GST @ 9.00 %                  72.00
                                                                                                                                    S GST @ 9.00 %                  72.00
               ADVANCE RECEIPT                                                                                    Grand Total :                944.00
                                                                                                                                       Round off:                944.00
                                                             In words : Rs. Nine Hundred Forty Four Only
                                                                                                                                                R
   GSTIN:24ADNPK4533G1ZM State : (24)
                                                                                                                                               Paresh Kothari
  PAN. : ADNPK4533G
                                                                                                             PARESH KOTHARI
   Bank Name : Bank of Baroda
   A/c No.             7460100005184
  MICR No          360012006                                                                                                arvevornd Aseosa

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