YASH JAIN					 H.No.-19/190,Krishna Puri Mathiya,
Engineer						    Bhaiyaji Wali Gali,
Govt. approved Loss Assessor				     ALIGARH-202001
Surveyor. Lic No. 120431				yashjainsurveyor@gmail.com
IIISLA L/N/09452					    M.No. +91-8445355091
GSTIN-09BHJPJ5501J1Z9
					   Survey Fee Bill
To,
   Bajaj Allianz General Insurance Co. Ltd.	   Bill No. : B-03-24-03682
   Branch Office						  Date 21/03/2024
   15/54, 2nd floor, Virendra Smrati Complex, Civil Lines, Kanpur 208001 Code :yashjain.exe@surveyor.com
   GSTIN: 09AABCB5730G1ZV State Code: Uttar Pradesh (09)
	  Report Ref No YJ/BAGI/1DK1034/03-24/F/03729
	  Vehicle No.	 : UP81DK1034
	  Insured Name	: MR. JITENDRA KUMAR
	  Date Of Accident : 20-Feb-24			Assessed : 	      4,864.00
	  Policy/cover note no : OG-24-1305-1826-00043135     Estimate :		4,964.00
	  Claim No	    : OC-24-1302-1826-00013070	   IDV     :2	 81,557.00
  S No		Particulars			    HSN/SAC		   Amount 
   1 Final						    997162		     1,850.00
	   Professional Fee : Assessed Amount  4,864.00		     850.00
	   Photos/CD Expenses :						0.00
	   0 Photographs , Charged for 0 @ Rs. 0.00
	   Conveyance Expenses : Visited total 100 Kms. No of visits 1 charged @210.00/ Km 1,000.00
									  Sub Total:     1,850.00
									C GST @ 9.00 %     166.50
									S GST @ 9.00 %     166.50
	ADVANCE RECEIPT					    Grand Total:	  2,183.00
									  Round off :    2,183.00
			      In words : Rs. Two Thousand One Hundred Eighty Three Only
 GSTIN: 09BHJPJ5501J1Z9 State : (09)
 PAN.BHJPJ5501J
 Bank Name :PUNJAB NATIONAL BANK LTD					   YASH JAIN
 A/c No. 2961000100261910
									     Surveyor & Loss Assessor
 MICR No   202024005
 IFS Code :PUNB0296100

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