SAURABH JUNEJA
                                                     SURVEYOR & LOSS ASSESSOR
                                    H.No. 107, Hargobind Enclave, 1st Floor, Vikas Marg Extn. Delhi-110092
License No. : SLA 73349                                                               Mobile No.: 9899 474 475
Valid Up to: 08-04-2023                                                               E-Mail         : srbh.juneja@gmail.com
IIISLA No. : A/N/5997                                                                  Phone(s)        011 - 42058194

                                                                           Survey Fee Bill
To,
      Bajaj Allianz General Insurance Co. Ltd.                                                      Bill. No : B-03/21/05223
      Block No-4, 7 Th Floor DLF Tower Shivaji Marg New Delhi-110015                Date : 30/03/2021
      New Delhi-110015                                                                                    Code:
      GSTIN:07AABCB5730G1ZZ              State Code : Delhi (07)
                 Report Ref No                    SJ/BAGI/CBQ2156/03-21/F/13747
                 Vehicle No.                   :   DL3CBQ2156
                 Insured Name              :   MR RAJKUMAR
                 Date Of Accident          :    26/03/2021
                 Policy/cover note no           OG-21-1103-1801-00004177
                Claim No                      :   OC-21-1101-1801-00011394
  S No                                       Particulars                                              HSN/SAC                              Amount 
    1    Final                                                                                             997162                                    1,150.00
                   Professional Fee :       Assessed Amount  20,138.00                                    1,000.00
                   Photos/CD Expenses :                                                                                        0.00
                   0 Photographs , Charged for 0 @ Rs. 0.00
                  Conveyance Expenses :                                                                                  150.00

                                                                                                                                Sub Total : %            1,150.00
                                                                                                                            C GST @ 9.00 %               103.50
                                                                                                                            S GST @ 9.00 %               103.50
            ADVANCE RECEIPT                                                                                Grand Total :            1,357.00
                                                                                                                               Round off :             1,357.00
                                            In words : Rs. One Thousand Three Hundred Fifty Seven Only
GSTIN: 07AHGPJ3702K1ZG State : (07)
PAN.: AHGPJ3702K                                                                              SWA
Bank Name : AXIS BANK                                                                           TeFg
A/c No.            913020019916326
                                                                                               SAURABHJUNEJA
MICR No          110211039

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