VIKRANT GUPTA
                                        B.E.(Mech.)                                                                                                         Mobile No.:09811085077
                                                                                                                                                            Office cum Resi.:
                                                                                                                                                            273,Tagore Park,Behind Canara
                                                                                                                                                            Bank,Near Model Town-I,Delhi-9
                                                                       Insurance Surveyor & Loss assessor
                    SLA NO.                66550                                                                                                                         PAN NO.:AENPG3555M
                    Expiry On.:10/11/2021
                                                                                             SURVEY FEE &EXPENSES BILL
                            Ref.No.:VG/BAJAJ/245/2021                                                                                                                                   Date : 29.07.2021
                        1 INSURER                                                       : M/S Bajaj Allianz General Insurance Co. Ltd.,
                                                                                            DELHI
                       2'INSURED                                                        :POOJA MITTAL
                       3 Vehicle No.                                                    :DL6SBF4561
                      4 CLAIM No.                                                       OC-22-1101-1826-00000222
                 Professional Fee                                                                                                                                                       450.00
                 Conveyance Charges for Final Survey                                                                                                                                     150.00
                Conveyance RE-VISIT                                                                                                                                                            0.00
                Conveyance Charges for Re-inspection                                                                                                                                           0.00
               TOTAL                                                                                                                                                                     600.00
              Please issue cheque for the above said amount in the favour of Mr.VIKRANT
              GUPTA to be drawn on CANARA BANK,A/C No.2592101002205,Model Town
              Branch,IFSC CodeCNRB0002592.
              VIKRANTGUPTA
              Surveyor&Loss Assessor
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