Rajesh S. Thakker
                                                                                                             C.A.E., D.A.E., A.I.S.A.
                                                                     SURVEYOR, LOSS ASSESSOR & VALUER
                                                                           Licence No. SLA 20725 Exp. Dt. 17-08-2021
                                          5, PATEL COLONY, ROAD NO. 1, OPP. DARSHAN APARTMENT, JAMNAGAR - 361 008, (GUJARAT)
                                                          MO. 98242 11549, 94274 45301 E-mail : rajesh_thakker@rediffmail.com
                                                                                        Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                                           Bill. No : RST/203018
      Rajkot                                                                                                                        Date     : 27/10/2020
       1st Floor, Hotel K Rose Building, In Front Of Shastri Medan, Limda Chowk,                           Code     :
       Rajkkot
       GSTIN: 24AABCB5730G1Z3                      State Code: Gujarat (24)
                   Report Ref No                     :     RST/203018
                   Vehicle No.                         :     GJ10CN5776
                   Insured Name                    :     Gagubhai Samatbhai Asani
                    Date of accident                 :     04-10-2020
                   Policy/cover note no           :     OC-21-4377-1801-00000002
                   Claim No                           :     OC-21-2204-1801-00002079

    S No                                              Particulars                                                         HSN/SAC                                      Amount /
      1     Final                                                                                                             997162                                              1800.00
                      Professional Fee :             Assessed Amount  81525.00                                                       1500.00
                      Photos/CD Expenses :                                                                                                           50.00
                       CD with digital photographs
                      Conveyance Expenses :                                                                                                        250.00

                                                                                                                                                       Sub Total : 2                  1800.00
                                                                                                                                                   C GST @ 9.00 %                    162.00
                                                                                                                                                   S GST @ 9.00 %                     162.00
                ADVANCE RECEIPT                                                                                                      Grand Total : %                  2124.00
                                                                                                                                                       Round off : %                 2,124.00
                                                            In words : Rs. Two Thousand One Hundred Twenty Four Only
  GSTIN: 24AAUPT4514C1ZN State : (24)
   PAN. : AAUPT4514C
  Bank Name : HDFC Bank Ltd.,
                                                                                                                                                                RAjesh s.ThAkker
  A/c No.                : 01771500003760                                                                                                               C.A...D.Ae.A.II.S.A.
                             : 361240001                                                                                                                  SuRVeYCR &LCES ASSeSSOR
   MICR No

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