RAKESH KUMAR
                                                 SURVEYOR & LOSS ASSESSOR
 FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                          Mob.#9868110525/8836301125
                                          E-mail: majokarakesh61197@gmail.com
                                          License No. SLA-61197, Valid upto 07/10/2020
                                          Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
 Ref:- BAJAJ/FINAL/2020/21/0177                                                                 Dated: 10/09/2020
 HSN CODE:997162
 Bajaj Allianz General Insurance Company Limited.
Block No.4 7th Floor, DLF Tower-15, Shivaji Marg, 011-66278225, New Delhi-110001.
 GST Number:07AABCB5730GIZZ
 VEHICLE NO.               :       UP 13BD 0461
 INSURED NAME           :       MR. MOHMMAD ASIF
CLAIM NO.                   :       0C-21-1103-1802-00001155
PolICY No.                     :       OG-20-4328-1802-00001127
ASSESSED LOSS             :       Rs. 19400/-


 Professional
Professional Fee                                                                                                                          500.00
Visit to workshop                                                                                                                         150.00
RE-Inspection Charges                                                                                                                 150.00
Under repair                                                                                                                                  0.00
Spot Inspection fess                                                                                                                         0.00
TOTAL                                                                                                                                     800.00
CGST@9%:                                                                                                                                     72.00
SGST@9%                                                                                                                                          72
GROUND TOTAL                                                                                                                    944.00


Thanks & Regards
Rakesh Kumar
Suryeyors & Loss Assessors.

 Aonorized Sign atory)
             WE
Puhjab Natiober Bank,Shivaji Marg,Kirti Nagar,New Delhi.A/c.:-0148000100975603

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