Er. KANHAIYA CHAUHAN
Govt.Approved
SURVEYOR &LOSS ASSESSOR
INVESTIGATER,VALUER & CLAIM ADVISER
SPECIALIST IN MOTOR CLAIM`S
GST NO 09AENPC3685E1ZD
PAN NO.AENPC3685E
LICENCE NO.SLA-120150
BILL NO.MOTOR/FINAL/BAJAJ/554/20-21 DATE 28.03.2021
INSURERS BAJAJ ALLIANZ GENERAL INSURANCE CO. Ltd.
ADDRESS THE SILVER LINE,11/9,CIVIL LINES KANPUR
INSURED Mr Shyamu MODEL Bajaj Pulsar 125
POLICYICOVER NOTE : OG-21-4687-1802-00000488 VEHICLE NO. UP84 Y 7356
CLAIM NO. OC-21-1302-1802-00002579
DATE OF ACCIDENT : 22.03.2021 DATE OF SURVEY 25.03.2021
Amount (Rs.)Pa.
1. Survey Fee 500 00
covered 200 km From Panki to Ajay
2. Conveyance 1500
Motors Tirwa Kannauj & back @ 7.5/km 00
3. C D charges 00
4 Re-Inspection
5 S GST 9% on the Gross Fee Amount 180
6 C GST 9%on the Gross Fee Amount 180
7 Toll Tax
G Total[ 2360 00
Rupee Two Thausent Three Handred Sixty only.
Cheque No : Bank A/c No.20006890666
IFS code SBIN0000242
Date: Stae Bank of India
E.&O.E. Kanhaiya Chauhan SLA-120150
* SLA-120150
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