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/2020/21/0187                                                                  Dated: 18/09/2020
                                                  HSN/SAC 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.                :       DL 5SCC 5021
INSURED NAME           :       MR. ANISH KHAN
CLAIM NO.                    :       0C-21-1101-1871-00000155
PoliCY No.                              0G-20-1101-1871-00000526
ASSESSED LOSS             :       Rs. 7800/-


Professional
Professional Fee                                                                                                                             400.00
Visit to workshop                                                                                                                           150.00
RE-Inspection Charges                                         :                                                                        150.00
Under repair                                                        :                                                                           0.00
Spot Inspection fess                                                                                                                           0.00
TOTAL                                                                                                                                        700.00
CGST@9%:                                                                                                                                        63.00
SGST@9%                                                                                                                                              63
GROUND TOTAL                                                                                                                       826.00


Thanks & Regards
Rakesh Kumar
Surveyors& Ioss Assessors.
   LA-61
(Authofized Signatory)

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