AJAY KUMAR SHARMA
                                                                           [IIISLA No.: F/N/00843]
                                                                   SURVEYOR & LOSS ASSESSOR
                                   Flat No 124, Punjabi Bagh Apartments, Rohtak Road, New Delhi 110026
Licence No.    :SSLA 51877                                                                                        Mobile : 9810070269
Valid Upto       : 10-07-2023                                                                                                     :99818545559
GST No.           :07ACCPS9635H2Z7                                                                          Email   :ak_sharma576@yahoo.co.in
PAN                : ACCPS9635H
Invoice No. : AKS/BAGIC/20-21/6279                                                                                                        Date : 31/10/2020
                                                       PRE-RECEIPTED SURVEY FEE BILL

             Bajaj Allianz General Insurance Co. Ltd.
              DLF, Moti Nagar, Delhi
              Claim No.                                         OC-21-1103-1802-00002107
             Policy/C.Note No.                               OG-21-9906-1802-00123448
              Vehicle No.                                      UP15BU7908
             Make & Model                               TVS Jupitar 2015
             Insured                                             MR. RESHU KUCHHAL
             Estimated Loss                                  Rs. 0.00
             Place of Survey
                                                                                                                                                                                         AMOUNT
                                                                                                                                                                                          (In. Rs.)
              PROFESSIONAL CHARGES
              FINAL SURVEY FEE                                                                                                     400.00
                                                                                                                                                       400.00                    400.00
              CONVEYANCE CHARGES
              CONVEYANCE CHARGES                                                                                                 150.00
                                                                                                                                                       150.00                    150.00
                                                                                                                                                                                         550.00
              CGST @ 9.00%                                                                                                                                                      49.50
             SGST @ 9.00%                                                                                                                                                       49.50
                                                                                                                                                                                         649.00
                                                                                                                                                                                EEEEEEEEEE
              (Bill Amount in Words : Rs. Six Hundred Fourty Nine Only)
              Bank A/C No.        A/C No. 21740400000024
                                           MICR 110012054
                                           IFSC : BARB0KARAMP

---PAGE END---