Manoj Jain                                                                                234845 (Resi.)
 Fire,Motor,Enginnering                                                              Mobile      9425087045
 Surveyor & Loss Assessor                                                                 7693087045
 Investigator & Valuer                                                          Shreeji Nagar
 Email : manoj_jain_2001@yahoo.com                                                   Behind Vrandavan Colony
 GSTIN :23AEDPJ2084E1ZZ                                                 Khargone - 451001
                          Central Govt. Lic. No. SLA-40879 (Valid Up To 20th May 2021)
 Ref:Bajaj        206/020                                                                     Date:       07.12.2020
                                                       Professional Fee Bill

To
        The Manager
        Bajaj Allianz General Insurace Co. Ltd.
        Cust GSTIN/UIN :23AABCB5730G1Z5
1     Particular                               :             MH 18 BA 1971
2     Policy ICovernote No.             :             OG-20-1401-1803-00007617
3     Claim No.                               :             OC-21-2302-1803-00000096
4     Place/Date of occurrence       :             19.10.2020
5     Insured                                  :             SANJAY KANASE
                       Particular                                                                   Amount
1     Professional Fee                                                                             2500.00
        Reinspection Fee
2     Photographs CD                                                                                50.00
4     Travelling Expanses        (Khargone to Khalghat 50x2=100Km.@8/-)               800.00
5     Daily Allowance                      @500/-
6     Misc Expanses
                                                                     Total                                 3350.00
                                      CGST @                           9%                            302.00
                                      SGST @                           9%                            302.00
                                      Total Tax                                                            604.00
                                                                     Total                                 3954.00
Rs. Three Thousand Nine Hundred & Fifty Four Only
       Advance Receipt                                                                               JAIR
                                                                                                                Manoj Jain)
                                                                                                     x)           Surveyor
Bank A/c No.0287000100070315
Bank Name : Punjab National Bank Khargone                                                       Hr

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