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/2020/21/0223                                                                   Dated: 08/10/2020
                                                   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.                 :        UP 14DJ 2394
 INSURED NAME           :       MR. ASHOK KUMAR
 CLAIM NO.                              OC-21-1103-1802-00001767
 POLICY No.                              0G-21-1102-1802-00001936
 ASSESSED LOSS                      Rs. 5430/-


Professional
Professional Fee                                                                                                                               400.00
Visit to workshop                            (ROHINI TO BHOPURA .GZ .UP - 64*4 )                                                   256.00
RE-Inspection Charges                                          :                                                                             0.00
Under repair                                                                                                                                         0.00
Visi to Insured place                                                                                                                             0.00
TOTAL                                                                                                                                           656.00
CGST@9%:                                                                                                                                          59.04
SGST@9%                                                                                                                                            59.04
GROUND TOTAL                                                                                                                          774.08


Thanks & Regards
Rakesh Kumar
Surveyors & Loss Assessors.

(Authofixed Signatory)

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