RAJEEV BATRA
                                                                      (Surveyor & Loss Assessor)
Licence No.SLA/72709 Valid upto 22/03/2022                                                                     Ph.(M)9810143600
IIISLA MEMBERSHIP NO.-A/N/05042                                                                                          (0) 8800174968
B-30,3rd FLOOR (BACK SIDE)                                                                                                      (R)011-27672404
MAHATMA GANDHI ROAD                                                                                                   Email: r.batra@yahoo.co.in
ADARSH NAGAR,DELHI-110033
                                                                              Survey Fee Bill
To,
      Bajaj Allianz General Insurance Co.Ltd.                                                         Bill.No: B-11/20/06425
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Date    11/11/2020
       7TH FLOOR,DLF TOWER,SHIVAJI MARG,NEW DELHI                                    Code   Nil
       GSTIN:07AABCB5730G1ZZ              State Code : Delhi (07)
                  Report Ref No               :    RB/BAJ/20-21/07052
                  Vehicle No.                         UP 14DK 3570
                  Insured Name               :    MR.NEELAM RAGHAV
                  Date Of Accident           :    09/10/2020
                  Policy/cover note no     :    OG-20-1103-1802-00011904
                  Claim No                      :    OC-21-1103-1802-00001923

   SNo                                        Particulars                                                HSN/SAC                               Amount
      1    Final                                                                                                997162                                         650.00
                     Professional Fee:       Assessed Amount  5,400.00                                           500.00
                     Photos/CD Expenses:                                                                                           0.00
                      0 Photographs , Charged for 0 @ Rs. 0.00
                     Conveyance Expenses:                                                                                     150.00

                                                                                                                                     Sub Total:                650.00
                                                                                                                                 C GST @9.00 %                  58.50
                                                                                                                                 S GST @ 9.00 %                  58.50
               ADVANCE RECEIPT                                                                                  Grand Total:                767.00
                                                                                                                                     Round off:                767.00
                                                         In words : Rs. Seven Hundred Sixty Seven Only
   GSTIN:07AIGPB7033E1ZQ State :(07)                                         RAJEEVBATRA
   PAN.AIGPB7033E
   Bank Name:PUNJAB NATIONAL BANK
   A/c No.            0618000100079039                                                          SL1-72709
   MICR No          110024109                                                       SURVEYQR&LOSSASSESSOR.

---PAGE END---