Licence No. SLA/120614                                                                                          Mobile No.:9782773649
Valid upto 10th May 2021                                                                                                            9799730029
                                                                                                                         dipu.dilip2@gmail.com
                                                                                                          DILIP KUMAR PRAJAPAT
Surveyor & Loss Assessore of Motor
&Marin Cargo                                                                                                  SURVEYOR & LOSS ASSESSOR
GSTIN-                                                                                                                               154,Rabari Vas,
Reference N DKP/BGIC/08/2020/733                                                                                   Amli Road,Pindwara
                                                                                                                         Dist.Sirohi,Rajasthan-307022
                                                              BILL

Bill No.   733
                                                                                M/s. : Bajaj Allianz General Insurance Co. Ltd
Date          16/09/2020                                                         2nd &3rd floor,4 Hathroi Fort, Gopalbari
                                                                                         Ajmer Road, Jaipur-302001
                                                                                  GSTI
Claim No.               OC-21-1401-1843-00000049
Policy No               'OG-20-3022-1843-00000030
Vehicle No.             RJ-46-SH-2467
                                                                                  Date of Accident:         14/08/2020
Insured Name         GOVIND KUMAR SONI                            Date of Survey 17-08-2020
                                                         PARTICULARS                                                               AMOUNT

a Professional Fee                                                                              Final                                 500.00
                                                                                                         Re-Inspection
b Halting Allowance                                                                                                                     200.00

 Conveyance Local)                                            Final & Re-Inspection
d) Fare From         Sirohi To                                                                                                       1,120.00
    By Car                                                                                                                                 1,120.00
    Distance 140KM*8=1120
(e)Speed Post=40                                                                                                                         40.00

                                                                                                                                               2,980.00
                                                                                         Add  : CGST @ 9%
PAN No. CZJPK1227R                                                           Add. : SGST @ 9%
                                                                                        Add.   IGST @18%
                                                                                                         Total                              2,980.00
BANK -BANK OF BARODA
                                                                                                                        AR
Address :- Shree Ji Plaza,Near Telephone Exchange,Pindwara-307022
A/c Name Mr. Dilip Kumar Prajapat A/c No.55318100005070
IFS Code BARBOPINSIR Branch Code 307012027
                                                                                                             DILIP KUMAR PRAJAPAT

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