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/2020/21/0205                                                                 Dated: 05/10/2020
                                                 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.                         DL 5SBM 5515
INSURED NAME           :       MR. AJAY KUMAR
CLAIM NO.                    :       0C-21-1103-1802-00001636
POLICY No.                             0G-20-1101-1802-00023713
ASSESSED LOSS                     Rs. 5800/-


Professional
Professional Fee                                                                                                                           400.00
Visit to workshop                          Rohini to Loni,GZB, UP 68*4                                                272.00
RE-Inspection Charges                                         :                                                                          0.00
Under repair                                                        :                                                                          0.00
Visi to Insured place                                                                                                                         0.00
TOTAL                                                                                                                                      672.00
CGST@9%:                                                                                                                                      60.48
SGST@9%                                                                                                                                       60.48
GROUND TOTAL                                                                                                                      792.96


Thanks & Regards
Rakesh Kumar
Surveyors & Loss Assessors.

(Authorized Sighatory)
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