Yogesh Gupta
Surveyor & Loss Assessor
License No.     120998                                                    Office:                         SCF-10,Sector-6
Valid upto       20.01.2022                                                                       Bahadurgarh, Distt.Jhajjar
Deptt.            :Motor                                                                                            Haryana-124507
PAN No.         AIEPG3565C
                                                                                                                           M9728410038
Ref.No.YRK/Bajaj/20/Motor/125                                                                   September 29,2020
        Bajaj Allianz General Insurance Co.Ltd;
       Moti nagar
       Delhi.

                                          Policy No.       OG-21-1901-1802-00001878
                                           Claim No.       OC-21-1103-1802-00001737
                                         Vehilce No.      HR13L9147
                                 Insured's Name       :MRSANDEEP KUMAR

                                                                 SURVEY FEE BILL
 AProfessional Fee for Spot survey                                                :Rs.                       0.00
 (B)Professional Fee for Final survey                                               :Rs.                    550.00
        (Assessed loss amount Rs.)        11125.00
c Professional Fee for Re-Inspection survey                                 :Rs.                       0.00
        Conveyance Charges (Local)                    1                                :Rs.                    150.00
       Conveyance(Out Station)                          0             0                 :Rs.                        0.00
        Photographs-Digital                                  0             0                  :Rs.                       0.00
                                                                                                                                      700.00

                  Total Rs.700.00
       (Rs:-SEVEN HUNDRED ONLY.)
                            Gupta
                      N
               *
                      20998

       (Yogesh'Gupta)
        Surveyor and Loss Assessor
       NEFT Details:
       Name:               YOGESH GUPTA
       Bank:                INDUSIND BANK
       A/c No.:             159728410038

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