HIRAL S. PATEL
                                      SURVEYOR & LOSS ASSESSOR, VALUER
     Lic No        : 72693 / 19-22                                                                      417, Navrang Complex,
      Exp. Date    : 09-03-2022                                                                         Nr. Uttsav Hotel,
      Mobile No.  : 9879063617                                                                         Raopura,
     E-mail        : patelhiral66@yahoo.com                                                          Vadodara - 390 001.
OUR REF.                 : BAJAJ/HSP/20/1009                                                          13 February 2021
OUR BILL NO.           : BAJAJ/HSP/20/1009
                                                       BILL / ADV.RECEIPT.

To,
The Claim Manager,
Bajaj Allianz General Insurance Co. Ltd,
Branch Office, Baroda.

                                           Reg.:                  Final Survey of M/V No. GJ-06-DQ-8532
                                                               A/c. Mr. Naimesh G Nimbalkar
                                                                      Vadodara
                                                    Policy No.                    : OG-21-2201-1801-00008794
                                                    Claim No.                    : OC-21-2201-1801-00004607
                                                    Period                         : 17.10.2020 to 16.10.2021

SR NO.                                               PARTICULARS                                                    AMOUNT

   01.    PROFESSIONAL SURVEY CHARGES. : ( FINAL )                                               Rs.  2500.00
   03.    CONVEYANCE EXPENSES : ( FINAL VISIT)                                                      Rs.   0250.00
   05.   PHOTOGRAPH EXPENSES: Photo CD (Digital Photo)                                    Rs.   0040.00
   06.    HAULTING ALLOWANCE. :                                                                          Rs.   0000.00
                       SUB TOTAL.                                                                                    Rs.   2790.00
   07. SGST 09%                                                                                                  Rs.    251.00
             CGST 09%                                                                                                  Rs.    251.00
       Rs. Three Thousand Two Hundred Ninety Two Only.                                                 3292.00
                                                                                S.P
OUR PAN NO.           : AKUPP7626D
OUR GST NO.           : 24AKUPP7626D1ZT              SURVEYOR
                                                                      HLOSS ASSESSORS
INSURER GST NO.    : 24AABCB5730G1Z3
                                                                              72893-1922    @
                                                                                                              HIRAL PATEL
                                                                                                 SURVEYOR & LOSS ASSESSOR

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