SAURABH JUNEJA                                                                             Phone(s)       : 011 - 42058194
Surveyor & Loss Assessor                                                                                 Mobile(s)      : 9899474475
SLA 73349, Valid up to : 08-04-2023                                                                  Address        : H No 107, Hargobind Enclave,
Email : srbh.juneja@gmail.com                                                                                               1st Floor, Vikas Marg Extn.,
IIISLA No. : A/N/5997                                                                                                            Delhi - 110092
                                                                                        Survey Fee Bill
To,
       Bajaj Allianz General Insurance Co. Ltd.                                                                          Bill. No : B-08/20/03616
       Block No-4, 7 Th Floor DLF Tower Shivaji Marg New Delhi-110015                                      Date     : 18/08/2020
       New Delhi-110015                                                                                                       Code     :
       GSTIN: 07AABCB5730G1ZZ                      State Code: Delhi (07)
                    Report Ref No                           SJ/BAGI/SAP6122/08-20/F/11866
                    Vehicle No.                        :     DL5SAP6122
                    Insured Name                    :    ARUN JAIN
                    Date Of Accident          :            01/08/2020
                    Policy/cover note no           :     OG-20-1101-1802-00010218
                    Claim No                           :    OC-21-1101-1802-00000824
    S No                                             Particulars                                                        HSN/SAC                                      Amount Z
      1     Final                                                                                                            997162                                                650.00
                       Professional Fee :             Assessed Amount  2,300.00                                                         500.00
                       Photos/CD Expenses :                                                                                                           0.00
                        0 Photographs , Charged for 0 @ Rs. 10.00
                       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: 07AHGPJ3702K1ZG State : (07)
   PAN. : AHGPJ3702K
   Bank Name: AXIS BANK
   A/c No.                : 913020019916326
   MICR No              : 110211039                                                              SAURABH JUNEJA

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