Licence No. SLA/120014                                                                                      Mobil No.9782773649
Valid upto 10th May 2023                                                                                                      9799730029
                                                                                                                   dipu.daiip2@gmail.com
Surveyor & Loss Assessore of Motor                                                           DILIP KUMAR PRAJAPAT
&Marin Cargo                                                                                             SURVEYOR&LOSS ASSESSOR
GSTIN-                                                                                                                    154Rabari Vas
Reference N DKP/BGIC/02/2021/945                                                                             AmirRoac,Pmdwara
                                                                                                                  Dist.Sirohi,Rajasthan-307022
                                                           BILL
Bill No.   945
                                                                             M/s.:Bajaj Allianz General Insurance Co.Ltd
Date   :   26/02/2021                                                       2nd &3rd floor, 4 Hathroi Fort, Gopalbari
                                                                                     Ajmer Road,Jaipur-302001
                                                                              GSTI:
Claim No.              OC-21-1401-1802-00001270
 Policy No              OG-21-1901-1802-00069489
Vehicle No.            RJ46SE1416
                                                                              Date of Accident:         09/02/2021
Insured Name         MR ASKAR KHAN                                 Date of Survey 12/02/2021
                                                      PARTICULARS                                                           AMOUNT

a Professional Fee                                                                          Final                              500.00
b Halting Allowance                                                                                                               200.00
Conveyance Local
dFare From        Sirohi To Bhinmal
   By Car                                                                                       Final                            1.120.00
   Distance 140KM*8=1120
eSpeed Post=40                                                                                                                  40.00

                                                                                                                                       1,860.00
                                                                                    Add  : CGST @ 9%
PAN No. CZJPK1227R                                                        Add. SGST @9%
                                                                                    Add   IGST @18%
                                                                                                   Total                            1.860.00
BANK -BANK OF BARODA
Address :- Shree Ji Plaza,Near Telephone Exchange,Pindwara-307022
A/c Name Mr. Dilip Kumar Prajapat A/c No.55318100005070                                 Tile
IFS Code BARB0PINSIR Branch Code 307012027
                                                                                                                       tax
                                                                                                       DILIPKUMARPRAJAPAT

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