Licence No. SLA/22774                                                                                                           Mobile No. : 9829061788
Valid upto 8th March 2022                                                                                                  Phone :2611275,2617371
Surveyor & Loss Assessore of Motor, Fire                                                                                       ASHWANI BERI
Marin Miscellaneous                                                                                                          SURVEYOR & LOSS ASSESSOR
                                                                                                                                                          B - 13, Govind Marg
                                                                                                                                                     Near Sindhi Ice Factory
                                                                                                                                          Adarsh Nagar, Jaipur - 302 004

                                                                  BILL

Bill No. :    3035
                                                                                          M/s. :Bajaj Allianz General Insurance Co. Ltd.
Date            23-Oct-20                                                                  2nd & 3rd floor, 4 Hathroi Fort, Gopalbari, Ajmer Road,
                                                                                                     GST No- 08AABCB5730G1ZX
Claim No.         : OC-21-1401-1812-00000012

Policy No         :OG-20-1401-1812-00000907

Insured Property : RJ-14-PD-6143
                                                                                                 Date of Accident:                      07-09-2020
Insured Name : M/s Soni Nursing College                              Date of Survey                         21-09-2020
                                                             PARTICULARS                                                                                AMOUNT

(a) Professional Fee                                                                                                                                         2,500.00

(b) Halting Allowance
     Conveyance (Local)                                                                                    5ViISIT @ 350/-                     1,750.00
c

(c) Photo Charges - CD                                                                                                                                         50.00

(d) Fare From
     By
     Distance
                                                                                                                                                                          4,300.00
 GSTIN 08ABPPB2007A1ZE                                                           Add: CGST @ 9%                                       387.00
 PAN No.ABPPB2007 A                                                                 Add.: SGST@9%                                       387.00
                                                                                                      Add.: IGST  @ 18%
                                                                                                                          Total                                       5,074.00

 PUNJAB NATIONAL BANK
 247, MANISH MANSION, FRONTIER COLONY, ADARSH NAGAR, JAIPUR-302 004
 A/c Name Mr. Ashwani Beri A/c No. 4079000100005077
                                                                                                                                               iV
 IFS Code PUNB0407900, MICR No. 302024025
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                                                                                                                                          ASHWANI BERI

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