PRAVIN M. MUSALE
                                                     Motor Surveyor, Loss Assessor and Valuer
                                                   License No. : SLA - 73064 Exp.Dt. 08-02-2022
                                                               604 / Rilletta E / Casa Rio Gold,
                                            Kalyan-Shil Road, Dombivali East, Maharashtra - 421204
                                                                       Mobile. : 9821681100
                                                                     p_musale@yahoo.com

                                                                 Final Survey Fees Bill

BILL NO               : PM//BA/F/0043/19-20                                                                    Date : 10/06/2019

INSURERS           : BAJAJ ALLIANZ GENERAL INSURANCE CO. LT Div./Branch : Mumbai
POLICY NO.
CLAIM NO.            : OC-20-1901-1801-00006181
INSURED              : MR LALIT VIJAY CHUGH
VEHICLE NO.        : MH 04 GM 5382
SURVEYED AT : Vrinda Auto Works, Kalyan Ambernath Road on Dt. : 10/06/2019

Professional Fees                                                                                            Rs.                500.00
Photograph (at Rs. 10.00 x 0 Copy)                                                             Rs.                    0.00
Traveling Expenses 60 km. 30*2=60 kms. To & Fro 1 visit Rs. 7.50                    Rs.                450.00
Holting Allowance                                                                                            Rs.
Out city Allowance                                                                                           Rs.
Total                                                                                                              Rs.                950.00
18.00% GST Rs. 950.00                                                                                  Rs.                171.00
Net Total                  Rounded to Nearest Rupees :                                          Rs. :          1,121.00
RupeeS :ONE THOUSAND ONE HUNDRED TWENTY ONE ONLY

Service Tax No.       : GSTIN NO. - 27ALPPM7590M1Z3
PAN NO. :                    ALPPM7590M
                                                                                                                   PRAVIN M. MUSALE
Advance Receipt

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