RAKESH KUMAR
                                                    SURVEYOR & LOSS ASSESSOR
FLAT NO. 417, C-1, Muskan Appartment, Sector-17, Rohini, New Delhi-89
                                         Mob.#9868110525/8836301125
                                         E-mail: majokarakesh61197@gmail.com
                                         License No. SLA-61197,Valid upto 07/10/2023
                                         Pan No.AHEPK2434R/GST No.07AHEPK2434R2ZZ
Ref:- BAJAJ/FINAL/2020/21/0395                                                                     Dated: 16/12/2020
                                                    HSN/SAC CODE:997162
Bajaj Allianz General Insurance Company Limited.
Block No.4, 7th Floor. DLF Tower-15, Shivaji Marg, 011-66278225, New Delhi-110001.
GST Number:07AABCB5730GIZZ
VEHICLE NO.                 :        UP 17S 2435
INSURED NAME           :        TOUSIN
CLAIM NO.                     :        OC-21-1103-1826-00001105
POLICY No.                               OG-20-1102-1826-00006237
ASSESSED LOSS                       Rs. 6000/-


Professional
Professional Fee                                                                                                                                    400.00
Visit to workshop                                  Rohini To Rataul, UP 112*4                                                          448.00
RE-Inspection Charges                                                                                                                              0.00
Under repair                                                                                                                                             0.00
Spot inspection Fee                                                                                                                                   0.00
TOTAL                                                                                                                                                848.00
CGST@9%:                                                                                                                                                76.32
SGST@9%                                                                                                                                                 76.32
GROUND TOTAL                                                                                                                            1000.64



Thanks & Regards
Rakesh Kumar
                           KUM
                         LossAssessors.

(AuthorizedSignatory

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