VIKRANT GUPTA
                 B.E. (Mech.)                                                                          Mobile No. : 09811085077
                                                                                                            Office cum Resi.:
                                                                                                            273,Tagore Park,Behind Canara
                                                                                                            Bank,Near Model Town-I,Deihi-9
                                           Insurance Surveyor & Loss assessor:
    SLA No. : 66550                                                                                 PAN No. : AENPG 3555M
    Expiry On. : 10/11/2021                                                                             GSTin No.: 07AENPG3555M1Z3
                                                    SURVEY FEE & EXPENSES BILL
         Ref. No. : VG/BJJ/289/2020                                                                             Date : 27.09.2020
      1 INSURER                       : M/S Bajaj Allianz General Insurance Co. Ltd.,
                                                   7th Floor, DLF Tower, Shivaji Marg, New Delhi-15
                                                    GSTin No.: 07AABCB5730G1ZZ
     2 INSURED                        : TARIF ALI KHAN

     3 Vehicle No.                        DL 7SC 6245
     4 Claim No.                       O-21-1103-1802-00001418
                                                                                      HSN/SAC
  Professional Fee                                                               997162       450.00
  Re-inspection Survey Fees                                                                      0.00
 Conveyance Charges for Final Survey                                                  150.00
 Conveyance During Repair                                                                      0.00
 Conveyance Charges for Re-inspection                                                150.00
 Other Charges                                                                                          0.00
 TOTAL                                                                                                  750.00
 ADD CGST @ 9.0% on Total Bill Rupees                                              67.50
ADD SGST @ 9.0% on Total Bill Rupees                                               67.50
 GROSS tOtAL                                                                                     885.00

Please issue cheque for-the above said amount in the favour of Mr. VIKRANT GUPTA to be
drawn on CANARA BANK, A/C No. 2592101002205, Model Town Branch, IFSC Code:
 CNRB0002592.



                     WE50
VIKRANT GUPTA
Surveyor & Loss Assessor

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