HEMANT R. PANCHAL 
 Surveyor & Loss Assesor 
A-203, 2nd floor, Rushi Complex, Beside Hari Om Petrol Pump, L.P. Savani Road, 
Adajan, Surat - 394510. Mobile: 98244 -75769. 
Lic. No. 58125 Valid upto 30/01/2026. 
SURVEY BILL 
To, 
Bajaj Alianz Gen. Ins. Co. Ltd. 
Gujarat 
GST No. 24AABCB5730G1Z3 
Bill / Ref. No. : 1293 /23-24 Date: 13-03-2024 
Policy No OC-24-1021-1825-00025299 
Claim No OC-24-2203-1825-00002461 
Insured MEGHA BHAVIN MEHTA 
Vehicle no. GJ05RV3081 
Amount 
Rs. Rs. 
01. Survey Fees 2,500 
02. Out Station Allowance 
03. Travelling & Conveyance charges 750 
04. Photographs Charges 40 
05. Other Exps. 
3,290 
Add: GST CGST 09% 296 
GST No. 24AIWPP4714A1ZA SGST 09% 296 
PAN no. AIWPP4714A IGST 00% - 
ADVANCE RECEIPT Total Rs. 3,882 
&VAL 
HEMANT R. PANCHAL