J.BARANIKUMAR, D.M.E., P.D.Au.E.

,
Automobile Engineer/Insurance Surveyor/Loss Assessor
License No. SLA 29812 of Govt. of India. Exp. On 17.09.2020
Plot No: 77, K.S.V Nagar, Narasothipatty, Alagapuram (PO),
Salem – 636 004.
IIISLA Membership No: F/S/04414 Cell : 98427- 44268
E mail ID : jbaranislm@yahoo.co.in 73973- 92268
Bill No: Date : 05.01.2019

To
The Divisional Manager,
M/s.United India Insurance Co Ltd.,
Divisional Office,
Hosur.
UIIC GST No. 33AAACU5552C1ZQ

PROFESSIONAL BILL CUM VOUCHER

Insurer : Mr.J.Ravikumar, Anekal Tk.
Policy no : 1710003118P109253798
Vehicle Regn. Number : KA 51 AC 5972
Date of accident : 07.12.2018
Date of survey : 12.12.2018 and various dates
Estimate Rs. 980,000.00

Professional fees : 2,300.00

0.7% on Rs.780,000.00 : 5,460.00
Conveyance (By car on 12.12.2018) : 3,484.80 (165 Kms x 2 x Rs.10.56 per km)
Batta : 500.00
Photo charges Rs. 10 X 25nos : 250.00
Toll charges : 270.00 (copy toll receipt enclosed)
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Total Rs. 12,265.00
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Yours faithfully,
PAN Number: AGG PB 2010 B

(J.BARANIKUMAR)
BANK DETAILS
NAME : J.BARANIKUMAR
BANK ADDRESS: CANARA BANK, ALAGAPURAM BRANCH, FAIRLANDS,
SALEM – 636 016.
A/C. No : 1225 201 011043
IFSC CODE : CNRB 0001225
MICR CODE : 636015003

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