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9853/ 13.01.

2014

BILL

13/01/2014

ACCIDENT EXPENDITURE DETAILS REQUIRED OF VEHICLE NUMBER OR-02-4713 (TATA 1109 EX TURBO) VEHICLE OWNER NAME: RAJENDRA KUMAR PADHY
IFFCO TAKIO INSURANCE CO. LIMITED (POLICY NO-11 RAMB3G P400 POLICY #: 82052688)

01 02 03 04 05 06 07 08 09

CABIN OPENING & REPAIRING FITTING LOAD BODY OPENING & REPAIRING FITTING CHASSIS OPENING & REPAIRING FITTING HALF ENGINE OVER OILING MECHANICAL ITEM OPENING & REPAIRING FITTING ELECTRICAL ITEM OPENING & REPAIRING FITTING FRONT BUMPER OPENING & REPAIRING FITTING VEHICLE PAINTING & ARTS

Rs. 45000.00 Rs. 12000.00 Rs. 12500.00 Rs. 6500.00 Rs. 21500.00 Rs. 2500.00 Rs. 1500.00 Rs. 16500.00

TORCHING CHARGES FROM ACCIDENT PLACE TO Rs. 8500.00 BHUBANESWAR, AIGINIA, SARALA MOTOR GARAGE Total Amount Rs. 126500.00

(Rupees One Lakh Twenty Six Thousand Five Hundred Only)

Signature of the Vehicle Owner

Proprietor Maa Sarala Motor Garage

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