To: The Claims Manager Date: 9/Aug/23

Jubilee Allianz General Insurance (Mauritius) Limited Claim No. C/PL/2010/2023/2543

Port Louis Attn: Joelle
SURVEY REPORT (without prejudice)
1. Particulars of Vehicle
Vehicle Reg No. 8224 BZ 13
Make/Model TOYOTA Vitz Insurance Policy No. CCL/PC/11/2016/103085/EE/3/R/8
Colour Dark Purple Sum Insured/PAV: 390,000
Chassis no. NSP1302122400 Transmission Automatic
Engine No. 1NR0597082 Odo Reading (Km) [battery flat]
Year of Regn. 2013 Fuel used: Petrol
Date& Place of Survey:8/08 at Mahebourg Impact: Rear Elevation
Repairer: Garage Vishal Gunputh Pre Accident Condition Roadworthy
SPARE PARTS Repairer/Rs. Reliance/Rs. Fixit/Rs.
1 Rear Bumper 10,000 12,000 12,500
2 Rear Bumper Brackets 2,000 3,000 3,000
VAT (15%) VAT NIL VAT NIL VAT NIL
TOTAL COST OF SPARE PARTS (A) 12,000 15,000 15,500

LABOUR Rate/Hr AMOUNT / Rs.

Remove & Refit Rear Bumper + Brackets (& adj) 2.50 1,000
Boot Lid Accessories 1.50 600
Boot Garnish & trims 1.50 600
LH & RH Tail lamps 1.00 400
Repair: Rear Panel (Straighten & adj) 8.00 3,200
Boot Flooring (straighten & adj) 4.00 1,600
Boot Lid + Lock Mechanism (Recondition & align) 4.00 1,600
Others: Sundries & Consumables 600
Paint: Prepare/Re-spray parts + priming/blending/c.matching & polishing
12.00 9,600
Paint Materials
TOTAL COST OF LABOUR + MATERIALS (B) 19,200
TOTAL COST OF SPARE PARTS (A) 12,000
TOTAL COST OF LABOUR + MATERIALS (B) 19,200
TOTAL COST OF REPAIRS (A+B) 31,200
2. Sum claimed as per EOR: Rs. 87,043.50 Labour assessed (Rs./Hr): 400/800
Instruction for repairs: Survey only Survey carried out in presence of owner: Yes
Duration of repairs: 5 (five) working days Damage corroborate: as per ASF
Previous impacts: Yes Repairer if VAT registered: No
Note: *Attached are photos of Vehicle Reg. No.8224 BZ 13

I, Jibran Aubeeluck warrant that the foregoing statement and particulars are true to the best of my knowledge and belief. I have no present or prospective interest
in this claim that is the subject of this report and declare that I have no personal interest with respect to the parties involved

J. Aubeeluck
Motor Surveyor
Page 1 of 1