R. Natarajan, Dme, Dae, Fiiisla LICENSE NO: SLA-17364 VALID 20/12/2023 MOBILE: 98659 54088
R. Natarajan, Dme, Dae, Fiiisla LICENSE NO: SLA-17364 VALID 20/12/2023 MOBILE: 98659 54088
R. Natarajan, Dme, Dae, Fiiisla LICENSE NO: SLA-17364 VALID 20/12/2023 MOBILE: 98659 54088
Policy No :
Period of Insurance :
Type of Policy :
Insured Declared Value :
Claim No :
1. INSURER :
2. INSURED :
3. FINANCIARS IF ANY :
4. VEHICLE PARTICULARS:-
a. Registration No :
b. Date of Registration & Year of Manufacturing :
c. Chassis No. : Physically Verified.
d. Engine No. :
e. Makers Name :
f. Makers Classification :
g. Class of vehicle :
h. Type of body :
i. Type of fuel :
j. Cubic Capacity / Seating capacity :
k. Color of the vehicle :
l. G. V. W / Unladen weight / Carrying Capacity. :
m. Pre - Accident conditions : Fairly Maintained.
n. Tax Paid Details :
o. Fitness No & Validity :
p. Permit No & Validity. :
q. Trip Sheet Details. i. No. & Date. :
ii. From & To. :
iii. Type of Load & Carried Weight. : ( OR ) iii. No of Passengers at the time of accident.
HEAD OFFICE: BRANCH OFFICE:
Room No. 74, PG Mansion, Plot No.6, Preethi Nagar, Annanagar Extn.,
N. No. 8&10, Old No. 38 & 391 Palamarathupatti, Nagal Nagar (PO),
R. NATARAJAN, DME, DAE, FIIISLA MOBILE: 98659 54088
LICENSE NO: SLA-17364 VALID 20/12/2023 Email ID: natarajan17364@gmail.com
6. VERIFIED DETAILS:-
a. Policy Copy : Yes (Photo Copy).
b. Registration Certificate (Tax, FC). : Yes (Photo Copy).
c. Permit. : Yes (Photo Copy).
e. Driving License : Yes (Photo Copy).
f. Police report Details. : Yes (Photo Copy).
g. Trip Sheet Details : Not Applicable.
Policy No :
Period of Insurance :
Type of Policy :
Insured Declared Value :
1. INSURER :
0
0
2. INSURED :
0
0
3. VEHICLE PARTICULARS:-
a. Registration No :
b. Date of Registration & Year of Manufacturing :
c. Chassis No. : Physically Verified.
d. Engine No. :
e. Makers Name :
f. Makers Classification :
g. Class of vehicle :
4. ACCIDENT AND SURVEY DETAILS:-
a. Date and Time of Accident :
b. Place of Accident :
c. Place of Survey :
d. Date of Deputed for Re-Inspection. :
e. Date & time of Survey :
F. Deputed by whom :
5.SPARES RECOMMENDED AND OPINION:-
1. Spares recommended at cost. : Replaced with new one.
2. Spares with 0% Depreciation for (Plastic Parts) : Replaced with new one.
3. Spares with 0% Depreciation for (Metal Parts) : Replaced with new one.
2. Labor recommended. : Carried out to the satisfaction.
Note:- 1. Entire salvage produced for my Inspection, 2. 16 No of photos taken by me is enclosed herewith.
Spot Survey
Spot Survey By : Mr. ------------------., Madurai.
Spot Survey report received on : 25.03.2017 by post
R. NATARAJAN, DME, DAE, FIIISLA MOBILE: 98659 54088
LICENSE NO: SLA - 17364 VALID 20/12/2023 Email ID: natarajan17364@gmail.com
Total 0.00
Less depreciation @ 0% 0.00
Works out to 0.00
Add GST @ 28% 0.00
SUB TOTAL 0.00
Total 0.00
Less depreciation @ 0% 0.00
Works out to 0.00
Add GST @ 18% 0.00
SUB TOTAL 0.00
LABOUR CHARGES:-
Sl. No Description of Labour R & R (A) Repair (B) Painting (C) A+B+C
1 0.00 0.00 0.00 0.00
2 0.00 0.00 0.00 0.00
3 0.00 0.00 0.00 0.00
4 0.00 0.00 0.00 0.00
5 0.00 0.00 0.00 0.00
6 0.00 0.00 0.00 0.00
7 0.00 0.00 0.00 0.00
8 0.00 0.00 0.00 0.00
9 0.00 0.00 0.00 0.00
10 0.00 0.00 0.00 0.00
11 0.00 0.00 0.00 0.00
12 0.00 0.00 0.00 0.00
13 0.00 0.00 0.00 0.00
14 0.00 0.00 0.00 0.00
15 0.00 0.00 0.00 0.00
16 0.00 0.00 0.00 0.00
Total 0.00 0.00 0.00 0.00
R. NATARAJAN, DME, DAE, FIIISLA MOBILE: 98659 54088
LICENSE NO: SLA - 17364 VALID 20/12/2023 Email ID: natarajan17364@gmail.com
SUMMARY OF ASSESSEMENT
Sl. No Description Spares & Labour Estimated Billed Assessed Allowable
1 Spares 0.00 0.00 0.00
2 Labour 0.00 0.00 0.00
3 Labour towards towing charges 0.00 0.00 0.00
Total 0.00 0.00 0.00
Less Salvage Value 0.00
Works out to 0.00
Less Policy excess 500.00
Net liability to the Insurer. -500.00
Note:
1 Survey work assigned by.
2 20 No of photos taken by me is enclosed herewith.
Spot Survey
Spot Survey By : Mr. ------------------., Madurai.
Spot Survey report received on : 25.03.2017 by post
R. NATARAJAN, DME, DAE, FIIISLA MOBILE: 98659 54088
LICENSE NO: SLA - 17364 VALID 20/12/2023 Email ID: natarajan17364@gmail.com
TO
Sir
Pursuant to your request, I had been to M/S //////////////////////Madurai. and carried out survey work on the above
captioned vehicle, Please find the detailed final survey report as presented below.
(R. NATARAJAN)
Insurance Surveyor
Encl: 1. Final Survey report with 20 No of photos, 2. Repair Estimate, 3. Tax Invoice, 4. Claim Form, 5.Policy copy, 6. RC.,
7. DL., 8. Driver statement.
TO
The Branch Manager,
:
0
0
Sir
Re-Inspection Report for - :
Insurer :
Insured :
Policy No: :
Date of Accident :
Pursuant to your Instructions I had been to M/S K.V.V. Coach Builders, Kovilpappakudi, Madurai on ????? and carried
out Re-Inspection on the above captioned vehicle as having completed accident repair work. Please find the detailed Survey
Report as presented.
(R. NATARAJAN)
Insurance Surveyor
TO
The Branch Manager,
:
0
0
Sir
Final Survey report fees bill for the Vehicle Registration No. :
Insurer :
Insured :
Policy No::
Date of Accident :
Bank Details:
Account No : 352010100015288 - PAN NUMBER: AAWPN4166E
Bank Address : AXIS BANK, Salai road, Dindigul.
Account Type : Savings
IFSC Code : UTIB0000352 (R. NATARAJAN)
MICR Code : 624211002 Insurance Surveyor
TO
The Branch Manager,
:
0
0
Sir
Re-Inspection Survey fees bill for the Vehicle Registration :
Insurer :
Insured :
Policy No::
Date of Accident :
Bank Details:
Account No : 352010100015288 - PAN NUMBER: AAWPN4166E
Bank Address : AXIS BANK, Salai road, Dindigul.
Account Type : Savings
IFSC Code : UTIB0000352 (R. NATARAJAN)
MICR Code : 624211002 Insurance Surveyor