Er. SUNIL KUMAR
SURVEYOR & LOSS ASSESSOR
LICENCE NO: 73070 EXPIRY: 08.02.2028
PAN NO: AQUPK1480C
# 304, Village: Daria,
Near Railway Station, Chandigarh
Mobile: 098761-35253
e-mail:- ksunilsurveyor@gmail.com
Ref: SK/2024-25/OICL/7886
Date: 28/05/2025
PRIVATE & CONFIDENTIAL SURVEY REPORT
The report is issued by me as Licenced surveyor without prejudice in respect of cause, nature & extent of loss/damages and subject to the terms and conditions of Insurance Policy.
1INSURERSIDV= ₹4,50,000
ADDRESS
:
RO: Service Centre, Sector-17, Chandigarh
COVER NOTE/POLICY NO.
:
311100/31/2024/12345
Period: 01/04/2024 to 31/03/2025
:
The Oriental Insurance Co. Ltd.
2INSURED
ADDRESS
:
H.No. 123, Sector 22-B, Chandigarh - 160022
3HPA WITH
4VEHICLE PARTICULARSRC Original Checked & Found In Order
Registration No.
:
CH-01-AA-1234
Date of Registration issue
:
30/01/2020
Date of Registration expiry
:
29/01/2035
Chassis No
:
MA3ERLF1S00231390
Make & Year of Manufacturer
:
Maruti Suzuki Swift Dzire VXI, 2020
Pre-Accident Condition
:
Good
Registered Laden Weight
:
NA
Fitness Cert. Valid upto
:
NA
Route/area of Operation
:
NA
Road Tax Paid Upto
:
29/01/2035
Name of Regd. Owner as per RC
:
Rajesh Kumar
5DRIVER'S PARTICULARSDL Original Checked & Found In Order
Name of Driver
:
Rajesh Kumar
DOB: 15/08/1985
Address
:
H.No. 123, Sector 22-B, Chandigarh - 160022
LICENCE NO.
:
CHD-0120-1234567
Issuing Authority
:
DTO Chandigarh
Type of Licence
:
LMV, MCWG
6ACCIDENT HISTORY
Date of Accident
:
18/06/2023 | Time: 14:30
Place of Accident
:
Near Sector 17, Chandigarh
7DETAIL OF SURVEY
Date of Allotment of Survey
:
20/06/2023
Date and Time of Survey
:
22/06/2023 | Time: 11:00 and onwards
Date of Spot Survey Report Recd.
:
Spot Survey not received.
Person Present at the Time of Survey
:
Repairer was present
8PLACE OF SURVEY
Workshop
:
Maruti Suzuki Authorized Service Centre
Address
:
Plot No. 45, Industrial Area Phase-I, Chandigarh
9FIR DETAIL
10INJURY/THIRD PARTY LOSS
11CAUSE AND NATURE OF ACCIDENT
As stated in the Claim Form,
12OBERVATIONS/COMMENTS
As per the instructions of The Oriental Insurance Co. Ltd., I visited the Repairer's workshop. The Vehicle was carefully inspected, its damages were noted and photographs taken. The Photographs in the Under Repair Condition were also taken. The damages are commensurate with the cause and nature of accident.
13MAIN DAMAGES
14NOTES:
1Case allotted by The Oriental Insurance Co. Ltd.
2The loss of damage or liability has arisen proximately caused by the insured peril.
3None of the exclusion under the policy has is caused loss of damage or liability.
4The salvage of the vehicle has been destroyed/crushed in the presence of the Repairer.
5Re-inspection too has been done by me. All the replacemnets of parts and repair job have been dully carried out.
6At the time of survey, I talked with Insured and discussed about the loss.
15DETAIL OF ASSESSMENT
| CUBIC CAPACITY | 1248 | SO, EXCESS CLAUSE (IN RS.) | 1,000 |
| LIFE OF VEHICLE ( IN YEARS ) | 3.41 | SO, DEP. ON METAL (IN %) | 15 |
| GSTIN (IN %) FOR PARTS | 18 | GSTIN (IN %) FOR LABOUR | 18 |
| S.N. | Parts Name | Estimated | Metal | Plastic | Glass | Extra Bill | Sr. No. |
|---|
| 1 | Front Bumper Assembly | 4,500.00 | | 4,500.00 | | 300.00 | 1 |
| 2 | Bonnet Panel | 8,500.00 | 8,500.00 | | | 500.00 | 2 |
| 3 | Headlamp Assembly LH | 3,200.00 | | 3,200.00 | | | 3 |
| 4 | Windscreen Glass Front | 5,500.00 | | | 5,500.00 | 300.00 | 4 |
| 5 | Radiator Grille | 1,200.00 | | 1,200.00 | | | 5 |
| 6 | Front LH Fender | 6,000.00 | 6,000.00 | | | 500.00 | 6 |
| SUB TOTAL | 28,900.00 | 14,500.00 | 8,900.00 | 5,500.00 | 1,600.00 | |
| 18% ADD GST (9%CGST+9%SGST) | 5,202.00 | 2,610.00 | 1,602.00 | 990.00 | 288.00 | |
| SUB TOTAL | 28,900.00 | 17,110.00 | 10,502.00 | 6,490.00 | 1,888.00 | |
| LESS DEPRECIATION: |
| 15% OF METAL & 50% OF PLASTIC | | 2,566.50 | 5,251.00 | 0.00 | 0.00 | |
| NET FOR PARTS | 28,900.00 | 14,543.50 | 5,251.00 | 6,490.00 | 1,888.00 | |
| TOTAL NET FOR PARTS | 28,900.00 | 19,794.50 | | 1,888.00 | |
TOTAL AMOUNT OF DEPRECIATION (In Rs): 7,817.50
LABOUR DETAIL
| LABOUR ESTIMATED5,300.00 |
|---|
| S.N. | DESCRIPTION | Estimate | R/R | DENTING | C/W | PAINTING |
|---|
| 1 | R/R Front Bumper | 500.00 | 500.00 | | | |
| 2 | Denting Bonnet Panel | 1,200.00 | | 1,200.00 | | |
| 3 | Painting Bonnet + Fender | 2,500.00 | | | | 2,500.00 |
| 4 | R/R Headlamp LH | 300.00 | 300.00 | | | |
| 5 | R/R Windscreen | 800.00 | 800.00 | | | |
| SUB TOTAL | 5,300.00 | 1,600.00 | 1,200.00 | 0.00 | 2,500.00 |
| LESS COST OF PAINT MATERIAL @25% | 625.00 |
| SUB TOTAL | | 1,600.00 | 1,200.00 | 0.00 | 1,875.00 |
| TOTAL (R/R, DENTING, C/W, PAINTING) | 4,675.00 |
| LABOUR | Estimated | Assessed |
|---|
| 5,300.00 | 4,675.00 |
| 18% ADD GST (9%CGST+9%SGST) | 954.00 | 841.50 |
| NET FOR LABOUR | 6,254.00 | 5,516.50 |
TOTAL AMOUNT OF LABOUR ASSESSED (in Rs): 5,516.50
| PARTS | 28,900.00 | 28,172.50 |
| LABOUR | 6,254.00 | 5,516.50 |
| SUB TOTAL | 40,356.00 | 33,689.00 |
| LESS EXCESS CLAUSE | | 1,000.00 |
| NET PAYABLE | 40,356.00 | 32,689.00 |
Report issued without prejudice or bias and is subject to the term and condition of the Policy and subject claim document being found in order. The Repairer/Insured has concurred with assessment. The damages are commensurate with the cause and nature of accident. The rates allowed are as per Authorised Dealer/Market rates which ever is less. Claim Form, Estimate, SF Bill, Photographs, Photocopies of RC, DL, C.Note, etc etc are enclosed.
PAYMENT MADE IN THE FAVOUR OF REPAIRER
CASHLESS CLAIM
SUNIL KUMAR