GLOW DENT VALANCHERY

ROHIT REGHUNATH, B-Tech, MI Flat No. 2 Insurance Loss Assessor, Chartered Engineer Aiswarya Apartments Licence No: SLA/74737 Near St. Alphonsa Church, Perinthalmanna Date of Expiry: 19th March 2023 FIRE-MOTOR-ENGINEERING MALAPPURAM-679322 e.mail [email protected] Land line: 04933-227882 Mobile :9995949885, 9037365852 PRIVATE AND CONFIDENTIAL FIRE (FINAL) SURVEY REPORT Under instructions from M/s. The New India Assurance Co. Ltd., Malappuram, I conducted a Survey at M/s. Glow dent. and my findings are as under: Policy Number : 76020011200100000296 Date : 28-Jul-2021 Claim Number : Ref No : FR-F/02-FSR-NIA-01/21-22 1. INSURERS : The New India Assurance Co. Ltd. Servicing MALAPPURAM office: 2ND FLOOR, M K TOWERS, MIDDLE HILL, MALAPPURAM, 676505, KERALA, 2.INSURED KFC MALAPPURAM A/C GLOW DENT VALANCHERI : DOOR NO.16/354 H & 1, IRIMBILAYAM, TIRUR, KERALA, 676101 3. POLICY PARTICULARS : a) Policy type : STANDARD FIRE AND SPECIAL PERILS POLICY b) Co-insurers c) Period Of Insurance : No d) Building number e) Location of Property : 19/08/2020 to 18/08/2021 f) Interest covered : 16/354 H, I g) Sum Insured : Irimbiliyam Grama Panchayat : Plant, Machinery and accessories, Furniture, fittings, fixtures and other contents : Plant, Machinery and accessories Rs.4,95,000; Furniture, fittings, fixtures and other contents Rs. 1,25,000. h) Date of damage : 16/04/2021 @ 12:00 noon i) Date on which request for survey : 18-Apr-2021 was received from the company j) Date of survey : 19/04/2021 @ 3:15Pm k) Place of survey : Insured's Premises (above address) i) Date/ Year of construction : k) Affected item : Machinary and Fixtures, furnishings l) Cause of loss : Short circuit m) Estimate loss : Rs. 140,690 /- n) Gross Assessed loss : Rs. 103,800 /- o) Net Adjusted loss : Rs. 71,555 /- 4. THE INSURED PROPERTY Machinaries, furniture, fixtures and fittings are insured under a SF&SP Policy with STFI addon.

,ROHIT REGHUNATH B-Tech, MI ; Insurance Loss Assessor Licence No: SLA / 74737 Date of Expiry: 19th March 2023 Continuation Sheet 2 5. SURVEY / OBSERVATION On Receipt of survey instruction, I, the undersigned visited the Glow dent on 19/04/2021. The Owner of the shop and his Staffs were available for facilitating my inspection of reported loss/ damage. The fire started from the main DB of the shop. The generator kept under the Db, the curtain next to it and the PVC false sealing burnt in the fire. The local people gathered and put off the fire with in no time with out further damage. A few stock damaged, but not insured, hence not assessed. 6.Nature and extent of damage Honda Genset completely burnt in fire Burnt Genset Curtain, partition and false sealing 7. INSURED'S CLAIM The Insured claimed a loss of Rs.1,40,690/- 8.DOCUMENTS VERIFIED FOR INSURABLE INTEREST Rent agreement, data from Kerala LSG site and licence copy 9. ASSESSMENT Plant, Machinery and accessories Rs.4,95,000/- SL Item Qty Rate No Rs. 81,000.00 1 Generator 1 Total Rs. 81,000.00 GST @ 18% Rs. 14,580.00 KFC @ 1% Rs. 810.00 Total Rs. 96,390.00 Rs. 19,278.00 Less dpn @ 20% Rs. 77,112.00 Net amount after dpn Rs. 250.00 Less salvage value Rs. 76,862.00 Total amount SI as per Policy Rs. 495,000.00 Rs. 735,690.00 Total cost of items present at the site as Rs. 565,287.00 mentioned by the insured Rs. 67,305.09 Total cost of items present in the site as mentioned by the Insured less dpn Amount after applying condition of average

,ROHIT REGHUNATH B-Tech, MI ; Insurance Loss Assessor Licence No: SLA / 74737 Date of Expiry: 19th March 2023 Continuation Sheet 3 Furniture, fittings, fixtures and other contents SI- Rs.1,25,000/- SL Description of work No Of Labour Area Rate Amount Ls No labours charge Ceiling work using PVC sheet Rs. 16,800.00 1 and Aluminium channels (405X330Cm) Curtain work on the front Rs. 6,000.00 end (330X300Cm) (incl 20M 2 cloth , 12ft rod and 2 custom clamps, labour charge for fitting ) Total Rs. 22,800.00 Assessed loss Rs. 22,800.00 Rs. 22,800.00 Depreciation Assessed amount Rs. 22,800.00 Rs. 5,700.00 The Fixtures, furnishings were made about 5 Years back. In my opinion, will attracts 25% depreciation. Depreciated cost Rs. 17,100.00 Valuation Sum Insured Rs. 125,000.00 Rs. 150,000.00 Total items present Rs. 14,250.00 Amount applied after applying condition of avg Items Assessed amount Adjusted amount Rs. 103,800.00 Rs. 81,555.09 Excess Rs. 81,555.09 5% of assessed amount minimum of Rs10,000/- Rs. 10,000.00 Summery of Assessment Rs. 71,555.09 Loss after applying condition of average Less Policy Excess Adjusted loss The Net Loss adjusted loss Rs. 71,555 (Rupees Seventy one thousand five hundred and fifty five only) COMMENTS 1. The damages sustained to the machinary and the funiture, fittings/ fixtures could be attributed to the causation of the said accident and appears to be consistent with it. 2. Police report not obtained, informed the insured to submit the same in the insurance office at the earliest. Enclosures : - 1. Policy copy. 2. Estimate for interior work and gen set. 3. Loss Assessment & Summary worksheet 4. Building ownership reciept, rent agreement, licence copy. 5. Photographs. “THIS REPORT IS ISSUED WITHOUT PREJUDICE” ROHIT REGHUNATH