PO THOMAS THARAKAN SAJITHA BHAVAN
KOVOOR ARINALL0OR
SURVEYOR/LOSS ASSESSOR
SLA 35822 EXP 22.01.2026 P.O KOLLAM KERALA
Phone: 9447176450
Mail ID:pottharakan@gmail.com
TO WHOMSOEVERIT MAY CONCERN
REPORT FORTHIRD PARTY PROPERTY DAMAGES
TP VEHICLE KL 07CW 6707
Pursuant to the request from Mr.sALUVARHGESE SAM CHANGAYIL PRSE VILLA
PERINGALA PO KAYAMKULAM the undersigned surveyor had on 10.06.202
inspected the Maruti SWIFT VXI KLO7C W6707 at M/S ARABIAN AUTO
GARRAGE BHARANIKAVU. and my observations are given beloww
It islearnt that on 10.04.24 at about 13.30 hours NEAR MATHOMA CHURCH
MULAVALA ONE CAR KLO2BH8525 with reckless speed hit on the front side of
the TP vehicle KLO7CW6707 causingextensive own damages to theTP vehicle
The KUNDARA police station have raised a case wide FIR No.0649/2024 dated
15.04.2024 against the vehicle no KL02BT 8525
Thisreport is issued for KLO7CW6707 to claim against vehicle NO KLO2BT 8525
ISSUED WITHOUT PREJUDICE
VEHICLE PURTICULARS (TP VEHICLE)
Reg No. KLO7CW6707
Reg. Owner SALU VARGHESE SAM
Date of Reg. 09.11.2008
Chassis No. MA3EKE41S00379873
Engine No. G13BBN462454
THOMAS THARAKO
Surveyc
SLA35S:.
Make/Model SWIFT VXi/2008
Class of Vehicle Motor car
Type of Body SALOON
Tax paid upto 31.01.2029
Seating Capacity
Fuel Used Diesel
Unladen Weight 1000kg
Cubic Capacity 1290
Colour PEALWHITE
KM READING NOT WORKING
DRIVER PARTICULARS
NAME OF DRIVER SHIBU.S
LICENCE NO. KL2319970000202
DATE OF ISSUE 20.01.1977
VALID UP TO 21.02.2033
VEHICLE AUTHORISED TO DRI M/CYCLE LMV
EXTENT OF DAMAGES
FR.BUMPER BROKEN
THOMAS THARAKA!O
SurveyOr
SLA 3582:
FR.GRILL BROKEN
RH&LH HEAD LIGHT BROKEN
FR.HOOD BUCKLED
HOOD HINGES BENT
RH FENDER BUCKLED
RH CHASIS APRONBENT &FOLDED
LH FENDER BUCKLED
LHCHASSIS APRON BENT & FOLDED
FR.CROSSMEMBER &MEMBER HOOD LOCK BUCKLED
FR.RH DOOR ASSY BENT & FOLDED
FR.LH D0OR ASSY BENT & FOLDED
INTER MEDIATE SHAFT BENT
AIR HOSE CUT
RH ENGINE MOUNDING CRACKED
INTERCOLLER CRUSHED
W/SHIELD GLASS BROKEN
RH & LH HEAD LIGHT BROKEN
WIRING HARNESS CUT
RH SUSPENSION ASSY BENT
RH LOWER ARM BENT
RH STABILIZER BAR BENT
RH BRAKE DISC BENT
THOMASTHARAANP.O
Surveyr
SLA 3F
CONDENSOR ASSY CRUSHED
RHSIDE BODY BENT& FOLDED
RH WHEEL HUB BENT
RH DRIVE SHFT BENT
RH DOOR POWER WINDOW ASSY CRUSHED
WIPER TANK BROKEN
RH TYRE ASSY WITH DISC CRUSHED
REAR RH DOOR BENT
FR.BUMPER HOOD,RH DOOR,RH FENDER,LH FENDER,RHSIDE BODY, REAR RH
DOOR,LH DOOR &SALOON TOP TO BE REPAINTED.
ESTIMATE
THE REPAIRERS M/S ARABIN AUTO GARAGE BHARANICAVU HAVE SUBMITTED
ANESTIMATE FOR LABOUR RS 42000 AND PARTS FOR REPLACEMENT RS
130729.00 BASED ON THE DISCUSSIONS WITH THE REPAIRERS THE LOSS IS
WORKED OUT AS BELOW
THOMAS THARAKAN.F.O
$urveyor
SLA35822
MOTORO.D. CLAIM
IN SALU VARGHESE SAM POL CALCULATION SHEET-VER.6 (VMIEDIUMI)
CL.No. VEH.No. KLO70W 6707
EST
SPARES NIL DEPRECIATION (GLASS)
SR.
No NAME OF PARTS
SR. ESTIMATE AMOUNT|
AS PER
BRN
LS ASSESSED GST TOTAL LESS NET
NC AMOUNT BILL
1/GLASS W/SHIELD o AMOUNT % TAX AMOUNT DEPREAMOUNT
2RH WINDOW GLASS 4100 -
4,100 4,100
855 855 855
7OTAL (A) -
4955 4,955 4,955
ISPARES0TO 50 % DEPRECIATION (METAL)
EST
DEPRECIATION APPLICABLE 50.00|%
s.N AMOUNTBLS
o
NAME OF PARTS SR.ESTIMATE
NO
AS PER RN ASSESSED GST TOTAL LESS NET
1| FR.BUMPER AMOUNT BILL AMOUNT TAX AMOUNT DEPRE AMOUNT
2|UPPER GRILL 2800 2,800 1,400 1,400
3LOWER GRILL 570 570 285 285
4RH FENDER 350 350 175 175
5/RH FENDER LINING 1900 1,900 950 950
6|FR.RH DOOR 320 320 160 160
7RH MIRROR 6600 -
6,600 3,300 3,300
8|RH DOOR HINGES 900 900 450 450
9|RH DOOR LATCH 800 -
800 400 400
10]w/sHIELD BEEDING 1700 1,700 850 850
11\RH DOOR GLASS RUNNER 1075 -
1,075 538 538
12\RH WEATHER STRIP 490 490 245
-
290
245
13 RH WINDOW REGULATOR 290 145
1518
145
14 POWER WINDOW SWITCH 1,518 759
15 HORN ASSY 1795
1,795
759
255 898
16| FOG LAMP ASSY 255 128 128
17 RH HEAD LIGHT 1260 1,260 630 630
18]LH HEAD LIGHT 2520 2,520 1,260 1,260
19 RH INDICATOR 2681 2,681 1,341 1,341
20|WIPER TANK
135 135 68 68
21 WIPER TANK PUMP
265 265 133 133
325 325
22wIRING HARNESS 163 163
18415
23|DOOR HANDLE 18,415 9,208 9,208
250 250
24\BRAKE PAD 125 125
1730
25)DRIVE SHAFT 1,730 865 865
6500
26]DASH BOARD STAY 6,500 3,250 3,250
1300 1,300
27|RH LoWER ARM 650 650
1350 1,350
28]STABILIZER BAR 675 675
1470 1,470
TOTAL (B) 735 735
59564 59,564 29,782 29,782
THOAS THARAKANEO
Surveyor
SLA 35322
2
N SALUVARGHESE SAM IVOTORO.D.
POL
CLAIM CALCULATION SHEET-VER.6 (MEDIU)
KLO70W 6707
SPARES 50% DEPRECIATION (PLASTIC ETC) CL.No. VEH.N.
50.00|% C
DEPRECIATION APPLICABLE
S.N
EST AMOUNT BLS|
SR. ESTIMATE AS PER NET
NAME OF PARTS RN ASSESSED GST TOTAL LESS
NO AMOUNT AMOUNT
1/sTABILUZER LINK BILL AMOUNT TAX AMOUNT DEPRE
2 RH STRUT ASSY 500 500 250 250
3/RH SUSPENSKON COH 2680 2,680 1,340 1,340
RH STEERING KNUONE 713 713 357 357
RH SUSPENSION ASSY 1945 1,945 973 973
6]suSPENSION FRAME 1596 1,596 798 798
7 RH HEEL HU¯B 6200 6,200 3,100 3,100
8|RH WHEEL BEARING 528 528 264 264
9|FR. BRAKE DISC 970 970 485 485
10|RH CALIBER ASSY 1260 1,260 630 630
11|INNER BALL JOINT 3057 3,057 1,529 1,529
12TIE ROD END 1509 1,509 755 755
13RH TYRE 2616 2,616 1,308 1,308
14 RH WHEEL RIM 4500 4,500 2,250 2,250
15|RH VWHEEL CAP 1273 1,273 637 637
16}cONDENSOR ASSY 475 475 238 238
17 cOMPRESSOR CLUTCH 5856 5,856 2,928 2,928
18 HOOD 6380 6,380 3,190 3,190
19 w/SHIELD GARNISH 5744 5,744 2,872 2,872
20 FRBUMPER MEMBER 1072 1,072 536 536
21APRON RH SIDE 850 850 425 425
22APRON SDE RH 3406 3,406 1,703 1,703
960
23BRHSIDE SL 960 480 480
404 404
240PAN CENTRE PLLAR 319
202 202
250PANEL SDE BODY OUTER 319 160 160
6515 6,515 3,258 3,258
26
27
28
29
30
31
32
33
34
35
36
37
38
TOTAL (C 61328| 61,328 30,664 30,664
TOTAL PARTS A+B+C Rs. 65,401
LABOUR CHARGES
TAS THARAKAN.PO
Suveyor
SLA35822
iOTOR 0.D. CLAIM CALCULATION SHEET-VER.6 (MEDIUM) KLO70W 6707
IN SALU VARGHESE SAM POL VEH.NO.
CL.No.
GST MULTIPUER 0.00
LABOUR CHARGES OTHERIHAN PAINTING (2)
|No A4OUNiT ASESSED REMARKS)
PARTICULERS
1/BODY SHELL STRIPPING AND COMPLETE PARTS
AMOUNTAS PER ESTIMATE
SETTING 5000
2ENGINE REMOVING SETTING 1000
3]WINDSHIELD GLASSCUTTING PASTING 2200
4|sUSPENSION SETTING 1500
5)STEERING SYSTEM SETTING 1500
6BECTROANLABOUR 2000
7AC GAS CHARGING 1200
8RH APRON CUTTINGWELDING 2500
9IREARUH DOORS LEVEUNG 1000
10'soE BODY UTTG WEDING 2000
11lLH APRON LEVELING 1000
12
13
15|WITHOUT GST |TOWING CHARGE 5000
TOTAL
Rs. Rs. 25,900
ADD GST Rs.
Rs.
NET AMOUNT (X) Rs. Rs. 25,900
PAINTING LABOUR CHARGES(Y) DEP(PAINT.MET) %0 P.MET 0% P.LABOUR 100% GST
ESTIMATE ASSESSED PANEL APPROVED PAINTING PAJNTING
No PARTICULARS AMOUNT DISCOU. MATERIAL LABOUR TOTAL
AMOUNT AMOUNT
1/VEHICLE AS AWHOLE
2EXPECT LH DOORS AND DICKY 18000 18000 13000 18000
3
4
5
6
7
8
10
TOTAL 0 18000| 18000 18000 18000
LESS DEPRECIATION NA
BALANCE AMOUNT 0 18000 18000
GST
OTHER ADJ. IF ANY
NET AMOUNT 18000
TOTAL LABOUR CHARGES ( X+Y) Rs. 43,900
SUMMARY
THOMAS THARAKAN,R0
Surveyor
SLA35322
*,
IN MOTOR O.D. CLAIM
SALU VARGHESE SAM JPOL
PARTS (A) CALCULATIOCL.No.
N SHEET-VER.6(MEDIUM)VEH.No. KLO70W 6707
PARTS (B) 4,955
PARTS (C) 29,782
TOTAL PARTS 30,664
LABOUR CHARGES (X) 65,401
PAINTING CHARGES Y 25,900
TOTAL LABOUR CHARGES 18,000
GROSS AMOUNT( PARTS + 43,900
LESS POUCY EXCESS LABOUR) 1,09,301
LESS SALVAGE
LESS 1,801
|TOTAL DEDUCTION
1,801
NET CLAIM PAYABLE
Rs. 107500
CLAIM SETTLEMENT DETAILS
PARTS NOTE:
65401 BASED ON THE ABOVE ASSESSMENT RS107500.00
LABOUR 43900 (RUPEES ONE LAKH SEVENTY FIVE HUNDRES
GST WILL BE RESONABLE FOR REMAKING THE ABOVE TP VEHICLE
LESS EXCESS
KLO7CW6707 ITS PRE ACCIDENT CONDITION.
LESS SALVAGE
1,801
LESS OTHERS
NET PAYABLE Rs. 1,07,500
HOMAS THAAk.
Survecr
SLA35822
PO THOMAS THARAKAN SAJITHA BHAVAN
SURVEYOR/ LOSS ASSESSOR
SLA35822 EXP
KOVOOR ARINALLOOR P.0
22.01.2026
Mail ID:pottharakan@gmail.com
KOLLAM KERALA
Phone: 9447176450
SUMMARY OF ASSESSMENT
TP VEHICLE KLO7CW6707
TOTAL COST OF PARTS LESS RS 65401.0
DEPRECIATION
TOTAL LABOUR CHARGES RS 43900.00
TOTAL LOSS RS 109301.00
LESS SALVAGE VALUE RS 1801.00
NET LOSS RS 197500.00
BASED ONTHE ABOVE ASSESSMENT Rs 107500.00 (ONE LAKHS
SEVENTY FIVE THOUSAND AMOUNTIS RESONABLE FOR REMAKING TP
VEHICLE KLO3AB 7227 TO ITS PREACCIDENT CONDITION.
THE MARKET VALUE OF THE ABOVE VEVICLE SWIFT VXI 2008 MODEL IS
ONLY 110000.DEDECTING SALAVAGE VALUE RS 25.000. THE LOSS IS
ASSESED AS BELOW
HONAKAi
SLA33322 .PO
RAS THARAKAN:EO :
Surveyor
SLA35822
ASSESSMENT ON TOTAL LOSS BASSIS
MARKET VALUE OF THE VEHICLE 110000
LESS SALVAGE VALUE w)TH RC BOOK
25000.00
NET LOSS 85000.00
DASED ON THE ABOVE ASSESSMENT RS R5000.0o IS THE NET LOSS FoR
THEVEHICLE KLO7CW6707 TO CIAIM AGIST THE VEVICLE NO KL0ZDn
8525
THOMAS TiATAKAN.PO
Surveyor
SLA 35822
.
POTHOMAS THARAKAN
SAJITHA BHAVAN
SURVEYOR/ LOSS ASSESSOR
SLA35822 EXP KOVOOR ARINALLOORP.O
22.01.2026
Mail ID:pottharakan@gmail.com
KOLLAM KERALA
Phone: 9447176450
BILL/RECEIPT
PROFESIONAL FEES FINAL SURVEY Rs 5000.00
CONVEYANCE EXXPENSE 2 VISIT -RS1000.00
PHOTO CHAGES
RS 300.00
TOTAL Rs.6300.00
Received from MR.SALU VAGGHESRE SAM a sum of rupees 6300.00
(SIX THOUSAND THREE HUNDRED ) for assessing the loss for the TP
vehicle KLO7
CW 6707
THOMAS THARAUi.O
Surveyor
SLA 35822
-KLOZCH6707
