Professional Documents
Culture Documents
#: PCA/M/201245
27th October 2010
Dear Sir,
Kind Attn: Mr. Rajesh J. Parekh
Re: Loss and damage by fire on 25th October 2010 at about 2.00 p.m. to the stocks of
Zenith Packaging Industries located at Plot No. W-170(B), MIDC Industrial Area, Taloja,
Raigad.
We refer to your above claim and to our visit to your factory at Taloja on 26 th October 2010.
During the visit we observe the damages and held discussions with you. We had collected the
information/documents that were provided to us. Now to proceed further with the processing
of your claim, please provide us the following information/documents,
1. Copy of claim form duly filled in & signed.
2. A detailed statement describing the Occurrence. Please describe the origin of fire, its
detection and spread, fire fighting efforts made and control of the fire, with all
time factors in proper sequence. Please also mention the time of arrival and departure of
fire brigade tender, who attended the fire, and also the place from where they came. Any
difficulties faced in fighting the fire may also be brought out clearly.
3. Your opinion about cause of fire / loss.
4. Copy of FIR.
5. Copy of Panchnama.
6. Copy of fire brigade report.
7. Copy of news paper cutting (if any)
8. Claim bill on your letter head (i.e. type of product, qty., amount, etc.) along with all
supporting documents such as invoices, payment proofs, challans, etc.
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14. Details to arrive at the quantity claimed by you for the affected / damaged raw
material, WIP and finished goods.
15. Copy of stocks register (inward / outward).
16. Copies of the Excise Returns of Stocks submitted by you to Excise Department
between 01.04.10 and date of fire.
17. Certificate from the Excise department giving the item wise quantities & values of
stocks lying in the factory at the time of fire.
18. Copies of the VAT record for the period 01.04.10 till date of loss, duly certified by
VAT Authorities.
19. For semi-finished and finished stocks please provide us the copy of purchase order,
job cards, copies of delivery challans/ bills etc.
Thanking you.
Yours sincerely,
for Puri Crawford & Associates India Pvt. Ltd.
A. N. Maurya
(General Manager)
Cc: Bajaj Allianz General Insurance Co. Ltd. Kind Attn. – Mr. Amol Salvi