SLA 74140                                                                   Valid upto -  22.09.2022
                                             JIGNESH S.THAKKAR
     3ST No 24AFWPT8975J3Z5                                                                PAN NO.     AFWPT8975J
                                               Surveyor & Loss Assessor
                   232Shrushti ComplexAbove SBI,N.HNo.8Kamrej Char Rasta,Surat
    Mobile No.9904096492/ Office 9978696492                               Email: thakkar97@gmail.com
    BANK NAME STATE BANK OF INDIA                                           A/cNo     372150008
   BRANCH KAMREJ CHAR RASTA                                           IFSC CODE SBIN0005149
   MICR Code395002028                                                       A/c Type   CURRENT
                                                      TAX INVOICE
   Bill No.                   273/2020-21/JT                                                    Date:  1-Dec-2020
   Insurer                   Bajaj Allianz General Ins.Co.Ltd
                               MZ 30-37,Upper Ground Floor,Megh Mayur Plaza,Near HDFC Bank, Athwalines,
                               Parle Point,Surat,Gujarat,India. Pin Code395 007
                               GSTIN24AABCB5730G1Z3
   Claim No.                            OC-21-2203-1843-00000037           Date of Accident:    02-Oct-20
  Policy No.                            OG-19-2203-1843-00000639
   Insured's Name                    Mr JUGALBHAI JAMBUBHAI CHAUDHARI
  Vehicle No.                          GJ26R3586
  Make/Model                        BAJAJ/PULSAR NS 200

  PARTICULARS                                                                         AMOUNT
                                               VISIT      KMS       RS
 Spot Survey                 No                                                                   0.00
 Professional Charges                                                                          750.00
 Conveyance                                1         168       7.00                      1176.00
Spot Conveyance                                                                                   0.00
Re-Inspection                                                                                       0.00
Photo Charges                                                                                     25.00
Misc.Charges                                                                                       0.00
 Amount                                                                                           1951.00
                                                                       CGST          9%           175.59
   GST                  SAC CODE-997162               SGST          9%           175.59
                                                                      IGST          0%              0.00
TOTAL                                                                                            2302.00

In wgrasRuppess Two Thousand Three Hundred Two Only
      S7140
JIGNESH S.THAKKAR

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