Licence No. - SLA 74140                                                                                Valid upto --   22.09.2022
                                                  JIGNESH S. THAKKAR
GST No. 24AFWPT8975J3Z5                                                                             PAN No. -      AFWPT8975J
                                                    Surveyor & Loss Assessor
                  232, Shrushti Complex, Above SBI, N. H No.8, Kamrej Char Rasta, Surat.
Mobile No. 9904096492 / Office : 9978696492                                      Email: thakkar97@gmail.com
BANK NAME STATE BANK OF INDIA                                                    A/c No.       37215500008
BRANCH    KAMREJ CHAR RASTA                                                     IFSC CODE SBIN0005149
MICR Code  395002028                                                                   A/c Type     CURRENT
                                                            TAX INVOICE
Bill No.                       405/2020-21/JT                                                             Date : 10-Feb-2021
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 Code : 395 007.
                                  GSTIN - 24AABCB5730G1Z3
Claim No.                                 OC-21-2203-1802-00001112             Date of Accident : 12-Jan-2021
Policy No.                                 OG-20-2250-1802-00000777
Insured's Name                        MR. KANUBHAI B CHAUDHARI.
Vehicle No.                               GJ19AP7981
Make/ Model                            HONDA / ACTIVA

PARTICULARS                                                                                    AMOUNT

                                                     VISIT       KMS         RS
Spot Survey                    No                                                                            0.00
Professional Charges                                                                                     500.00
Conveyance                                                  132        7.50                           990.00
Spot Conveyance                                                                                              0.00
Re-Inspection                                                                                                   0.00
Photo Charges                                                                                                 25.00
Misc. Charges/Toll charges                                                                               0.00
Amount                                                                                                        1515.00
                                                                                CGST           9%             136.35
   GST                      SAC CODE - 997162                  SGST           9%            136.35
                                                                                IGST            0%                0.00

TOTAL                                                                                                        1788.00

In words : ,RuppessOne Thousand Seven Hundred Eighty Eight Only
                               KARY
                        4140
  JIGNESTSSHAKKAR
 Survey&& Loss Assessor

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