TAX INVOICE
MINESH VALLABHDAS SHAH                                      LICENCE NO. -SLA/63819
Surveyor-Loss Assessors-Valuer-Investigator            EXP.DATE : 26/04/2021
MOTOR-MARINE(C)-ENGINEERING                                            IIISLA MEMBERSHIP NO.: F/W/01143
CONTACT :9824032094 /9824444179                            Email: mvshah2@gmail.com
OFFICE : 0265-2325523 - BARODA                                                      mvshah2@rediffmail.com
OFFICE :02642-262524 -BHARUCH
GSTIN NO. 24AHNPS2949A1ZA                                      PAN No.: AHNPS2949A

  INVOICE NO.:   1036/20-21                                                    DATE :    26-May-20
BILLED TO,
M/s. Bajaj Allianz General Insurance Co. Ltd                  BUY.GSTIN NO          24AABCB5730G1Z3
4th Floor, Atlantis Hetitage, B/h Atlantis Heights          PAN No.:                 AABCB5730G
Opp. Swagat petrol pump, Sarabhai Main Road,           PLACE OF SUPPLY :GUJARAT
Baroda.                        GUJARAT                  INDIA           STATE OF SUPPLY:GUJARAT
PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING,
OURJOB REF.NO.                                  #20050026
INSURED/Vehicle No.                          MRS.RAMILABEN AHIR/GJ16 AU 7776
POLICY NO./Claim no.                         OG-20-2225-1812-00000034 / OC-21-2201-1812-00000002
DATE OF SURVEY                              :   18-05-2020
PLACE OF SURVEY                                  AT FARUK AUTO,BHARUCH
DESCRIPTION OF SERVICE CHARGES                                                                             AMOUNT
PROFESSIONALSURVEY FEES:     Gross Assessed Rs.34000.00                              Rs.               1000.00
CONVEYENCE (TO & FRO):                   1       KMS.  @   Rs.          450.00         Rs.                 450.00
HALTING ALLOWANCE:                                                                                         Rs.                     0.00
PHOTOGHRPHS / CD @ 40/-:              1       NOS.  @   Rs.           40.00           Rs.                   40.00
OTHERS(INCEDENTAL IF ANY) :                                                                               Rs.                     0.00
SUB TOTAL TAXABLE :                                                                                           Rs.               1490.00
      HSN/SAC                                                                         CGST     @         9%  Rs.                  134.00
         CODE:                         TAXES (00440169)                     SGST     @         9%  Rs.                  134.00
        997162                                                                           IGST      @         0%  Rs.                     0.00
                                                                                 TOTAL AMOUNT WITH TAX     Rs.                1758.00
    Amount In Words :     ONE THOUSAND SEVEN HUNDRED FIFTY-EIGHT ONLY.
      HSN/SAC            TAXABLE             CENTRAL TAX                STATE TAX                INTERSTATE TAX
         CODE                  VALUE             RATE      AMOUNT       RATE        AMOUNT        RATE        AMOUNT
        997162                1490.00             9%         134.00         9%          134.00          0%            0.00
  TOTAL TAX Rs.            268.00        TWO HUNDRED SIXTY-EIGHT ONLY
BANK DETAILS FOR PAYMENT
BANK NAME :       BANK OF BARODA
BRANCH       :      AKOTA
                                                                              .                               MINESH V.SHAH
IFSC CODE    :      BARBOAKOTAX                                 PSLA                  (SURVEYOR / LOSS ASSESSOR)
                                                                                                              LIC.No.SLA 63819/18-21.
MICR CODE           390012021
CURRENT A/C.NO.:06760200000417                      Advamoss-Beeipt.                        MINESH V.SHAH
E& O.E-Subject to Vadodara Jurisdiction                                                                   (PROPRIETOR)
ADDRESS : * 101, Kanha Appt.,52, Purshottam Nagar, Urmi Cross Road., Akota, Vadodara -390020

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