TAX INVOICE MINESH VALLABHDAS SHAH LICENCE NO.-SLA/63819 Surveyor-Loss Assessors-Valuer-Investigator EXP.DATE:26/04/2021 FIRE-MOTOR-MARINE(C)-ENGINEERING-MISC. IIISLA MEMBERSHIP NO.: F/W/01143 CONTACT :98240 32094 Email: mvshah2@gmail.com OFFICE:9723815456-BARODA mvshah2@rediffmail.com OFFICE:9824444179-BHARUCH GSTIN NO.: 24AHNPS2949A1ZA PAN No.:AHNPS2949A INVOICENO. 1313/20-21 DATE: 23-Sep-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 OFSUPPLY:GUJARAT Baroda. GUJARAT INDIA STATE OF SUPPLYGUJARAT PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING, OURJOB REF.NO. #20080190 INSURED/Vehicle No. MR.SIVRAM ILASARIYA/GJ 16 W 0278 POLICY NO./Claim no. OG-20-2225-1803-00001158/OC-21-2201-1803-00000106 DATE OF SURVEY 24/08/2020 (Spot) 25/08/2020 onwards Final PLACE OF SURVEY Spot At ANK GIDC,SAI BODY WORKS ANKLESHWAR DESCRIPTION OF SERVICE CHARGES AMOUNT PROFESSIONALSURVEY FEES: SPOT+ASSESSED LOSS Rs.30500.00 Rs.. 1750.00 CONVEYENCE(TO&FRO): 2 KMS. @ Rs. 450.00 Rs. 900.00 HALTING ALLOWANCE: (Spot + Final ) Rs. 0.00 PHOTOGHRPHS/CD@40/- 1 NOS. @ Rs. 40.00 Rs. 40.00 OTHERS(INCEDENTALIF ANY): Rs. 0.00 SUBTOTAL TAXABLE : Rs. 2690.00 HSN/SAC CGST @ 9% Rs. 242.00 CODE TAXES (00440169) SGST @ 9% Rs. 242.00 997162 IGST @ 0% Rs. 0.00 TOTALAMOUNT WITH TAX- Rs. 3174.00 Amount In Words : THREE THOUSAND ONE HUNDRED SEVENTY FOUR ONLY HSN/SAC TAXABLE CENTRAL TAX STATE TAX INTERSTATE TAX CODE VALUE RATE AMOUNT RATE AMOUNT RATE AMOUNT 997162 2690.00 9% 242.00 9% 242.00 0% 0.00 TOTAL TAX RS. 484.00 FOUR HUNDRED EIGHTY FOUR ONLY BANK DETAILS FOR PAYMENT BANK NAME : BANK OF BARODA amnlel BRANCH : AKOTA MINESH V.SHAH LdA IFSCCODE BARBOAKOTAX (SURVEYOR/LOSS ASSESSOR) SLA LIC.No.SLA 63819/18-21 819-18- MICR CODE 390012021 5075 CURRENTA/C.NO. 06760200000417 Advance receipt. MINESH V.SHAH E&O.E-Subject to Vadodara Jurisdiction (PROPRIETOR) ADDRESS : *101, Kanha Appt.,52,Purshottam Nagar,Urmi Cross Road., Akota,Vadodara -390020 ---PAGE END---