Dhimant R. Shah 204, Amrut Com. Center, Sardarnagar Main Original for Road, Rajkot -360 001 Receipient Tel: +91 281 2464015 PAN NO.:AKNPS3659J GSTIN: 24AKNPS3659J1ZJ Tax Invoice Invoice No: SDR-201920-1737 Policy no.: 0G-21-2202-1803-0000-1025 Invoice date: 18-08-2020 Vehicle number: GJ-11-X-9801 Estimate Amount : 134500 Insured Name: RUPESHBHAI J.PARMAR State: Gujarat Code 24 Claim no. : 0C-21-2204-1803-00000068 Bill to Party Ship to Party Name: Bajaj Allianz General Insurance Company Ltd. Name: Bajaj Allianz General Insurance Company Ltd. Address:402-408, 4th floor, Turquoise, 4th FLOOR , C G ROAD, Panchwati Address: 402-408, 4th floor, Turquoise, 4th FLOOR , C G circle, Ahemdabad, 380006 ROAD, Panchwati circle, Ahemdabad, 380006 GSTIN: 24AABCB5730G1Z3 GSTIN: 24AABCB5730G1Z3 State: Gujarat Code 24 State: Gujarat Code 24 s. CGST SGST Product Description SAC code UOMQty Rate Amount DiscountTaxable Value Total No. Rate Amount Rate Amount 1Survey Fee 997162 1 1500 1500 0 1500 9 135 9| 135| 1770 2[Local Expance 997162 0 0 0 0 0 9 0 9 0 0 3Outstation Allowance 997162 1 2100 2100 0 2100 9 189 9 189 2478 4Spot Survey Fee 997162 0 0 0 o 0 9 0 9 0 0 5Traveling Expenses: 997162 1| 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 6|CD EXPANCE 9972162 1 50 50 o 50| 9 4.5 9 4.5| 59 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 Total 4 3650 o 3650 328.5 328.5 4307 Total Invoice amount in words Total Amount before Tax 3650 Add: CGST 328.5 Add: SGST 328.5 FOUR THOUSAND THREE HUNDRED SEVEN ONLY Total Tax Amount 657 Total Amount after Tax: 4307 Bank Details GST on Reverse Charge 0 Bank A/C: ICICI BANK LTD. eritified that the particulars given above are true and corre Bank IFSC:ICIC0000153 Dhimant R. Shah A/C NO.: 015305001007 HIMANT SURVEY DONE AT PRABHAT MOTORS,KESHOD 280KM X 7.5 =1960 ---PAGE END---