"Original For Recipient"
Priority Insurance Surveyors & loss Assessors Pvt Ltd
202-203, 2nd Floor, Abhishree Adroit, Nr. Gwaliya Sweets, Mansi                                                           PRIORITY
Cross Road, Vastrapur, Ahmedabad, Gujarat -- 380015
Phone #:+91 7940029357
Email : accounts@prioritysurveyors.co.in
                                                                          Tax Invoice
To,                                                                                                                   Invoice No : 3111-2012-0112
Bajaj Allianz General Insurance Company Ltd                                                    Invoice Date:21/12/2020
4nd Floor,Turquoise ,Near Panchvati Circle, CG Road
,Ellisbridge, Ahmedabad.

State       : Gujarat (Code -24)
GSTIN No : 24AABCB5730G1Z3
Place of Supply : Gujarat
Insured                       Riyazkhan Mukhtarkhan Pathan     Vehicle Number           GJ-01-DZ-1479
Policy #                      OG-21-2202-1803-00002628         Nature Of Loss            Own Damage
Claim #                      OC-21-2202-1803-00000613         Type of Vehicle           Truck
 SR.NO.                             DESCRIPTION                               QTY.         UNIT         RATE         AMOUNT
      1      Survey Fees                                                                 1           Each        1000.00               1000.00
      2      Local Conveyance Charges - 1st Visit                              1           Each         250.00                 250.00
                                                                                                             Sub Total                                 1250.00
                                                                                                             CGST @    9.00%                      112.50
                                                                                                            SGST @    9.00%                      112.50
                                                                                                             Grand Total                              1475.00
                                                                                                            Say                                             1475
                                      INR : ONE THOUSAND FOUR HUNDRED SEVENTY FIVE ONLY

E. and O.E.                                                                            Bank Details
Subject to Ahmedabad Jurisdiction                                       Bank Name      : HDFC Bank Ltd
GSTIN No                          : 24AAECP6441K1ZB                    A/C No           00692560008630
HSN/SAC Code                   997169                                      IFSC Code      : HDFC0000069
PAN No                             : AAECP6441K                             Micro Code      380240005
Survey License No              72461/2018-2021                       Branch            : Ashram Road, Ahmedabad
Corporate Identity Number   : U74120GJ2008PTC053700



Authqrizea   igratory

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