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 :97238 15456-BARODA                                                         mvshah2@rediffmail.com
OFFICE : 98244 44179 -BHARUCH
GSTIN NO.24AHNPS2949A1ZA                                      PAN No.: AHNPS2949A

  INVOICENO.  1373/20-21                                                    DATE:     13-Oct-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,           PLACEOFSUPPLY:   GUJARAT
Baroda.                        GUJARAT                   INDIA           STATE OF SUPPLY:  GUJARAT
PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING,
OUR JOB REF.NO.                                  #20070135
INSURED/Vehicle No.                           MR.KISHANLAL SHARMA/GJ 16 Z 7414
POLICY NO./Claim no.                          OG-20-2225-1803-00000712 /OC-21-2201-1803-00000055
DATE OF SURVEY                              :    14/07/2020 ONWARDS
PLACE OF SURVEY                                  AT AKHATAR WELDING ANKLESHWAR
DESCRIPTION OF SERVICE CHARGES                                                                              AMOUNT
PROFESSIONALSURVEY FEES:     ASSESSED LOSS Rs.67500.00                              Rs.               1500.00
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.               1990.00
      HSN/SAC                                                                         CGST     @         9%  Rs.                  179.00
         CODE                         TAXES (00440169)                     SGST     @         9%  Rs.                  179.00
        997162                                                                           IGST      @         0%  Rs.                      0.00
                                                                                  TOTALAMOUNTWITH TAX-   Rs.                2348.00
    Amount In Words :    TWO THOUSAND THREE HUNDRED FORTY EIGHT ONLY
      HSN/SAC            TAXABLE             CENTRAL TAX                STATE TAX                INTERSTATE TAX
         CODE                 VALUE             RATE      AMOUNT       RATE        AMOUNT        RATE        AMOUNT
        997162                1990.00             9%         179.00         9%          179.00          0%           0.00
  TOTAL TAX RS.           358.00        THREE HUNDRED FIFTY EIGHT ONLY
BANK DETAILS FOR PAYMENT                                       V.
BANK NAME :       BANK OF BARODA                                                       O
BRANCH       :      AKOTA                                                                                                                  HIV.SH
                                                                                                                MINESH V.SHAH
IFSC CODE    :      BARBOAKOTAX                                                           (SURVEYOR / LOSS ASSESSOR)
                                                                                                                                                          SLA
                                                                                                                LIC. No. SLA 63819/18-21           918
MICR CODE           390012021                                                                                                            LOSS
CURRENT A/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

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