Tax Invoice MOHAMMED UVESH .V.MALVAT Invoice No : 888 Surveyor & Loss Assessor (Moter) Lic No SLA73478 Valid Upto August 2023 Dated : 7-Oct-2020 88 Sarani Society_132' Ring Road B/h APMC MARKET Vasna ToInaka Insured Name : ATLAS COPCO Ahmedabad : OC-21-202-1801-00002579 GSTIN/UIN: 24AMHPM9424B1Z9 Claim No Contact : 9898070189- 9925007717 Policy No : OG-21-1934-1801-00003340 E-Mail : uveshmalvat@gmail.com Make and Model : M@ M Motor Vehicle No : GJ06JQ7710 Shipped To Party Billed To Party BAJAJ ALLIANZ GIC LTD BAJAJ ALLIANZ GIC LTD 4TH FLOOR, TURQUOISE BUIL , NEAR 4TH FLOOR, TURQUOISE BUIL ,, NEAR PANCHVATI , CROSSROADS, C,G. ROAD PANCHVATI,CROSSROADS, C,G. ROAD AHMEDABAD 380006 AHMEDABAD 380006 State Name Gujarat, Code : 24 State Name : Gujarat, Code : 24 GSTIN/UIN 24AABCB5730G1Z3 GSTIN/UIN : 24AABCB5730G1Z3 PAN/IT NO PAN/IT No : Place of Supply Gujarat SI Description of Goods HSN/SAC GST Amount No. Rate 1 01.01 Profesnal Fees 997162 18% 2,500.00 2 C GST 225.00 3 S GST 225.00 Total 2,950.00 Amount Chargeable (in words) E.&0.E Indian Rupees Two Thousand Nine Hundred Fifty Only HSN/SAC Taxable Central Tax State Tax Total Value Rate Amount Rate Amount Tax Amount 997162 2,500.00 9% 225.00 9% 225.00 450.00 Total 2,500.00 225.00 225.00 450.00 Tax Amount (in words) : Indian Rupees Four Hundred Fifty Only Company's PAN : AMHPM9424B Declaration Company's Bank Details We declare that this invoice shows the actual price of the Bank Name : 06.01 ICICI BANK goods described and that all particulars are true and A/c No. : 034401511645 correct. Branch & IFS Code : Vasna Ahmedabad &JGIG08Q0344 Customer's Seal and Signature for MOHAMMED UVE$M u MALVAT SyA73472 ANMEDAAD AuthonseaSignatofy SUBJECT TO AHMEDABAD JURISDICTION This is a Computer Generated Invoice ---PAGE END---