K.RAZENDHIRANE B.E., B. SC., FIIISLA., F.I.L.A, WISLA Insurance Surveyour/Loss Assessor Member Ship "Fellow" - FS/03749 SLA 35136 Validity :02.12.2022 Off:11A,Vallalar Road,Kamaraj Nagar,Pondicherry -605011 Res: No.2, Mariamman Koil Street, Kurumbapet, Pondicherry -605009. e-mail : razendhirane@gmail.com, Mobile No:9842333589,9629933589,Tel No:0413-4207797. PAN No:AETPR1940K GST No: 34AETPR1940K1Z0 TAX INVOICE for the SERVICE PROVIDED in duplicate Reverse Charge : Place of survey Villupuram Invoice No.: 104/Bajaj/2020-21 Invoice Date : 07.07.2020 Details of Receiver ( Billed to:-- Name M/s. Bajaj Allianz General Insurance Co Ltd Address Chennai GSTIN 33AABCB5730G1Z4 Policy Number OG-20-1501-1811-00000264 Claim Motor OD Claims Claim Number OC-21-1501-1811-00000003 Insured Name Mrs.M.Mallika Name of Product/HSN/ Taxable Total S.NoService SAC Amount Value CGST .SGST IGST amount Rate Amount Rate Amoun Rate Amount Insurance Claims adjustment 1 services 997162 1690.00 0% 0.00 0% 0.00 18% 304.20 Total amount 1994.20 No Details 1 Professional Fees 1000.00 2 Photo Charges CD 50.00 2 Conveyance Charges 80 km by car 640.00 3 Batta /Halting charge 0.00 4 Postal/Misc Charges Total 1690.00 Total Invoice Amount in Words: Total Amount Before Tax 1690.00 ADD:CGST 9 0.00 ADD:SGST 9 0.00 Bank Details : ADD:IGST 18 304.20 Bank Account No : 005601024553 Tax Amount : GST 1994.20 Bank Branch IFSC : ICICO000056 Name of the Account K.RAZENDHIRANE GST Payable on Reverse Charge : Branch Name Mission Street, Pondicherry Type Saving J K.RAZENDHIRANE, SLANS K.RAZENDHIANE,B.E.B.SC. 35Y36 3 SURVEYOR/LOSSASSESSOR ---PAGE END---