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 OFFICE97238 15456-BARODA mvshah2@rediffmail.com OFFICE :9824444179-BHARUCH GSTIN NO.24AHNPS2949A1ZA PAN No.: AHNPS2949A INVOICE NO.1545/20-21 DATE: 28-Nov-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, PLACE OF SUPPLY: GUJARAT Baroda. GUJARAT INDIA STATE OF SUPPLY:GUJARAT PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING, OUR JOB REF.NO. #20110377 INSURED/Vehicle No. : MR.BHANABHAI VASAVA/GJ 16 BN 7784 POLICY NO./Claim no. OG-21-9910-1801-00057360/OC-21-2201-1801-00003394 DATE OF SURVEY : 05-11-2020 PLACE OF SURVEY : AT LUCKY MOTOR VALIA DESCRIPTION OF SERVICE CHARGES AMOUNT PROFESSIONALSURVEY FEES: ASSESSED LOSS RS.29000.00 Rs. 1000.00 CONVEYENCE (TO& FRO): 86 KMS. @ Rs. 7.50 Rs. 645.00 HALTINGALLOWANCE : Rs. 0.00 PHOTOGHRPHS/CD@40/- 1 NOS. @ Rs. 40.00 Rs. 40.00 OTHERS(INCEDENTALIF ANY) Rs. 0.00 SUBTOTALTAXABLE : Rs. 1685.00 HSN/SAC CGST @ 9% Rs. 152.00 CODE TAXES (00440169) SGST @ 9% Rs. 152.00 997162 IGST @ 0% Rs. 0.00 TOTAL AMOUNT WITH TAX - Rs. 1989.00 Amount In Words : ONE THOUSAND NINE HUNDRED EIGHTY NINE ONLY HSN/SAC TAXABLE CENTRAL TAX STATE TAX INTERSTATE TAX CODE VALUE RATE AMOUNT RATE AMOUNT RATE AMOUNT 997162 1685.00 9% 152.00 9% 152.00 0% 0.00 TOTAL TAX Rs. 304.00 THREE HUNDRED FOUR ONLY BANK DETAILS FOR PAYMENT H BANK NAME : BANK OF BARODA BRANCH : AKOTA MINESH V.SHAH IFSCCODE : BARBOAKOTAX (SURVEYOR/LOSS ASSESSOR) SLA LIC.No.SLA 63819/18-21 319-18- MICRCODE 390012021 4L095 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 ---PAGE END---