RAKESH TRIVEDI
    SURVEYOR/ LOSS ASSESSOR                                                                                            Mobile no-9425180732 &
    S.L.A.-16997 VALID UPTO 28/09/2023                                                                                                 9826564069
    Category- FELLOW- Motor, Engg,Misc & Fire                                                 MIG(DIx)-1, M P Housing Board Colony
    PAN : ACWPT4121D                                                                                       Near New Bus Stand SHAHADOL (MP)
    GST No.: 23ACWPT4121D1ZM                                                                                        SHAHADOL (MP) Pin 484001
    Bank of Baroda A/C No-12930100005566                                                                      email.: rakeshsdl@yahoo.co.in
    IFCS Code Number-BARBOSOHAGP
    MICR Code Number-484012001
   INVOICE NO. :       RT/7561                                                                                                                     Date: 11/01/2021
                                                                           TAX CREDIT INVOICE
   BILLED TO,
   THE CLAIMS MANAGER                                                                       BUY. GSTIN NO    23AABCB5730G1Z5
   Bajaj Allianz General Insurance Co Ltd, BHOPAL                                    PAN No. :            AABCB5730G
   BHOPAL (MP)                                                                                     PLACE OF SUPPLYBHOPAL (MP)
   BHOPAL (MP)                    M P                         INDIA                       STATE OF SUPPLYM P
  PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING.
   Vehile Number                                          MP18CA0395
  INSURED                                                   MR ALOK SINGH
  POLICY NO.                                               OG-21-3373-1801-00000073
  Claim Number                                           OC-21-2301-1801-00000847
  DATE OF SURVEY                                        10/11/2020-
  PLACE OF SURVEY                                      M/s. Gupta Automobiles, Umariya (MP)
  DESCRIPTION OF SERVICE CHARGES                                                                                                    AMOUNT
  PROFESSIONAL SURVEY FEES         Assessed Amount                    Rs.                   40623               Rs.                         1250.00
  CONVEYENCE: By Car                           150         KMS.       @      Rs.              7.50               Rs.                         1125.00
  LOCAL PETROL RATE                             71.71        /Its
                             Shahdol to UMARIYA (MP)& Back By Car MP18CA6069
 CONVEYANCE: LOCAL AT SDL                                                                                                     Rs.                              0.00
 HALTING ALLOWANCE                             Per day @750/-                                                           Rs.                              0.00
 PHOTOGHRPHS :                                     0           Nos        @      Rs.             40.00               Rs.                              0.00

OTHERS :                                                                                                                               Rs.                              0.00
                                                    SUB TOTAL TAXABLE                                                            Rs.                        2375.00
       HSN / SAC                                                                             CGST     @            9%        Rs.                          214.00
         CODE :        TAXES (00440169) GST No.: 23ACWPT4121D1ZM      SGST     @            9%        Rs.                          214.00
         997162                                                                               IGST      @             0%        Rs.                              0.00
                                                                                              TOTAL AMOUNT WITH TAX -         Rs.                        2803.00
        Amount In Words :         RS. TWO THOUSAND EIGHT HUNDRED THREE ONLY.
       HSN/ SAC           TAXABLE                  CENTRAL TAX                         STATE TAX                           INTERSTATE TAX
         CODE               VALUE               RATE            AMOUNT         RATE           AMOUNT             RATE                AMOUNT
        997162              2375.00               9%               214.00           9%            214.00               0%                   0.00
   TOTAL TAX RS.          428.00      RS. FOUR HUNDRED TWENTY EIGHT ONLY.
                                                                                                                                                                                     9
                                                                                                                                                                      u
                                                                                                                                                                 RAKESH TRIVEDI
                                                                                                                                      3 Licence No.
                                                                                                                                                 SURVEYPR/LOSS ASSESSOR
E & O.E - Subject to Shahdol (MP) Jurisdiction.                                                                                 16907     1a
                                                                                                                                     0

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