SAP INSURANCE SURVEYORS & L A PVT.LTD.

206,BINORI AMBIT,NEXT TO JAIN TEMPLE,OPP NEW YORK TOWER,S G ROAD,THALTEJ,
AHMEDABAD.380 059.PHONE (O) 40034803,E Mail : sapsurveyors05@gmail.com
Surveyor,Loss Assessor & Valuer.                             Lic.No.SLA 72495,Dt. of Exp.13-09-2023
AJAY P.SHARMA                                                      PARAG D.SHAH
D.A.E.                                                                       D.A.E.
Surveyor,Loss Assessor & Valuer.                             Surveyor,Loss Assessor & Valuer.
Lic.No.SLA 17753,Dt.of Exp.01-02-2021                  Lic.No.SLA 25959,Dt. of Exp.07-11-2022
Mobile 98250 65858                                                  Mobile:98250 68799
PAN No :AAICS9971M                TAX INVOICE        GSTIN :24AAICS9971M1ZJ
To,
Bajaj Allianz General Insurance Co. Ltd.,                  Invoice No.          SAP/0368/20
IV th Floor Turquoise Building,                                   Invoice Date        31/10/2020
Panchvati Cross Roads,C.G.Road,                            Policy No.            OG-20-9910-1801-00212632
Ahmedabad 380006.                                                  Claim No.             OC-21-2202-1801-00005365
GSTIN :24AABCB5730G1Z3                                    Insured                Mrs.Shruchi Siddharth Nayak.
State : GujaratCode : 24                                         Make & Regn.No.M Alto Lxi/ 16      GJ-24-AA-5015
Sr.        Description of                            Taxable           CGST                  SGST
No.   Services Provided    SAC Code     Value      Rate  Amount  Rate  Amount  Total Amount
  1  Survey Fees.                       997162       750.00     9          67.50     9          67.50               885.00
  2  Local Expenses-02 Visi     997162        700.00     9          63.00     9          63.00               826.00
  3  Travel Expenses.                997162                        9                         9
  4  Out Station Expenses.         997162                        9                         9
  5  Photograph Expenses.        997162                        9                         9
  6  Reinspection Fees.              997162                        9                         9
  7  Local Expenses.                  997162                        9                         9
  8  Photograph Expenses.        997162                        9                         9
            Total Value                                     1450.00                130.50                 130.50             1711.00
   Total Value (in Words)One Thousand Seven Hundred Eleven Only.
Bank Details :                                                                            Total Amount Before Tax             1450.00
Name : HDFC Bank Ltd                                                                                 Add:CGST                130.50
A/C No :00482560002667                                                                             Add :SGST               130.50
RTGS/NEFTIFSC:HDFC0000048                                                     Total Tax Amount               261.00
                                                                                                     Total Amount After Tax              1711.00
                                                                                                   GST on Reverse Charge
                                                                          For,SAP INSURANCE SURVEYORS & L A P.LTD.

                                                     LICNo.
                                                   SLA 72495
                                                                                           AUTHORISED SIGNATORY

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