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 OFFICE9723815456-BARODA mvshah2@rediffmail.com OFFICE :9824444179-BHARUCH GSTINNO.24AHNPS2949A1ZA PAN No.:AHNPS2949A INVOICE NO. 1897/20-21 DATE: 26-Mar-21 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. #21030681 INSURED/Vehicle No. MR ASIFKHAA PATHAN/GJ 16 X 9391 POLICY NO./Claim no. OG-21-2225-1803-00002175 /OC-21-2203-1803-00000418 DATE OF LOSS/DATE OF SURVEY 23-03-2021 PLACE OF SURVEY AT KGN REPAIRING PALEJ DESCRIPTION OF SERVICE CHARGES AMOUNT PROFESSIONALSURVEY FEES: ASSESSED LOSS Rs.150000.00 Rs. 2500.00 CONVEYENCE(TO&FRO): 1 KMS. @ Rs. 450.00 Rs. 450.00 HALTING ALLOWANCE : Rs. 0.00 PHOTOGHRPHS/CD @40/-: 1 NOS. @ Rs. 40.00 Rs. 40.00 OTHERS(INCEDENTALIF ANY): Rs. 0.00 SUB TOTALTAXABLE : Rs. 2990.00 HSN/SAC CGST @ 9% Rs. 269.00 CODE: TAXES (00440169) SGST @ 9% Rs. 269.00 997162 IGST @ 0% Rs. 0.00 TOTALAMOUNT WITH TAX - Rs. 3528.00 Amount In Words : THREE THOUSAND FIVE HUNDRED TWENTY EIGHT ONLY HSN/SAC TAXABLE CENTRAL TAX STATE TAX INTERSTATE TAX CODE VALUE RATE AMOUNT RATE AMOUNT RATE AMOUNT 997162 2990.00 9% 269.00 9% 269.00 0% 0.00 TOTAL TAX RS. 538.00 FIVE HUNDRED THIRTY EIGHT ONLY BANK DETAILS FOR PAYMENT BANK NAME : BANK OF BARODA BRANCH : AKOTA MINESH V.SHAH IFSCCODE : BARBOAKOTAX (SURVEYOR/LOSS ASSESSOR) LIC.No.SLA 63819/18-21 MICR CODE 390012021 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---