GST No. 09ACVPD6053B1ZM                                                                                           State Uttar Pradesh
                                                                             TAX INVOICE
      PAN. ACVPD6053B                                                                                                    Code 09
                                                             SANJAY DWIVEDI
                                                                       Surveyor & Loss Assesor
                                                   License No. : 36742 Valid Upto : 29th April 2023
                                                              B-52, Ganga Nagar, Mawana Road, Meerut (UP)
                                              Ph. : 0121-4033709, 9837109331 Email : dwivedi_sanjay11@yahoo.co.in
  Invoice No. 6317/2020-2021                  Date      02-11-2020
                                                                                                                     Policy No.          OG-21-4332-1802-00000182
                                                                                                                     Claim No.          OC-21-1103-1802-00002040
BAJAJ ALLIANZ GENERAL INS. CO. LTD
                                                                                                                     Insured             RAHUL
Block No 04, 7 Th Floor,DLF Tower 15 Shivaji Marg New Delhi
                                                                                                                     Vehicle No.        UP 14 DN 7683
                                                                                                                    Make                SPLENDOR
                                                                                                                     Date of Survey    21-10-2020
                                                                                                                     Place of Supply  Uttar Pradesh
 GST No. : 07AABCB5730G1ZZ
State : Delhi Code : 07                                                                               Estimated Amt.Rs. 25000.00
                                                                                                                     Assessed Amt. Rs. 18871.00
                                                                   HSN I SAC        Amout[SGST      SGST|[CGST|     CGST  IGST       IGST      Total
S.No.  Particulars of Services
                                                                   Code                           Rate|   Amount  Rate   Amount   Rate    Amount|    Amount
 1.    Final Survey Fee                                  997162                550.00   0.00         0.00   0.00         0.00  18.00        99.00     649.00
 2.     Final Survey Conveyance                       997162                960.00   0.00         0.00   0.00         0.00  18.00       172.80     1132.80













                                                                      Total          1510.00                 0.00[                 0.00              271.80|    1781.80
Amount in Words : FRupees One Thousand Seven Hundred Eighty Two Only
  OUT STN CONVAINCE FROM MEERUT TO MUZAFAARNAGAR & BACK 120KM @ RS 8/KM =960.00

 Bank A/C Detail :
 A/c No. 4038000100039677 [PNB, Ganga Nagar, Mawana Road, Meerut] IFSC : PUNB0403800
A/c No. 50100051796221 [HDFC bank Ltd., 381 W.K.Road, Meerut] IFSC : HDFC0000285                                    SANJAY DWIVEDI

---PAGE END---