"Original For Recipient"
Priority Insurance Surveyors & loss Assessors Pvt Ltd
202-203, 2nd Floor, Abhishree Adroit, Nr. Gwaliya Sweets, Mansi                                                            PRIORITY
Cross Road, Vastrapur, Ahmedabad, Gujarat -- 380015
Phone #: +91 7940029357
Email : accounts@prioritysurveyors.co.in
                                                                          Tax Invoice
To,                                                                                                                     Invoice No  : 3111-2011-0066
Bajaj Allianz General Insurance Company Ltd                                                     Invoice Date : 12/11/2020
4nd Floor ,Turquoise ,Near Panchvati Circle, CG Road
Ellisbridge, Ahmedabad.

State       : Gujarat ( Code - 24 )
GSTIN No : 24AABCB5730G1Z3
Place of Supply : Gujarat
Insured                       Alpeshbhai Ganpatbhai                 Vehicle Number           GJ-02-VV-3221
Policy #                      OG-20-2202-1803-00029659          Nature Of Loss            Own Damage
Claim #                      OC-21-2202-1803-00000526          Type of Vehicle           Truck
  SR. NO.                             DESCRIPTION                                QTY.         UNIT         RATE         AMOUNT
      1      Survey Fees                                                                 1            Each        1500.00                1500.00
      2      Local Conveyance Charges - 1st Visit                              1            Each         250.00                  250.00
                                                                                                              Sub Total                                  1750.00
                                                                                                              CGST @    9.00%                      157.50
                                                                                                              SGST @    9.00%                      157.50
                                                                                                              Grand Total                              2065.00
                                                                                                             Say                                              2065
                                                      INR : TWO THOUSAND SIXTY FIVE ONLY

E. and O.E.                                                                            Bank Details
Subject to Ahmedabad Jurisdiction                                        Bank Name      : HDFC Bank Ltd
GSTIN No                          : 24AAECP6441K1ZB                    A/C No            : 00692560008630
HSN/SAC Code                  : 997169                                      IFSC Code       : HDFC0000069
PAN No                              : AAECP6441K                             Micro Code      : 380240005
Survey License No               : 72461 / 2018-2021                       Branch            : Ashram Road, Ahmedabad
Corporate Identity Number   : U74120GJ2008PTC053700
For Priority Insurance Surveyors & Loss Assessors Pvt. Ltd


Authorized Sjg natory
                   GIT

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