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 OFFICE:9723815456-BARODA mvshah2@rediffmail.com OFFICE :9824444179-BHARUCH GSTIN NO.24AHNPS2949A1ZA PAN No.: AHNPS2949A INVOICENO. 1812/20-21 DATE: 27-Feb-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. #21025113 INSURED/Vehicle No. MR.BHUPENDRA PATEL/GJ 06 AZ5193 POLICY NO./Claim no. OG-21-2201-1803-00002351 /OC-21-2201-1803-00000327 DATE OF SURVEY 24-02-2021 PLACE OF SURVEY AT SHREE SHYAM TRUCK VADODARA DESCRIPTION OF SERVICE CHARGES AMOUNT PROFESSIONALSURVEY FEES: ASSESSED LOSS Rs.3675.00 Rs. 500.00 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. 990.00 HSN/SAC CGST @ 9% Rs. 89.00 CODE: TAXES (00440169) SGST @ 9% Rs. 89.00 997162 IGST @ 0% Rs. 0.00 TOTAL AMOUNT WITH TAX - Rs. 1168.00 Amount In Words : ONE THOUSAND ONE HUNDRED SIXTY EIGHT ONLY HSN/SAC TAXABLE CENTRAL TAX STATE TAX INTERSTATE TAX CODE VALUE RATE AMOUNT RATE AMOUNT RATE AMOUNT 997162 990.00 9% 89.00 9% 89.00 0% 0.00 TOTAL TAX RS. 178.00 ONE HUNDRED SEVENTY EIGHT ONLY BANK DETAILS FOR PAYMENT BANK NAME : BANK OF BARODA Comulah BRANCH : AKOTA MINESH V.SHAH IFSCCODE BARBOAKOTAX (SURVEYOR/LOSS ASSESSOR) LA LIC.No.SLA 63819/18-21 2-18-2 MICRCODE 390012021 LOSS CURRENTA/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---