Licence No. - SLA 74140                                                                                     Valid upto --   22.09.2022
                                                      JIGNESH S. THAKKAR
  GST No. 24AFWPT8975J3Z5                                                                                 PAN No. -       AFWPT8975J
                                                         Surveyor & Loss Assessor
                     232, Shrushti Complex, Above SBI, N. H No.8, Kamrej Char Rasta, Surat.
  Mobile No. 9904096492 / Office : 9978696492                                        Email: thakkar97@gmail.com
  BANK NAME STATE BANK OF INDIA                                                       A/c No.       37215500008
  BRANCH    KAMREJ CHAR RASTA                                                       IFSC CODE SSBIN0005149
  MICR Code  395002028                                                                      A/c Type     CURRENT
                                                                TAX INVOICE
  Bill No.                        501/2020-21/JT                                                                Date : 26-Mar-2021
  Insurer                        Bajaj Allianz General Ins.Co.Ltd.
                                     MZ 30-37, Upper Ground Floor, Megh Mayur Plaza, Near HDFC Bank, Athwalines,
                                     Parle Point,Surat, Gujarat, India. Pin Code : 395 007.
                                     GSTIN - 24AABCB5730G1Z3
  Claim No.                                  OC-21-2203-1801-00004047              Date of Accident :   8-Feb-2021
  Policy No.                         :       OG-21-2203-1801-00003295
  Insured's Name                :       MRS. JIGNABEN VARIA.
  Vehicle No.                                 GJ05JD4606
 Make/ Model                             CHEVROLET/ SAIL

 PARTICULARS                                                                                       AMOUNT
                                                       VISIT       KMS         RS
 Spot Survey                     No                                                                               0.00
Professional Charges                                                                                      1000.00
Conveyance                                                                                                     500.00
Spot Conveyance                                                                                                 0.00
Re-Inspection                                                                                                      0.00
Photo Charges                                                                                                   25.00
Misc. Charges/Toll charges                                                                                 0.00
Amount                                                                                                          1525.00
                                                                                  CGST           9%             137.25
    GST                      SAC CODE - 997162                  SGST           9%             137.25
                                                                                 IGST             0%                0.00
TOTAL                                                                                                          1800.00

In words: Ruppess One Thousand Eight Hundred Only

JIGNESI S.THAKKAR
Surveyor.&Loss Assessor

---PAGE END---