Dhimant R. Shah 204, Amrut Com. Center, Sardarnagar Main Original for Road, Rajkot -360 001 Receipient Tel: +91 281 2464015 PAN NO.:AKNPS3659J GSTIN: 24AKNPS3659J1ZJ Tax Invoice Invoice No: SDR-201920-1957 Policy no.: 0G-20-1919-1803-00001216 Invoice date: 12-10-2020 Vehicle number: GJ-32-T-1168 Estimate Amount : 142796 Insured Name: AMBUJA CEMENTS LTD State: Gujarat Code 24 Claim no. : 0C-21-2204-1803-00000133 Bill to Party Ship to Party Name: Bajaj Allianz General Insurance Company Ltd. Name: Bajaj Allianz General Insurance Company Ltd. Address:402-408, 4th floor, Turquoise, 4th FLOOR , C G ROAD, Panchwati Address: 402-408, 4th floor, Turquoise, 4th FLOOR , C G circle, Ahemdabad, 380006 ROAD, Panchwati circle, Ahemdabad, 380006 GSTIN: 24AABCB5730G1Z3 GSTIN: 24AABCB5730G1Z3 State: Gujarat Code 24 State: Gujarat Code 24 s. CGST SGST Product Description SAC code UOMQty Rate Amount DiscountTaxable Value Total No. Rate Amount Rate Amount 1Survey Fee 997162 1 1500 1500 0 1500 9 135 9| 135| 1770 2[Local Expance 997162 0 0 0 0 0 9 0 9 0 0 3Outstation Allowance 997162 0 3248 3248 0 3248 9 292.32 9 292.32 3832.64 4Spot Survey Fee 997162 0 0 0 o 0 9 0 9 0 0 5Traveling Expenses: 997162 1| 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 6[CD EXPANCE 9972162 1 50 50 o 50| 9 4.5 9 4.5| 59 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 0 0 0 9 0 9 0 0 Total 3 4798 o 4798 431.82 431.82 5661.64 Total Invoice amount in words Total Amount before Tax 4798 Add: CGST 431.82 Add: SGST 431.82 FIVE THOUSAND SIX HUNDRED SIXTY ONE RUPEES AND SIXTY FOUR PAISA ONLY Total Tax Amount 863.64 Total Amount after Tax: 5661.64 Bank Details GST on Reverse Charge 0 Bank A/C: ICICI BANK LTD. eritified that the particulars given above are true and corre Bank IFSC:ICIC0000153 Dhimant R. Shah A/C NO.: 015305001007 HIMANT SURVEY DONE AT M K MOTORS, KODINAR 433 KMX 7.5 RS =3248 ---PAGE END---