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 :97238 15456-BARODA                                                        mvshah2@rediffmail.com
OFFICE : 98244 44179 -BHARUCH
GSTIN NO. 24AHNPS2949A1ZA                                      PAN No.: AHNPS2949A

  INVOICENO.  1507/20-21                                                   DATE:    13-Nov-20
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,           PLACEOF SUPPLY:   GUJARAT
Baroda.                       GUJARAT                  INDIA           STATE OF SUPPLY:  GUJARAT
PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING,
OURJOB REF.NO.                                  #20110382
INSURED/Vehicle No.                           MR.DILWAR DABHOYA/GJ 16X 8110
POLICY NO./ Claim no.                    :   OG-20-2202-1803-00029303 /OC-21-2201-1803-00000181
DATE OF SURVEY                              :    10-11-2020
PLACE OF SURVEY                                  AT KGN AUTO JAMBUSAR
DESCRIPTION OF SERVICE CHARGES                                                                             AMOUNT
PROFESSIONALSURVEY FEES:     ASSESSED LOSS RS.50000.00                              Rs.               1500.00
CONVEYENCE(TO&FRO):                 110     KMS.  @   Rs.            7.50           Rs.                 825.00
HALTINGALLOWANCE :                                                                                         Rs.                     0.00
PHOTOGHRPHS /CD @ 40/-:              1       NOS.  @   Rs.           40.00           Rs.                   40.00
OTHERS(INCEDENTALIF ANY) :                                                                               Rs.                     0.00
SUB TOTAL TAXABLE :                                                                                           Rs.               2365.00
      HSN/SAC                                                                         CGST     @         9%  Rs.                  213.00
        CODE:                         TAXES (00440169)                     SGST     @         9%  Rs.                  213.00
        997162                                                                           IGST      @         0%  Rs.                     0.00
                                                                                 TOTAL AMOUNT WITH TAX -   Rs.                2791.00
    Amount In Words :    TWO HOUSAND SEVEN HUNDRED NINETY ONE ONLY
      HSN/SAC            TAXABLE             CENTRAL TAX                STATE TAX               INTERSTATE TAX
         CODE                 VALUE             RATE      AMOUNT       RATE        AMOUNT        RATE        AMOUNT
        997162               2365.00             9%         213.00         9%          213.00          0%            0.00
  TOTAL TAX Rs.           426.00        FOUR HUNDRED TWENTY SIX ONLY
BANK DETAILS FOR PAYMENT
BANK NAME :       BANK OF BARODA
                                                                                                               OaL
BRANCH       :      AKOTA                                                            B
                                                                                                              MINESH V.SHAH
IFSCCODE             BARBOAKOTAX                                                          (SURVEYOR / LOSS ASSESSOR)
                                                                                                                                                     O3.SLA
                                                                                                              LIC. No.SLA 63819/18-21          279-18-1
MICR CODE           390012021                                                                                                        CRAILOSS
CURRENT A/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

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