Tax Invoice MOHAMMED UVESH .V.MALVAT Invoice No 618 Surveyor & Loss Assessor (Moter) Dated Lic No SLA73478 Valid Upto August 2020 : 24-Aug-2020 88 Sarani Society 132' Ring Road : P RAJMOHAN Insured Name B/h APMC MARKET Vasna Tolnaka Ahmedabad Claim No OC-21-2202-1825-000000446 GSTIN/UIN:24AMHPM9424B1Z9 Contact :9898070189 9925007717 Policy No : OG-20-2202-1825-00002208 E-Mail :uveshmalvat@gmail.com Make and Model: HYUNDAI VENUE Motor Vehicle No :GJ01KX1581 Shipped To Party Billed To Party BAJAJ ALLIANZ GIC LTD BAJAJ ALLIANZ GIC LTD 4TH FLOOR,TURQUOISE BUIL,NEAR 4TH FLOOR,TURQUOISEBUIL..NEAR PANCHVATI,CROSSROADS,C,G.ROAD PANCHVATI,CROSSROADS,C,G.ROAD AHMEDABAD 380006 AHMEDABAD 380006 State Name :Gujarat,Code:24 State Name :Gujarat,Code :24 GSTIN/UIN :24AABCB5730G1Z3 GSTIN/UIN :24AABCB5730G1Z3 PAN/IT NO PAN/IT No Place of Supply Gujarat SI Description of Goods HSN/SAC GST Amount No. Rate 1 01.01 Profesnal Fees 997162 18% 2,500.00 2 CGST 225.00 3 SGST 225.00 Total 2,950.00 Amount Chargeable (in words) E.&O.E Indian Rupees Two Thousand Nine Hundred Fifty Only HSN/SAC Taxable Central Tax State Tax Total Value Rate Amount Rate Amount Tax Amount 997162 2,500.00 9% 225.00 9% 225.00 450.00 Total 2,500.00 225.00 225.00 450.00 Tax Amount (in words) : Indian Rupees Four Hundred Fifty Only Company's PAN :AMHPM9424B Declaration Company's Bank Details We declare that this invoice shows the actual price of the Bank Name :06.01 ICICI BANK goods described and that all particulars are true and A/c No. 034401511645 correct. Branch &IFS Code:Vasna Ahmedabad&ICICO000344 Customer's Seal and Signature for MOHAMMED UVESH V.MALVAT M O SLA 73478 Authorised Signatory AHMEDABA SUBJECT TO AHMEDABAD JURISDICTION ---PAGE END---