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 : 98244 44179-BHARUCH
GSTIN NO.  24AHNPS2949A1ZA                                     PAN No.: AHNPS2949A
 INVOICE NO. 1656/20-21                                                   DATE:    29-Dec-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,           PLACE OF SUPPLY:   GUJARAT
Baroda.                       GUJARAT                  INDIA           STATE OF SUPPLY :  GUJARAT
PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING,
OUR JOB REF.NO.                                  #20120483
INSURED/Vehicle No.                          MR.REVALBHAI VASAVA/GJ 05 JD 1544
POLICY NO./Claim no.                          OG-20-2225-1801-00007511 /OC-21-2201-1801-00003813
DATE OF SURVEY                                   10-12-2020
PLACE OF SURVEY                                 AT SIRAJ MOTOR GARAGE NETRANG
DESCRIPTION OF SERVICE CHARGES                                                                            AMOUNT
PROFESSIONALSURVEY FEES:     ASSESSED LOSS RS.25000.00                             Rs.              1000.00
CONVEYENCE (TO& FRO):                 130     KMS.  @   Rs.            7.50           Rs.                 975.00
HALTING ALLOWANCE :                                                                                         Rs.                    0.00
PHOTOGHRPHS/CD @40/-              1       NOS.  @   Rs.           40.00          Rs.                   40.00
OTHERS(INCEDENTALIF ANY):                                                                               Rs.                     0.00
SUB TOTAL TAXABLE :                                                                                           Rs.               2015.00
      HSN/SAC                                                                        CGST     @         9%  Rs.                  181.00
        CODE:                         TAXES (00440169)                     SGST     @         9%  Rs.                  181.00
        997162                                                                          IGST      @         0%  Rs.                      0.00
                                                                                TOTAL AMOUNT WITH TAX -   Rs.                2377.00
    Amount In Words :    TWO THOUSAND THREE HUNDRED SEVENTY SEVEN ONLY
      HSN/SAC            TAXABLE            CENTRAL TAX                STATE TAX               INTERSTATE TAX
         CODE                 VALUE             RATE      AMOUNT       RATE        AMOUNT        RATE        AMOUNT
        997162               2015.00             9%         181.00         9%          181.00         0%           0.00
  TOTAL TAX Rs.           362.00        THREE HUNDRED SIXTY TWO ONLY
BANK DETAILS FOR PAYMENT
BANK NAME :       BANK OF BARODA
BRANCH       :     AKOTA                                                                                                               SHV
                                                                                                              MINESH V. SHAH
IFSCCODE    :      BARBOAKOTAX                                                          (SURVEYOR/ LOSS ASSESSOR)      SLA.
                                                                                                              LIC. No.SLA 63819/18-21         $19-18-2
MICRCODE:      390012021                                                                                                        PLOSST
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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