GST No. 09ACVPD6053B1ZM                                                                                          State Uttar Pradesh
                                                                            TAX INVOICE
      PAN. ACVPD6053B                                                                                                   Code 09
                                                            SANJAY DWIVEDI
                                                                       Surveyor & Loss Assesor
                                                  License No. : 36742 Valid Upto : 29th April 2023
                                                              B-52, Ganga Nagar, Mawana Road, Meerut (UP)
                                              Ph. : 0121-4033709, 9837109331 Email : dwivedi_sanjay11@yahoo.co.in
  Invoice No. 6194/2020-2021                  Date      07-10-2020
                                                                                                                    Policy No.          OG-20-1901-1802-00106054
                                                                                                                     Claim No.          OC-21-1103-1802-00001587
 BAJAJ ALLIANZ GENERAL INS. CO. LTD
                                                                                                                    Insured             MANISHA BHARTI
Block No 04, 7 Th Floor,DLF Tower 15 Shivaji Marg New Delhi
                                                                                                                    Vehicle No.        UP 15 CE 2316
                                                                                                                    Make                JUPITER
                                                                                                                     Date of Survey    18-09-2020
                                                                                                                     Place of Supply  Uttar Pradesh
GST No. : 07AABCB5730G1ZZ
State : Delhi Code : 07                                                                              Estimated Amt.Rs. 10000.00
                                                                                                                    Assessed Amt. Rs. 3660.00
                                                                   HSN I SAC        Amout[SGST      SGST|[CGST|     CGST  IGST       IGST      Total
S.No.  Particulars of Services
                                                                   Code                          Rate|   Amount  Rate   Amount   Rate    Amount|    Amount
 1.    Final Survey Fee                                  997162                400.00   0.00         0.00   0.00         0.00  18.00        72.00     472.00
 2.    Final Survey Conveyance                       997162                300.00   0.00         0.00   0.00         0.00  18.00        54.00      354.00[












                                                                      Total            700.00                 0.00[                 0.00[              126.00|     826.00
Amount in Words : FRupees Eight Hundred Twenty Six Only


 Bank A/C Detail :
A/c No. 4038000100039677 [PNB, Ganga Nagar, Mawana Road, Meerut] IFSC : PUNB0403800
A/c No. 50100051796221 [HDFC bank Ltd., 381 W.K.Road, Meerut] IFSC : HDFC0000285                                    SANJAY DWIVEDI

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