Licence No. - SLA 74140                                                                                     Valid upto -  22.09.2020
                                                   JIGNESH S.THAKKAR
GST No.24AFWPT8975J3Z5                                                                                 PAN No.-      AFWPT8975J
                                                      Surveyor & Loss Assessor
                   232, Shrushti Complex, Above SBI, N. H No.8, Kamrej Char Rasta, Surat.
Mobile No.9904096492/Office9978696492                                       Email: thakkar97@gmail.com
BANK NAME STATE BANK OF INDIA                                                      Ac No.       37215500008
BRANCH    KAMREJ CHAR RASTA                                                      IFSC CODE SBIN0005149
MICR Code 395002028                                                                     A/c Type     CURRENT
                                                              TAX INVOICE
Bill No.                        106/2020-21/JT                                                                Date :20-Jul-2020
Insurer                        Bajaj Allianz General Ins.Co.Ltd.
                                   MZ 30-37,Upper Ground Floor,Megh Mayur Plaza, Near HDFC Bank, Athwalines,
                                   Parle Point,Surat, Gujarat, India. Pin Code : 395 007.
                                   GSTIN -24AABCB5730G1Z3

Claim No.                                  OC-21-2203-1802-00000153             Date of Accident :  20-Jun-20|
Policy No.                                  OG-21-1901-1802-00011000
Insured's Name                         MR SALIMBHAI GAFARBHAI PATEL
Vehicle No.                                GJ05PN7978
Make/Model                             SUZUKI/ACCESS

PARTICULARS                                                                                        AMOUNT

                                                       VISIT        KMS         RS
Spot Survey                    No                                                                                0.00
Professional Charges                                                                                         500.00
Conveyance                                                                                                       250.00
Spot Conveyance                                                                                                  0.00
Re-Inspection                                                                                                       0.00
Photo Charges                                                                                                    25.00
Misc. Charges                                                                                                       0.00
Amount                                                                                                             775.00
                                                                                   CGST           9%              69.75
    GST                      SACCODE-997162                  SGST           9%              69.75
                                                                                   IGST            0%                0.00
TOTAL                                                                                                             915.00

In words :Ruppess Nine Hundred Fifteen Only
                             *
 *    SLASETO
 10
 JGNESH S.THAKKAR
 Surveyor&LossAssessor

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