Licence No.:73224 VISHAL C.TANNA Valid up to: 28th Sep.2022 SURVEYOR& LOSS ASSESSOR IIISLA Member No.: A/W/06402 Office No.215, Govinda Complex Mobile 09898212711 Opp. Panchratna Appartment, email .: vishal.tannasurveyor@gmail.com GIDC,Vapi 396191 TAX INVOICE Invoice No. 273 REF.NO. VTBAG/FIN/0289/2020 Date : 07/12/2020 Bajaj Allianz General Insurance co. Ltd. MZ 30-37,Upper Ground Floor,Megh Mayur Plaza,Athwalines,Parle Point,Surat-Dumas Road,Surat Gujarat - 395007 BRDIV OG-18 Insurer Name Bajaj Allianz General Insurance co. Ltd. MZ 30-37,Upper Ground Floor,Megh Mayur Plaza,Athwalines,Parle Point,Surat-Dumas Road,Surat Gujarat -395007 BRDIV GST No. GST NO.:24AABCB5730G1Z3 Insured Mr.Sarfraj Rafique Hussain Ahmad Gita Nagar Claim no. OC-21-2203-1803-00000159 Policy No. OG-21-2218-1803-00000115 Subject GJ 15YY 9675 Sr.No. Particular Amount Professional Fees 2500.00 2 Travelling/Conveyance 2 VISIT 500.00 3 Digital Photographs No's @ (CD Charge) 50.00 4 Haltage 0.00 5 Others if any 0.00 6 0.00 7 0.00 TOTAL 3050.00 Add CGST @ 9.00% 274.50 Add SGST 9.00% 274.50 Grand Total 3599.00 Surveyor Code SAC 997162 RUPEES THREE THOUSAND FIVE HUNDRED NINETY NINE ONLY PAN Number : ADFPT7401E GSTIN:24ADFPT7401E1ZS Advance Receipt Vishal C.Tanna ---PAGE END---