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 OFFICE97238 15456-BARODA mvshah2@rediffmail.com OFFICE:9824444179-BHARUCH GSTIN NO. 24AHNPS2949A1ZA PAN No.:AHNPS2949A INVOICENO. 1791/20-21 DATE: 22-Feb-21 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 OFSUPPLY: GUJARAT Baroda. GUJARAT INDIA STATE OF SUPPLY: GUJARAT PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING, OURJOB REF.NO. #21010580 INSURED/Vehicle No. : MR.URMILABEN VASAVA/GJ 16 AJ 4905 POLICY NO./Claim no. : OG-21-2225-1801-00000983 /OC-21-2201-1801-00004750 DATE OF SURVEY 21-01-2021 PLACE OF SURVEY AT NATIONAL LITE AUTO GARAGE RAJPIPLA DESCRIPTION OF SERVICE CHARGES AMOUNT PROFESSIONALSURVEY FEES: ASSESSED LOSS Rs.9135.00 Rs. 500.00 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(INCEDENTALIFANY) Rs. 0.00 SUB TOTAL TAXABLE : Rs. 1515.00 HSN/SAC CGST @ 9% Rs. 136.00 CODE: TAXES (00440169) SGST @ 9% Rs. 136.00 997162 IGST @ 0% Rs. 0.00 TOTAL AMOUNT WITH TAX - Rs. 1787.00 Amount In Words : ONE THOUSAND SEVEN HUNDRED EIGHTY SEVEN ONLY HSN/SAC TAXABLE CENTRAL TAX STATE TAX INTERSTATE TAX CODE VALUE RATE AMOUNT RATE AMOUNT RATE AMOUNT 997162 1515.00 9% 136.00 9% 136.00 0% 0.00 TOTAL TAX Rs. 272.00 TWO HUNDRED SEVENTY TWO ONLY BANK DETAILS FOR PAYMENT BANKNAME : BANK OF BARODA aulil BRANCH AKOTA MINESH V. SHAH IFSCCODE : BARBOAKOTAX (SURVEYOR/LOSS ASSESSOR) SLA LIC. No.SLA 63819/18-21 MICR CODE 390012021 CLOTT 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 ---PAGE END---