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 INVOICE NO. 1588/20-21 DATE: 12-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, OURJOB REF.NO. #20110399 INSURED/Vehicle No. MR.SAMSHAD ANSARI/GJ 16 BL 6544 POLICY NO./Claim no. : OG-20-2225-1802-00007625 /OC-21-2201-18025-00000627 DATE OF SURVEY : 13/11/2020 ONWARDS PLACE OF SURVEY : AT ANAS MOTORS ANKLESHWAR DESCRIPTION OF SERVICE CHARGES AMOUNT PROFESSIONALSURVEY FEES: ASSESSED LOSS RS.16500.00 Rs. 450.00 CONVEYENCE(TO&FRO): 1 KMS. @ Rs. 450.00 Rs. 450.00 HALTING ALLOWANCE : Rs. 0.00 PHOTOGHRPHS/CD @40/-: 1 NOS. @ Rs. 40.00 Rs. 40.00 OTHERS(INCEDENTALIF ANY): Rs. 0.00 SUB TOTALTAXABLE: Rs. 940.00 HSN/SAC CGST @ 9% Rs. 85.00 CODE: TAXES (00440169) SGST @ 9% Rs. 85.00 997162 IGST @ 0% Rs. 0.00 TOTAL AMOUNT WITH TAX - Rs. 1110.00 Amount In Words : ONE THOUSAND ONE HUNDRED TEN ONLY HSN/SAC TAXABLE CENTRAL TAX STATE TAX INTERSTATE TAX CODE VALUE RATE AMOUNT RATE AMOUNT RATE AMOUNT 997162 940.00 9% 85.00 9% 85.00 0% 0.00 TOTAL TAX RS. 170.00 ONE HUNDRED SEVENTY ONLY BANK DETAILS FOR PAYMENT BANK NAME : BANK OF BARODA BRANCH : AKOTA MINESH V.SHAH IFSCCODE : BARBOAKOTAX (SURVEYOR/LOSS ASSESSOR) SLA LIC.No.SLA 63819/18-21 N319-15-1 MICR CODE 390012021 RA-COSS 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---