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
OFFICE :9723815456-BARODA                                                        mvshah2@rediffmail.com
OFFICE :98244 44179-BHARUCH
GSTIN NO.  24AHNPS2949A1ZA                                      PAN No.:AHNPS2949A
 INVOICENO.  1483/20-21                                                   DATE:   05-Nov-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 OFSUPPLY:   GUJARAT
Baroda.                       GUJARAT                  INDIA           STATE OF SUPPLY:   GUJARAT
PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING,
OUR JOB REF.NO.                                  #20110361
INSURED/Vehicle No.                           MR.RATILALBHARVAD/GJ 16Z2040
POLICY NO./Claim no.                          OG-21-2216-1803-00000212 /OC-21-2201-1803-00000175
DATE OF SURVEY                                    O2/11/2020 (SPOT) 04/11/2020 (FINAL)
PLACE OF SURVEY                                  AT SPOT NR JAMBUSAR AND KGN AUTO JAMBUSAR
DESCRIPTION OF SERVICE CHARGES                                                                             AMOUNT
PROFESSIONALSURVEY FEES:     ASSESSED LOSS Rs.45000.00+SPOT                  Rs.               1750.00
CONVEYENCE(TO&FRO):                 210     KMS.  @   Rs.            7.50           Rs.               1575.00
HALTINGALLOWANCE :                          (SPOT 100KM +FINAL 110KM)            Rs.                     0.00
PHOTOGHRPHS/CD @ 40/-:              1       NOS.  @   Rs.           40.00          Rs.                   40.00
OTHERS(INCEDENTALIF ANY):                                                                               Rs.                     0.00
SUB TOTAL TAXABLE :                                                                                           Rs.               3365.00
      HSN/SAC                                                                        CGST     @         9%  Rs.                  303.00
         CODE:                         TAXES (00440169)                     SGST     @         9%  Rs.                  303.00
        997162                                                                          IGST      @         0%  Rs.                     0.00
                                                                                TOTALAMOUNT WITH TAX -   Rs.                3971.00
    Amount In Words :    THREE THOUSAND NINE HUNDRED SEVENTY ONE ONLY
      HSN/SAC            TAXABLE             CENTRAL TAX                STATE TAX               INTERSTATE TAX
         CODE                 VALUE             RATE      AMOUNT      RATE        AMOUNT        RATE       AMOUNT
        997162               3365.00             9%         303.00         9%          303.00          0%           0.00
  TOTAL TAX RS.           606.00        SIX HUNDRED SIX ONLY
BANK DETAILS FOR PAYMENT
BANK NAME :       BANK OF BARODA
BRANCH       :     AKOTA                                                                                                               SHI
                                                                        @                                    MINESH V.SHAH
IFSCCODE            BARBOAKOTAX                                                          (SURVEYOR/LOSS ASSESSOR)
                                                                                                                                                       SLA
                                                                                                              LIC.No.SLA 63819/18-21
MICR CODE:      390012021                                                                                                         LOSSA
CURRENT A/C.NO. 06760200000417                      Adance 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---