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. 1496/20-21                                                   DATE:    11-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 OF SUPPLY:   GUJARAT
Baroda.                       GUJARAT                  INDIA           STATE OF SUPPLY :  GUJARAT
PROFESSIONAL SERVICES RENDERED FOR THE FOLLOWING,
OUR JOB REF.NO.                                 #20110368
INSURED/Vehicle No.                          Mr.Bhaveshkumar Aptel/GJ 16 BJ 1710
POLICY NO./ Claim no.                          OG-21-2225-1802-00002142/OC-21-2201-1802-00000581
DATE OF SURVEY                                   04-11-2020
PLACE OF SURVEY                                  At Kamal Auto Netrang
DESCRIPTION OF SERVICE CHARGES                                                                            AMOUNT
PROFESSIONALSURVEY FEES:     ASSESSED LOSS Rs.5000.00                               Rs.                350.00
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(INCEDENTAL IF ANY) :                                                                               Rs.                    0.00
SUB TOTALTAXABLE :                                                                                          Rs.              1365.00
      HSN/SAC                                                                        CGST     @         9%  Rs.                  123.00
        CODE:                         TAXES (00440169)                     SGST     @         9%  Rs.                  123.00
        997162                                                                          IGST      @        0%  Rs.                     0.00
                                                                                TOTAL AMOUNT WITH TAX -   Rs.               1611.00
    Amount In Words :    ONE THOUSAND SIX HUNDRED ELEVEN ONLY
      HSN/SAC            TAXABLE            CENTRAL TAX               STATE TAX               INTERSTATE TAX
         CODE                 VALUE             RATE      AMOUNT      RATE       AMOUNT        RATE       AMOUNT
        997162               1365.00             9%         123.00         9%          123.00          0%           0.00
  TOTAL TAX RS.           246.00        TWO HUNDRED FORTY SIX ONLY
BANK DETAILS FOR PAYMENT                                          J.SH
BANK NAME :      BANK OF BARODA
                                                                                                             Oomn
BRANCH       :     AKOTA
                                                                                                             MINESH V.SHAH
IFSCCODE    :       BARBOAKOTAX                                                          (SURVEYOR / LOSS ASSESSOR)
                                                                                                                                                      SLA
                                                                                                             LIC.No.SLA 63819/18-21          819-18-
MICR CODE          390012021                                                                                                        PLOSSP
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

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