"Original For Recipient"
Priority Insurance Surveyors & loss Assessors Pvt Ltd
202-203, 2nd Floor, Abhishree Adroit, Nr. Gwaliya Sweets, Mansi                                                         PRIORITY
Cross Road, Vastrapur, Ahmedabad, Gujarat -- 380015
Phone #: +91 7940029357
Email : accounts@prioritysurveyors.co.in
                                                                       Tax Invoice
To,                                                                                                                Invoice No : 3111-2101-0112
Bajaj Allianz General Insurance Company Ltd                                                   Invoice Date : 26/03/2021
4nd Floor ,Turquoise ,Near Panchvati Circle, CG Road
,Ellisbridge, Ahmedabad.


State       : Gujarat (Code - 24)
GSTIN No : 24AABCB5730G1Z3
Place of Supply : Gujarat
Insured                     Mohammed Hamza Yusuf Memon Vehicle Number          RJ-27-GC-8080
Policy #                     OG-20-2214-1803-00000510         Nature Of Loss           Own Damage
Claim #                     OC-21-2202-1803-00000670         Type of Vehicle           Truck

 SR.NO.                           DESCRIPTION                              QTY.        UNIT        RATE         AMOUNT
      1      Survey Fees                                                              1           Each       2500.00               2500.00
      2      Local Conveyance Charges - 1st Visit                            1           Each        350.00                 350.00
      3      Local Conveyance Charges - 2nd Visit                           1           Each        350.00                 350.00
      4      R. Inspection visits                                                      1           Each        350.00                 350.00
                                                                                                         Sub Total                                3550.00
                                                                                                         CGST @   9.00%                     319.50
                                                                                                         SGST @   9.00%                     319.50
                                                                                                         Grand Total                             4189.00
                                                                                                         [Say                                           4189
                                      INR : FOUR THOUSAND ONE HUNDRED EIGHTY NINE ONLY

E. and O.E.                                                                         Bank Details
Subject to Ahmedabad Jurisdiction                                      Bank Name      : HDFC Bank Ltd
GSTIN No                         : 24AAECP6441K1ZB                   A/C No            : 00692560008630
HSN/SAC Code                 : 997169                                     IFSC Code      HDFC0000069
PAN No                            : AAECP6441K                            Micro Code     : 380240005
Survey License No              : 72461 /2018-2021                      Branch           : Ashram Road, Ahmedabad
Corporate Identity Number: U74120GJ2008PTC053700
For Priority Insurance Surveyors & Loss Assessors Pvt. Ltd
                                                      LOSSY

Authorized Signatory
                                                   L10

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