TAX INVOICE
MINESH VALLABHDAS SHAH                                 LICENCE NO.-SLA/63819
Surveyor-Loss Assessors-Valuer-Investigator          EXP.DATE :26/04/2021
MOTOR-MARINE(C)-ENGINEERING                                      IIISLA MEMBERSHIP NO.: F/W/01143
CONTACT 9824032094/9824444179                         Email: mvshah2@gmail.com
OFFICE 0265-2325523-BARODA                                               mvshah2@rediffmail.com
OFFICE :02642-262524-BHARUCH
GSTINNO.:24AHNPS2949A1ZA                                 PAN No.:AHNPS2949A
 INVOICE NO.:1040/20-21                                            DATE B0-May-20
BILLED TO,
M/s. Bajaj Allianz General Insurance Co.Ltd               BUY.GSTIN NO         24AABCB5730G1Z3
4th Floor,Atlantis Hetitage, B/h Atlantis Heights         PANNo.:              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.                             #20050032
INSURED/Vehicle No.                       MR.BHANSINGH/GJ 06 AT 6335
POLICY NO./Claim no.                       OG-20-2201-1803-00002566/OC-21-2201-1803-00000016
DATE OF SURVEY                               22/05/2020 at Spot & 26/05/2020 onwards Final
PLACE OF SURVEY                             AT SPOT KARJAN,AT KRANTI SHOW REPAIRING VADODARA
DESCRIPTION OF SERVICE CHARGES                                                                   AMOUNT
PROFESSIONALSURVEY FEES:    SPOT+ASSESSED LOSS Rs.75000.00                Rs.             2250.00
CONVEYENCE(TO&FRO):              150    KMS.@ Rs.          7.50          Rs.             1125.00
HALTING ALLOWANCE:                             Spot 90 KM + Finals)                 Rs.                  0.00
PHOTOGHRPHS/CD@40/-:            1      NOS.@Rs.          40.00         Rs.                40.00
 OTHERS(INCEDENTALIF ANY                                                                     Rs.                  0.00
SUBTOTALTAXABLE:                                                                               Rs.            3415.00
     HSN/SAC                                                               CGST    @       9%  Rs.               307.00
        CODE:                     TAXES (00440169)                  SGST    @       9%  Rs.               307.00
       997162                                                                 IGST     @       0%  Rs.                   0.00
                                                                       TOTAL AMOUNT WITH TAX     Rs.              4029.00
   Amount In Words :   FOUR THOUSAND TWENTY NINE ONLY
      HSN/SAC          TAXABLE           CENTRAL TAX              STATE TAX             INTERSTATE TAX
        CODE               VALUE           RATE     AMOUNT     RATE      AMOUNT      RATE      AMOUNT
       997162             3415.00           9%        307.00        9%        307.00        0%          0.00
  TOTAL TAX Rs.          614.00      SIX HUNDRED FOURTEEN ONLY
BANK DETAILS FOR PAYMENT
BANK NAME:     BANK OF BARODA
BRANCH      :     AKOTA
                                                                                                MINESH V.SHAH
IFSC CODE          BARBOAKOTAX                                                   (SURVEYOR/LOSS ASSESSOR)
                                                                                                LIC.No.SLA 63819/18-21
MICR CODE        390012021
CURRENTA/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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