JAY DWARKADHISH MOTORS
                BAJAJ
                                                     RAJKOT JAMNAGAR HIGHWAY OPP.MELDI MATA MANDIR
                Distetig Akead
                                                                               HAPA, JAMNAGAR,
GSTIN No. : 24AAJFJ1446Q1ZZ                                                                    Tax Invoice         Debit Memo          ORIGINAL
PAN No.:AAJFJ1446Q
 State              Gujarat        State Code :24
 Invoice No.      SP2378
 Invoice Date     15/12/2020
                            Details of Receiver (Billed to)                                                   Details of Consignee(Shipped to)
Name           BAJAJ ALLIANCE GENERAL INSURANCE COMPANY LTD Name        : BAJAJ ALLIANCE GENERAL INSURANCE COMPAI
                  1
Address      1ST FLOOR,HOTEL K ROSE BUILDING                         Address     :1ST FLOORHOTEL K ROSE BUILDING
                    LIMBDA CHOCK,RAJKOT                                                                LIMBDA CHOCK,RAJKOT
                    RAJKOT                                                                                      RAJKOT
State            Gujarat                        State Code :24                   State         :Gujarat                       State,Code24
GSTIN No.  24AABCB5730G1Z3                                                   GSTIN No.  24AABCB5730G1Z3
PAN No.        AABCB5730G                                                           PAN No.      AABCB5730G
 Sr.     Part No,    Description of Goods           HSNISAC          Qty|        RateDiscount[GST%   SGST      CGST         Amount
     1BH184000   GLASS GREEN WINDSHLD   70072190         1.000    3372.88                 18.00     303.56     303.56       3980.00
                          ONE PIECEFL
     252AZ0176   ED COATED SIDE DOOR LH  87149990         1.000    2125.00                 28.00     297.50     297.50       2720.00
     3AZ213126.   HOOD ASSLY YELLOW        87081090         1.000    2620.31                 28.00     366.84     366.84       3354.00
     4AZ211093   ASSLY HOOD FRAME UG     87082900         1.000     781.25                  28.00     109.38     109.38       1000.00
     5BODY WOR BODY WORK                      998729            1.000    2711.86                 18.00     244.07     244.07       3199.99
     6PAINT        PAINT WORK                     998729            1.000    2372.88                 18.00     213.56     213.56       2800.00
      7R@R        R@R.CHARGES                 998729            1.000    1694.92                 18.00     152.54     152.54       2000.01













                                                   Sub Total               7.000                                                     1687.45   1687.45     19053.99
GST Summary          Amount          SGST          CGST            Total
Sales 5%
Sales 12%
Sales 18%              10152.54         913.73         913.73       11980.00
Sales 28%               5526.56         773.72        -773.72        7074.00
Sales 0%
Total                     15679.10        1687.45       1687.45       19054.00                                                  Invoice Total      1.9054.00
GJ10TW5238 CLAIM NO -OC-21-2204-1803-00000331
Invoice Value (In Words) :Nineteen Thousand Fifty Four Only
 TERM & CONDITION                                                                                                            For, JAY DWARKISONOyTORS
 Subject to HAPA jurisdiction.

                                                                                                                                                            Althoris Siggatory
E.&O.E.                                                                                                        Certifed that the particulars given Sg    rue and correct

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