N Vardhaman Autowheels Private Limited Behind Ford Showroom NH-06, G.E. RoadKumhari,Durg, 490042 E-Mail service@vw-vapl.co.in State Code CHATTISGARH/ CG/ 22 Phone No. 6262065999 GST Regst. No. 22AAGCV9761J1ZW Fax No. C.I.N. No. U50400CT2019PTC009338. Tax Invoice Customer Name: Bajaj Allianz General Insurance Co Ltd Repair Order No.: SOA2000303 Customer Address: Shiv Mohan Bhavan Vidhanshabha Road Repair Order Date: 06 - Jul - 20 Pandri Raipur Invoice Number: PIA2000324 Raipur, 492001 Invoice Date: 09 - Jul - 20 India Model: Polo Highline Petrol Customer State: CHATTISGARH/ CG/ 22 Kms In: 33384 GST Regst. No.: 22AABCB5730G1Z7 Kms Out: 33390 Cust PAN/ TIN No.: AABCB5730G Service Advisor: SUNNY KESHRWANI VIN: MEXC16602GT078607 S.A. Mob. No.: 626200022 Regn. No.: CG04LG8031 Next Service Due Date: GST Customer Type Registered Order Customer: Mr. AAKASH SAHU H NO -661 MOWA LAXMI NAGAR BACK SIDE OF PAL ELE RA Raipur, 492001 India Mobile No. : 9981148274 Demanded Repair (Customer Voice) 1 FRONT SIDE DAMAGE 2 BACK SIDE DAMAGE Labor Details s. Category Qty. Customer GST Base Total Amount Description Labor Code SAC No. Share % Amount GST Incl. Tax 1 GFF/Guided functions . 01500000 Paid 00998729 1.00 100.00 800.80 144.14 944.94 CGST - 9.00% - 72.07, SGST - 9.00% - 72.07 2 Lock carrier remove+reinstall 50381950 Paid 00998729 1.00 100.00 1,500.20 270.04] 1,770.24 CGST - 9.00% - 135.02, SGST - 9.00% - 135.02 3 Front Bumper Painting 99999901 Paid 00998729 1.00 100.00 4,921.80 885.92] 5,807.72 CGST - 9.00% - 442.96, SGST - 9.00% - 442.96 4 Front Bumper Remove Refit 99999921 Paid 00998729 1.00 100.00 800.80] 144.14] 944.94 CGST - 9.00% - 72.07, SGST - 9.00% - 72.07 5 Misc / Consumables 99MCRP07 Paid 00998729 1.00 100.00 351.00 63.18 414.18 CGST - 9.00% - 31.59, SGST - 9.00% - 31.59 Total Labor 9,882.02 Parts Details s. Unit Customer GST Base Total Amount No. Description Part No. Category HSN Qty. Incl. Tax Price Share % Amount GST 1 CLIP 6R0941511 Paid 73182990 1.00 86.44 100.00 86.44 15.56 102.00 CGST - 9.00% - 7.78, SGST - 9.00% - 7.78 2 CARRIER 6RG805588L Paid 87089900 1.00 3,220.31 100.00 3,220.31 901.68 4,121.99 CGST - 14.00% - 450.84, SGST - 14.00% - 450.84 6RG805915A 100.00 3 RETAINER Paid 87089900 1.00 521.88 521.88 146.12 668.00 9B9 CGST - 14.00% - 73.06 SGST - 14.00% - 73.06 6RG807217B 4 COVER Paid 87081090 1.00 2,025.00 100.00 2,025.00 567.00 2,592.00 GRU CGST - 14.00% - 283.5, SGST - 14.00% - 283.5 6RG853671A 5 GRILLE Paid 87089900 1.00 646.88 100.00 646.88 181.12 828.00 RYP CGST - 14.00% - 90.56, SGST - 14.00% - 90.56 6 VENT 6RG898665F Paid 87081090 1.00 820.31 100.00 820.31 229.68 1,049.99 ---PAGE END--- ) Vardhaman Autowheels Private Limited Behind Ford Showroom NH-06, G.E. RoadKumhari,Durg, 490042 E-Mail service@vw-vapl.co.in State Code CHATTISGARH/ CG/ 22 Phone No. 6262065999 GST Regst. No. 22AAGCV9761J1ZW Fax No. C.I.N. No. U50400CT2019PTC009338. Parts Details S. Qty. Unit Customer GST Base Total Amount No. Description Part No. Category HSN Price Amount GST Incl. Tax Share % CGST - 14.00% - 114.84, SGST - 14.00% - 114.84 |COVER 6RU807241 1.00 Paid 87081090 188.28 100.00 188.28 52.72 241.00 GRU CGST - 14.00% - 26.36 SGST - 14.00% - 26.36 Total Parts 9,602.98 Total Parts And Labor : 19,485.00 Labor Parts Rounded off Amount : 0.00 CGST 9.00 % 753.71 7.78 SGST 9.00 % 753.71 7.78 CGST 14.00 % 0.00 1039.16 SGST 14.00 % 0.00 1039.16 1,507.42 2,093.88 Final Amount : 19,485.00 Rupees : NINETEEN THOUSAND FOUR HUNDRED EIGHTY FIVE RUPEES AND ZERO PAISA ONLY Whether tax is payable in reverse charge? Yes / No Remarks Area (Safety related)/ Advice for Future Repair DECLERATION: I / We do hereby declare that the particulars given above are true and correct. The amount indicated represents the price actually charged and there is no additional consideration flowing directly or indirectly from the buyer. Customer Signature Dealer Authorized Signature ---PAGE END--- 2 Vardhaman Autowheels Private Limited Behind Ford Showroom NH-06, G.E. RoadKumhari,Durg, 490042 E-Mail service@vw-vapl.co.in State Code CHATTISGARH/ CG/ 22 Phone No. 6262065999 GST Regst. No. 22AAGCV9761J1ZW Fax No. C.I.N. No. U50400CT2019PTC009338. HSN/SAC Code wise GST Summary HSN/SAC Code Base Amount IGST % IGST Amount CGST % CGST Amount SGST % SGST Amount Total 00998729 8,374.60 9.00 753.71 9.00 753.71 9,882.02 73182990 86.44 9.00 7.78 9.00 7.78 102.00 87081090 3,033.59 14.00 424.70 14.00 424.70 3,882.99 87089900 4,389.07 14.00 614.46 14.00 614.46 5,617.99 Total 15,883.70 1,800.65 1,800.65 19,485.00 ---PAGE END---