TAX INVOICE Issued under GST Invoice Rules Original :For Recipient Duplicate :For Supplier BAJAJ ALLIANZ GENERAL INSURANCE CO LTD Invoice No : IKM0DO2021000825 GOVERNMENT EMPLOYEES Invoice Date :18/03/2021 BAJAJALLIANZGENERALINSURANCECO Model : TATA TIAGO 291,XTRIUM,2ND FLR,NEXT TO HOLY FAMILY CHURCH, Chassis No : MAT626288LKJ35308 MUMBAI SUBURBAN, MUMBAI SUBURBAN Insurance Co : BAJAJ ALLIANZ GENERAL INSURANCE MUMBAI, 400099 CO.LTD Maharashtra(27) Insurance Type : Phone No (Res,Off,Mob): 8669043688,, 8669043688 Insurance Expiry Date : Customer GSTIN : 27AABCB5730G1ZX Kms. : 1102 A/C Code : 1-150N11Y3 Vehicle Regn. No : MH05EJ4582 Place of Supply: 27-Maharashtra Job Card No. : JC-KrishM-KM-2021-000835 Job Card Date : 18/03/2021 Service Request Type : Accident Customer P.O. No - Date : Payment Method : CASH Warranty Expired :N Dealer PAN:AAHFK2649E Dealer GSTIN : 27AAHFK2649E1ZC PAN : Total Insuran SGST/UTGS Disc Campai CGST Total Amt| s Part#/Job Amt Extra ce Taxabl| T HSN/SAC Particulars Type UoM Qty Rate Amt/Itegn Disc Disc % (Incl. No Code (Base Chg Liabilitye AmttRateAmounRateAmoun Taxes) m % Price) % % t % t ORVM 7009.10.95424811001|AASSY WITH 6,305. 6,305.0 1 Paid Each 1 6,305.08 0 9 567.46 9 567.46 7,440.00 0 52 AUTOFOLD, 08 8 CO-DRIVER FITMENT 8,300.0 2 998714 OTFIT CHARGES PAID 0 08300 0.00 9 747.00 9 747.00 9,794.00 0 PAINTING FITMENT CHARGESS 1,660.0 3 998714 OTFIT PAID 0 01660 0.00 9 149.40 9 149.40 1,958.80 TRIPPING & 0 REPAIR Sub Total: 16,265.08 Total Tax Amount : 2,927.72 Discount on Labour : (2.80) Parts Net Taxable Amount : 6,305.08 Final Labour Invoice Amount : 11,750.00 Final Parts Invoice Amount : 7,440.00 @ 9% CGST on Labour: 896.40 @ 9% SGST on Labour: 896.40 @ 9% CGST on Parts: 567.46 @ 9% SGST on Parts: 567.46 Gross Amount : 19,190.00 Adjustments : 0.00 Rupees Nineteen Thousand One Hundred Ninety Only. Grand Total : 19,190.00 Note: ---PAGE END--- Tax Payable under Reverse Charge -- No Special Observations : Terms and Conditions : E. & O.E. 1) Goods once sold will not be taken back or exchanged except as required by law. 2) Only the courts of DOMBIVALI shall have jurisdiction in any proceedings relating to this contract. 3) I have inspected the vehicle MH05EJ4582 and taken delivery of the vehicle only after being satisfied regarding the maintenance work carried out in the vehicle. I do not have any grievances/complaints pertaining to the chassis no MAT626288LKJ35308 4) I hereby consent and authorize KRISHNA MOTORS / KALYAN-DOMBIVLI and Tata Motors Limited for usage of all the data disclosed above and also to share all my details and documents for promotional, marketing and transactional activities of Tata Motors Ltd. or any of its group companies/subsidiaries/ authorized dealers, in accordance with Tata Motor's Privacy Policy. I shall inform in writing to Tata Motors Limited, if I intend to withdraw my aforesaid consent. For KRISHNA MOTORS Customer's Signature Authorized signatory ---PAGE END--- KRISHNA MOTORS * GATEPASS * Customer Name : BAJAJ ALLIANZ GENERAL INSURANCE CO LTD Invoice Ref. : IKM0DO2021000825 dated 18/03/2021 Account Name : GOVERNMENT EMPLOYEES Invoice Amount : Rs. 19,190.00 Vehicle No : MH05EJ4582 Job Card / Order ref : JC-KrishM-KM-2021-000835 dated 18/03/2021 Chassis No : MAT626288LKJ35308 Gate Pass No & Date : Model Name : TATA TIAGO Vehicle / Goods received in good condition and to our satisfaction. ---PAGE END---