KISAN MOTORS BHAVNAGAR ROAD, NEAR SWAMI NARAYAN TEMPLE, BOTAD, BHAVNAGAR, 364710, State Code: 24 Contact: 02849-253273, , GSTIN No: 24AAEFK8234E1ZK Authorised Service Center: Hero MotoCorp Ltd. TAX INVOICE Original For Recipient Duplicate For Transporter Cash Triplicate For Supplier Place of Supply GUJARAT, 24 Customer Name BAJAJ ALLIANZ GENERAL INSURANCE CO LTD Invoice No 20366BC21V12189 Address Invoice Date 22-03-2021 10:40:55 Job Card No 20366-02-RJC-0321-11893 Model SPLENDOR + VIN MBLHAR070J5D03322 Vehicle Reg No GJ33C6475 Kms 16621 Joyride Expiry Date 31-03-2022 State Code Insurance Expiry Date 31-01-2021 GSTIN No. Next Service Due Date 02-06-2021 (On or Before) C/o Contact Name BABUBHAI NANUBHAI KHANDALA Contact Address TURKHA ROAD BHAGAT NI VADI VARIYA DEVI MANDIR PACHAL, ; BOTAD, GUJARAT, GoodLife Card # / Category / Points :: / / Billing Total Taxable CGST. SGST. Total S.No. Description of Goods /Services HSN Code Qty[UOM] Rate Discount .Type Value Value. Rate.IAmount..Rate....Amount Amount Parts Details 53200AAE200S-STEM COMP Paid PC! 617.19 617.19 14% 86.41 14% 86.41 790.00 1 87141090 1 617.19 0.00 STRG 53100AAE110S-PIPE STRG Paid PC| 257.81 0.00 14% 14% 2 87141090 1 257.81 257.81 36.091 36.09 330.00 HANDLE 61313KCC900S-STAY R. PC] 3 87141090 Paid 1 23.44 23.44 0.00 23.44 14% 3.28 14% 3.28 30.00 HEADLIGHT 61314KCC900S-STAY L Paid PC 4 87141090 1 31.25 31.25 0.00 31.25 14% 4.38: 14% 4.38 40.00 HEADLIGHT 61312149300S- Paid PC 3.13 12.52 0.00 1.75 1.75 5 87141090 4 12.52 14% : 14% 16.03 BOOTHEADLIGHT BRACKET 83410AAEH00ZBS-FR Paid PC 710.94 710.94 0.00 710.94 14% 99.53 14% 99.53 910.00 6 87141090 1 VISOR-BLACK (NH-1TYPE-2) 83407KCC902S-CUSHION PC] 7 40169990 Paid 2 8.47 16.95 0.00 16.95 9% 1.53 9% 1.53 20.00 FR.VISOR 83403KCC830S-CUSHION PC! 8 40169990 Paid 1 17.80 17.80 0.00 17.80 9% 1.60 9% 1.60 21.00 SEAL VISOR FRONT 53178AAFH00S-LEVER PC| 9 87141090 Paid 1 54.69 54.69 0.00 54.69 14% 7.66 14% 7.66 70.00 COMP.L STRG.HNDL. 88120AAEH31S-MIRROR Paid PC| 93.22 0.00 93.22 9% 8.39 9% 8.39 10 70091090 1 93.22 110.00 ASSY L BACK 11 88110AAEH31S-MIRROR Paid PC] 93.22 93.22 0.00 93.22 8.39 9% 8.39 70091090 1 9% 110.00 ASSY R BACK 12 25K160S-BALL RACES KIT 84821051 Paid 1 PC| 245.76 245.76 0.00 245.76 9% 22.12 9% 22.12 290.00 13 17500AAE100SS-FUEL TANK Paid PC|3,906.25 [3,906.25 14% 14% 87141090 1 0.00|3,906.25 546.88 546.88 5,000.00 (BLACK NH-1 (TYPE-2)) Total 6,081.04 0.006,081.04 828.00 828.00 7,737.04 Labour Details 307004-HANDLE BAR 9987 Paid 1 90.00 90.00 0.00 90.00 9% 8.10 9% 8.10 106.20 (R/R) 307011-STEM COMPSTRG 2 9987 Paid 200.00 200.00 0.00 200.00 9% 18.00 9% 18.00 236.00 (Dismantle/ Assemble ) 301015-TANK SET FUEL 3 9987 Paid 1 131.00 131.00 0.00 131.00 9% 11.79 9% 11.79 154.58 (R/R/C) Total 421.00 0.00 421.00 37.89 37.89 496.78 CGST(Parts) @ 14% on Amount 5,614.09 785.97 CGST(Parts) @ 9% on Amount 466.95 42.03 SGST(Parts) @ 14% on Amount 5,614.09 785.97 ---PAGE END--- 1T Net Amount 8,233.82 StAY SAFE STAY A HERO Round Off 0.18 Wear a mask Maintain Wash & sanitize social distancing hands regularly Invoice Amount Payable 8,234.00 Total Invoice Value (In figure) 8,234.00 Total Invoice Value (In Words) Rs. Eight Thousand Two Hundred Thirty Four Only Tax Payable under Reverse Charge-No For KISAN MOTORS Authorised Signatory Note: 1.E&0.E 2. This is a computer generated invoice 3. All disputes subject to jurisdiction of Botad Jurisdiction 4. Goods once sold will not be taken back or replaced 5. Received above detailed vehicle in good condition I give Hero MotoCorp Ltd. (HMCL) and its agents/partners consent to contact me for any marketing or promotional communications through any medium and enable WhatsApp assistance. I understand HMCL privacy policy as mentioned on www.heromotocorp.com. Customer Signature Gate Pass Gate Pass Dt &Time 22-03-2021 10:40:55 Vehicle In Dt 18/03/2021 GatePass No 20366-02-RSRB-0321-13943 Invoice No 20366BC21V12189 Reg No GJ33C6475 Invoice Amt 8,234.00 VIN MBLHAR070J5D03322 Received above detailed vehicle in good condition. Customer Signatory Authorised Signatory ---PAGE END---