Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier Insurance Invoice TAX INVOICE SHAMAN CARS INDIA PVT. LTD. PAN : AABCS4308P; GSTIN: 27AABCS4308P1Z1; CIN: Add: 167, CST Road, Vidhya Nagari,Santacruz, Mumbai, Maharashtra, India - 400098 Phone: +912261399399 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Lessor/Bill to Bajaj Allianz General Insurance Co. Lessee/Ship to JAYANT VED Veh. Reg. No. MH03BW9268 Invoice No. SR155B20-13205 Ltd. Phone +919820049846 Model BRIO Invoice Date 29-01-2021 04:53 PM GSTIN 27AABCB5730G1ZX GSTIN Chassis No. MAKDD173HFN307403 RO No. SER-RO-DD155B-2021-11473 Address 952/954 Appa Sahab Marathe Ship to BLD NO173/4848 PANT NAGAR Engine No. L12B34014062 RO Type BP Marg, Prabhadevi Nr Chetanya Twr GHTKOPAR EAST Mumbai 400075 Wrnty Start 26-11-2015 Visit Date 17-01-2021 12:20 PM Mumbai Maharashtra 400093 India Maharashtra India Place of Supply Maharashtra State Maharashtra Invoice Type Mileage 16725 State Code 27 State Code 27 IRN Number 08be185c7e1fd0eb020f2e89717 a6ad2a5fd5a3976766225c5496 26fa4d2cb3f PAN IRN Version 1.1 P/L Labor Code / HSN / Description Issue Qty UoM Job Value Disc Dis Insurer Insured Insurer Taxable CGST SGST / UTGST Amount(?) Part# SAC Type /RTLP / Item % % Amt % Amt Disc Amt Amount % Amt % Amt BONET REPLACMENT PAINT - (Body & Paint Work) 60100TG2K00 998714 Replace HOOD Paid 1 390.00 190 0 100.00 390.00 0.00 0.00 190.00 200.00 9 18.00 9 18.00 236.00 ZZ812100 PNTENGNHO PAINT CHGS ENGINE 998714 Paid 5730.00 0 20 100.00 5730.00 0.00 0.00 1146.00 4584.00 9 412.56 9 412.56 5409.12 DM HOOD - METALLIC Supply Type : B2B ---PAGE END--- HONDA Original for Recipient Duplicate for Transporter Triplicate for Supplier 60100TG2K00 870899 Paid 100.00 0.00 0.00 14 14 P HOOD COMP 1 NOS 3112.14 0 0 3112.14 0.00 3112.14 435.70 435.70 3983.54 zZ 00 FRONT GLASS REPLACEMENT - (Body & Paint Work) 73101TG2K00 Replace GLASS, L 998714 Paid 1 2015.00 615 0 100.00 2015.00 0.00 0.00 615.00 1400.00 9 126.00 9 126.00 1652.00 831120 FRONT WINDSHIELD 700721 P 73101TG2K00 GLASS. FR WSHLD Paid 1 NOS 3716.63 0 0 100.00 3716.63 0.00 0.00 0.00 3716.63 9 334.50 9 334.50 4385.62 90 400829 RUBBER A FRONT Paid NOS P 73125SYY000 1 98.06 0 0 100.00 98.06 0.00 0.00 0.00 98.06 9 8.83 9 8.83 115.71 90 WINDSHIELD DAMPER 400829 RUBBER B FRONT P 73126SYY000 Paid 1 NOS 65.40 0 0 100.00 65.40 0.00 0.00 0.00 65.40 9 5.89 9 5.89 77.17 90 WINDSHIELD DAMPER 400829 RUBBER.FR WSHLD P 73125TG1T00 Paid 1 NOS 90.38 0 0 100.00 90.38 0.00 0.00 0.00 90.38 9 8.13 9 8.13 106.65 90 DAM A 870899 NOS P 91568TF0003 CLIP.FR WSHLD UPR Paid 2 51.76 0 0 100.00 103.52 0.00 0.00 0.00 103.52 14 14.49 14 14.49 132.51 00 381400 3M-SINGLE STEP P IA260165336 Paid 2 NOS 140.00 0 0 100.00 280.00 0.00 0.00 0.00 280.00 14 39.20 14 39.20 358.40 10 PRIMER 10 ML OTLOSEKI025 350699 SEALANT KIT WITH P Paid 2 NOS 763.00 0 0 100.00 1526.00 0.00 0.00 0.00 1526.00 9 137.34 9 137.34 1800.68 A 99 PRIMER LHS PILER REPAIR PAINT - (Body & Paint Work) L RPRBPLR 998714 REPAIR 'B' PILLAR Paid 1 300.00 0 0 100.00 300.00 0.00 0.00 0.00 300.00 9 27.00 9 27.00 354.00 PAINT CHGS 'B' L PNTBPLRM 998714 Paid 1 2410.00 1110 0 100.00 2410.00 0.00 0.00 1110.00 1300.00 9 117.00 9 117.00 1534.00 PILLER - METALLIC RHS FRONT DOOR REPAIR PAINT - (Body & Paint Work) R/RFT FRONT RH L RRFTFRDOR 998714 Paid 1 200.00 0 0 100.00 200.00 0.00 0.00 0.00 200.00 9 18.00 9 18.00 236.00 DOOR REPAIR FRONT RH L RPRFRDOR 998714 Paid 1 200.00 0 0 100.00 200.00 0.00 0.00 0.00 200.00 9 18.00 9 18.00 236.00 DOOR PAINT CHGS FRONT PNTFRDRPNL L 998714 DOOR PANEL LH/RH - Paid 1 5590.00 0 20 100.00 5590.00 0.00 0.00 1118.00 4472.00 9 402.48 9 402.48 5276.96 M METALLIC RHS PILER REPAIR PAINT - (Body & Paint Work) L RPRAPLR 998714 REPAIR 'A' PILLAR Paid 1 300.00 0 0 100.00 300.00 0.00 0.00 0.00 300.00 9 27.00 9 27.00 354.00 PAINT CHGS 'A' Paid 106.56 L PNTAPLRM 998714 1 1480.00 0 20 100.00 1480.00 0.00 0.00 296.00 1184.00 9 106.56 9 1397.12 PILLER - METALLIC Recommendations: 0 POLICY NO=OG21190718010003729 CLAIMNO=OC211901180100011404 SERVE BY ANIKET 0 NO CASHLESS POLICY Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier Insurance Invoice TAX INVOICE SHAMAN CARS INDIA PVT. LTD. PAN : AABCS4308P; GSTIN: 27AABCS4308P1Z1; CIN: Add: 167, CST Road, Vidhya Nagari,Santacruz, Mumbai, Maharashtra, India - 400098 , Phone: +912261399399 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Name Bajaj Allianz General Insurance Co. Name JAYANT VED Veh. Reg. No. MH03BW9268 Invoice No. SR155B20-13205 Ltd. Phone +919820049846 Model BRIO Invoice Date 29-01-2021 04:53 PM GSTIN 27AABCB5730G1ZX GSTIN Chassis No. MAKDD173HFN307403 RO No. SER-RO-DD155B-2021-11473 Address 952/954 Appa Sahab Marathe Ship to BLD NO173/4848 PANT NAGAR Engine No. L12B34014062 RO Type BP Marg, Prabhadevi Nr Chetanya Twr GHTKOPAR EAST Mumbai 400075 Wrnty Start 26-11-2015 Visit Date 17-01-2021 12:20 PM Mumbai Maharashtra 400093 India Maharashtra India Place of Supply Maharashtra State Maharashtra Invoice Type Mileage 16725 State Code 27 State Code 27 IRN Number 08be185c7e1fd0eb020f2e89717a6ad 2a5fd5a3976766225c549626fa4d2cb 3f PAN IRN Version 11.1 SUMMARY Delivery against Cash/D.D ONLY may kindly be drawn in favor of Parts Details Amount() Labor Details Amount(&) "SHAMAN CARS INDIA PVT. LTD." Taxable Amt 8992.13 Taxable Amt 14140.00 o Salvage from repair must be collected at the time of delivery. Else will be CGST @ 9% 494.68 CGST @ 9% 1272.60 distroyed. SGST @ 9% 494.68 SGST @ 9% 1272.60 CGST @ 14% 489.39 Total Labor Amt 16685.20 Management shall not be responsible of consequences there after. SGST @ 14% 489.39 Total Parts Amt 10960.28 For any query / feedback, kindly contact: Service Manager: 9167186302; CRM: 9870500621; Landline: 022-61399399 TCS Tax @ % 0.00 o I/We hereby certify that our transaction of sales covered by this Bill/Cash Total Amount 27645.48 memorandum has been effected by me and it should be accounted for in the Net Amount 27645.48 turnover of sales while filling my returns. Grand Total (Rounded - Off) 27645.00 (-0.48) Amount in Words: Rupees Twenty Seven Thousand Six Hundred Fourty Five Only Amount of Tax Subject to Reverse Charges 0 I certify that I have taken delivery of my Vehicle & work has been done to my entire For SHAMAN CARS INDIA PVT. LTD. satisfaction (Customer's Signature and Date) Service Advisor : KIRAN SHINDE (Authorized Signatory) Supply Type : B2B ---PAGE END---