Scan QR Code for "Customer Awareness Videos" Tax Invoice Order Number :- JC-MP02AC03-01-2021-009729 Invoice Number :- MP02AC0320009941 Invoice Date :- 15/03/2021 04:57:10 PM Document Type :- Invoice Supply Type : Supplier Details (Ship From) : Ship To (Place of Delivery): Legal Name: Legal Name : BAJAJ ALLIANZ GENERAL INSURANCE COMPANY . BAJAJ ALLIANZ GENERAL INSURANCER COMPANY Dealer Name: SHYAM SANGAM AGENCIES Name: BAJAJ ALLIANZ GENERAL INSURANCE COMPANY . BAJAJ ALLIANZ GENERAL INSURANCER COMPANY Address : 7,B VAISHALI NAGAR,ANNAPURNA MAIN ROAD,INDORE India Address: 4TH FLOOR, COMMERCE HOUSE, OPP. GANGAUR SWEETS,JANJIRWALA SQ.,INDORE India 4TH FLOOR, COMMERCE HOUSE, OPP. GANGAUR SERRTS, JANJIRWALA SQ., India City: INDORE PIN Code : 452009 Account/Customer Id: 1-DGI18VJ 1-DH67KAM State: MP State 23 City: INDORE INDORE PIN Code : 452001 452001 Code: Phone(M) : 7314200090 Phone(O): State: MP MP State Code: 23 GSTIN No : 23ABHFS5071K1ZZ CIN No : Phone(M) : 744040121873142000 Phone(0) : 90 PAN No: ABHFS5071K Email : HONDASHYAM@YAH GSTIN No : 23AABCB5730G1Z5 UIN: OO.CO.IN Customer Care No: 18001007022/9981990974 PAN No: Email: Place Of Supply: Bill To (Details of Recipient): Legal Name: Legal Name : BAJAJ ALLIANZ GENERAL INSURANCE COMPANY . BAJAJ ALLIANZ GENERAL INSURANCER COMPANY Dealer Name: SHYAM SANGAM AGENCIES Name: BAJAJ ALLIANZ GENERAL INSURANCE COMPANY . BAJAJ ALLIANZ GENERAL INSURANCER COMPANY Address : 7,B VAISHALI NAGAR,ANNAPURNA MAIN ROAD,INDORE India Address: 4TH FLOOR, COMMERCE HOUSE, OPP. GANGAUR SWEETS,JANJIRWALA SQ.,INDORE India 4TH FLOOR, COMMERCE HOUSE, OPP. GANGAUR SERRTS, JANJIRWALA SQ.,India City: INDORE PIN Code : 452009 Account/Customer Id: 1-DGI18VJ 1-DH67KAM State: MP State 23 City: INDORE INDORE PIN Code : 452001 452001 Code: Phone(M) : 7314200090 Phone(O): State: MP MP State Code: 2323 GSTIN No : 23ABHFS5071K1ZZ CIN No : Phone(M) : 744040121873142000 Phone(0) : 90 PAN No: ABHFS5071K Email : HONDASHYAM@YAH GSTIN No : 23AABCB5730G1Z5 UIN: O0.CO.IN Customer Care No: 18001007022/9981990974 Pan No: Email: Loyalty ID : Frame No.: ME4JF505EGU126711 Model Name: ACTIVA 3G Jobcard Closed Date/Time: 15/03/2021 04:56:58 PM Engine No.: JF50EU3126689 Model Code: Activa 3G DLX Service Type: ACCIDENT Reg. No.: MP09UB6545 Color: GREY Service KM : 15475 Pick & Drop Availed: Sale Date: 18/06/2016 Selling Dealer: KASLIWAL AUTOMOBILES PVT LTD Unit Taxable Sr Part No/ Description HSN/SAC Sublet Billing Price UoM Total Discoun Discount Job Qty Amount Amount No Jobcode Code Type (Rs) t % (Rs) (Rs) 1 90101-GBL- BOLT 73181900 Paid 8.47 1 No's 8.47 10.00 7.62 710 ADJUST 2 90307- WASHERLOC 87141090 Paid 3.12 1 No's 3.12 10.00 2.81 GW3-980 K 6MM 3 90107- BOLT- 73181900 Paid 5.08 1 No's 5.08 10.00 4.57 KWP-900 WASH8*16 4 51110- FORK SUB 87141090 Paid 2,096.86 1 No's 2,096.86 10.00 1887.17 KWP-900 ASSY FR 5 05321- KITRACE 87141090 Paid 318.74 1 No's 318.74 10.00 286.87 KEM-P00 STEERING 6 44301-KPL- AXLEFR 87141090 Paid 87.50 1 No's 87.50 10.00 78.75 900 WHEEL 7 90306-KTE- NUTFLANGE 73181600 Paid 37.28 1 No's 37.28 10.00 33.55 ---PAGE END--- 8 61105- GROMMET 87141090 Paid 6.25 1 No's 6.25 10.00 5.62 KWP-900 FR FENDER 9 50306-KPL- NUTSTRG 87141090 Paid 25.78 1 No's 25.78 10.00 23.20 900 STEM LOC 10 53100- HANDLE 87141090 Paid 473.43 1 No's 473.43 10.00 426.09 KWP-910 COMPSTRG 11 81131- COVER 87141090 Paid 460.93 1 No's 460.93 10.00 414.84 KWP- INNER*NH1* 90OZA 12 45459- NUTBRAKE 87141090 Paid 15.62 2 No's 31.24 10.00 28.12 KWP-911 ADJUSTING 13 53172- BRACKETL 87141090 Paid 163.28 1 No's 163.28 10.00 146.95 KWP-910 BRAKE LEVER 14 53146-KRB- GRIP COMP 87141090 Paid 58.58 1 No's 58.58 10.00 52.72 901 THROT 15 53166-KRP- GRIP L 87141090 Paid 25.78 1 No's 25.78 10.00 23.20 980 HANDLE 16 53178- LEVERL 87141090 Paid 85.16 1 No's 85.16 10.00 76.64 KWP-D00 STRG HANDLE 17 35150-KZK- sW 85369030 Paid 50.84 1 No's 50.84 10.00 45.76 901 UNITLIGHTIN G 18 35200- SW UNIT 85365090 Paid 53.38 1 No's 53.38 10.00 48.04 KWP-901 WINKER 19 35160- SW UNIT 85369030 Paid 49.15 1 No's 49.15 10.00 44.24 KWP-901 START 20 35180- SW UNIT 85369030 Paid 50.00 1 No's 50.00 10.00 45.00 KWP-901 HORN 21 35170-KPL- sw 85365090 Paid 47.45 1 No's 47.45 10.00 42.70 842 UNITDIMMER 22 53168- HOUSING 87141090 Paid 89.84 1 No's 89.84 10.00 80.86 KWP-900 UND THROT 23 35340-KPL- SW.ASSYFR 85365090 Paid 41.52 2 No's 83.04 10.00 74.74 900 STOP 24 53173-KPL- BANDHANDL 87141090 Paid 4.68 1 No's 4.68 10.00 4.21 900 E BRKT 25 53185- ARM 87141090 Paid 46.87 1 No's 46.87 10.00 42.18 KWP-910 COMPRR ---PAGE END--- 26 37200- SPEEDOMET 90292020 Paid 815.25 1 No's 815.25 10.00 733.72 KWP-F01 ER ASSY 27 90115-KRP- SCREW 73181900 Paid 3.38 1 No's 3.38 10.00 3.04 980 HANDL LEVER PIVOT 28 53175- LEVER R 87141090 Paid 72.65 1 No's 72.65 10.00 65.38 KWP-D00 STRG HANDLE 29 80151- COVERCENT 87141090 Paid 144.53 1 No's 144.53 10.00 130.08 KWP- ER*NH-1* FOOZA 30 90302-KPL- NUTPUSH 3 73182910 Paid 4.23 10 No's 42.30 10.00 38.07 660 MM 31 83620- MOULL 87141090 Paid 15.62 1 No's 15.62 10.00 14.06 KWP-F01 BODY COVER 32 83520- MOULR 87141090 Paid 16.40 1 No's 16.40 10.00 14.76 KWP-F00 BODY COVER 33 64200- SET 87141090 Paid 471.87 1 No's 471.87 10.00 424.68 KWP- ILLUSTFR GOOZE COVER*TYP E2* 34 77240- CABLESEAT 87141090 Paid 33.59 1 No's 33.59 10.00 30.23 KWP-900 LOCK 35 50621- COVER 87141090 Paid 186.71 1 No's 186.71 10.00 168.04 KWP-901 UNDER 36 90344-KPL- NUTSUS 73181900 Paid 5.93 15 No's 88.95 10.00 80.06 900 5MM 37 93903- SCREWTAPP 73181900 Paid 4.23 20 No's 84.60 10.00 76.14 25380 ING5X16 38 17950- CABLE 87141090 Paid 82.03 1 No's 82.03 10.00 73.83 KWP-900 COMPCHOK E 39 83561-KPL- CUSHION. 40169990 Paid 10.16 1 No's 10.16 10.00 9.14 840 BODY COVER 40 53205- COVERHAND 87141090 Paid 697.64 1 No's 697.64 10.00 627.88 KWP- LE F0OZE FR*NHA04M* 41 33110- UNITHEAD 85122010 Paid 438.98 1 No's 438.98 10.00 395.08 KWP-F01 LIGHT 42 33460- LENSE 85122010 Paid 138.98 1 No's 138.98 10.00 125.08 KWP-F01 COMPL 43 33410- LENSECOMP 85122010 Paid 138.98 1 No's 138.98 10.00 125.08 ---PAGE END--- 44 53209- CLIPHEAD 87141090 Paid 7.03 2 No's 14.06 10.00 12.65 GAH-000 LIGHT 45 38501-KPL- RELAY 85369020 Paid 167.79 1 No's 167.79 10.00 151.01 901 COMPSTART 46 90102-KPL- SCREWFORK 73181900 Paid 4.23 2 No's 8.46 10.00 7.61 900 COVER 47 51103- COVER R 87141090 Paid 29.68 1 No's 29.68 10.00 26.71 KWP-940 PIVOT 48 51104- COVER L 87141090 Paid 28.12 1 No's 28.12 10.00 25.31 KWP-940 PIVOT 49 18318- PROTECTOR 87141090 Paid 26.56 1 No's 26.56 10.00 23.90 KWP-F00 MUFFLER 50 44311-KPL- COLLARFR 87141090 Paid 24.20 1 No's 24.20 10.00 21.78 900 WHEEL S 51 51400- CUSH ASSYR 87141090 Paid 388.28 1 No's 388.28 10.00 349.45 KWP-902 FR 52 51500- CUSHION 87141090 Paid 388.28 1 No's 388.28 10.00 349.45 KWP-902 ASSYL FR 53 MP020003- LUBRICATIO 65070000 Paid 4.30 1 No's 4.30 10.00 3.87 CONSUMA N& BLE GRISHING CHARGES 54 MP020003- POLISH VHI 65070000 Paid 51.00 1 No's 51.00 10.00 45.90 POLISH 55 MP020003- SEAT COVER 87141090 Paid 176.00 1 No's 176.00 24.40 133.06 SEAT COVER - SCOOTER 56 90102- BOLT ADPT 73181600 Paid 27.11 1 No's 27.11 10.00 24.40 KWP-900 8MM 57 88113-KRP- CAP LOCK 87141090 Paid 4.68 2 No's 9.36 10.00 8.42 901 NUT 58 90310-KPL- LOCK 73181600 Paid 10.16 1 No's 10.16 10.00 9.14 900 NUTMIRROR R 59 88110- MIRROR 70091090 Paid 159.32 1 No's 159.32 10.00 143.39 KWP-901 ASSY R BACK 60 88120- MIRROR 70091090 Paid 159.32 1 No's 159.32 10.00 143.39 KWP-901 ASSY L BACK 61 MP020003- GRIP COVER 87141090 Paid 44.50 1 No's 44.50 10.00 40.05 GRIP COMMAN ---PAGE END--- 62 93903- SCREWTAP. 73181900 Paid 2.54 20 No's 50.80 10.00 45.72 24380 4X12 63 50330- TRAY 87141090 Paid 280.47 1 No's 280.47 10.00 252.42 KWP-F00 COMPBATTE RY 64 MP020003- 10 NO BOLT 65070000 Paid 8.50 14 No's 119.00 10.00 107.10 NUT BOLT 65 SJ110015 CHASSIS 998729 550 Paid 0.00 1 Hrs 550.00 15.00 467.50 REPAIR 66 JB00056 LABOUR 998729 800 Paid 0.00 1 Hrs 800.00 15.00 680.00 CHARGE 67 SJ110045 PAINT 998729 350 Paid 0.00 1 Hrs 350.00 15.00 297.50 PROTECTIO N 68 SJ208800 COVER 998729 650 Paid 0.00 1 Hrs 650.00 15.00 552.50 COMP., L. BODY (DENTING /PAINTING) 69 SJ208700 COVER 998729 650 Paid 0.00 1 Hrs 650.00 15.00 552.50 COMP., R. BODY (DENTING /PAINTING) 70 SJ207000 PANEL 998729 450 Paid 0.00 1 Hrs 450.00 15.00 382.50 COMP., FLOOR (DENTING /PAINTING) 71 SJ207000 PANEL 998729 350 Paid 0.00 1 Hrs 350.00 15.00 297.50 COMP., FLOOR (DENTING /PAINTING) 72 SJ203236 RH FRONT 998729 550 Paid 0.00 1 Hrs 550.00 15.00 467.50 BODY PANEL PAINTING 73 SJ203235 LH FRONT 998729 550 Paid 0.00 1 Hrs 550.00 15.00 467.50 BODY PANEL PAINTING 74 SJ202000 FENDER, FR. 998729 550 Paid 0.00 1 Hrs 550.00 15.00 467.50 (DENTING /PAINTING) Total 13618.06 Sr HSN/SAC Code Taxable SGST/UTGST CGST IGST CESS Total Amount No Amount Rate Amount Rate Amount Rate Amount Rate Amount 1 73181900 224.77 9 20.23 9 20.23 265.22 2 87141090 6372.39 14 892.13 14 892.13 8, 156.66 3 73181600 67.10 9 6.04 9 6.04 79.17 4 85369030 134.99 9 12.15 9 12.15 159.29 5 85365090 165.48 9 14.89 9 14.89 195.27 6 90292020 733.72 9 66.04 9 66.04 865.80 7 73182910 38.07 9 3.43 9 3.43 44.92 8 40169990 9.14 9 0.82 9 0.82 10.79 9 85122010 645.25 9 58.07 9 58.07 761.39 ---PAGE END--- 11 65070000 156.87 9 14.12 9 14.12 185.11 12 70091090 286.78 9 25.81 9 25.81 338.40 13 998729 4,632.50 9 416.92 9 416.93 18 0.00 0.00 5,466.35 Invoice Amount 16706.55 Total Invoice Value (in figures) : 16707 Total Labour/Service Amount 5466.35 Total Invoice Value ( in words): Rupees Sixteen Thousand Seven Hundred Seven Only Total Parts Amount 11240.20 Payment Mode: Cash Total Tax Amount 3,088.49 If reverse charge applicable, then specify amount of tax: Total Invoice Amount 16706.55 Terms and Conditions: For SHYAM SANGAM AGENCIES 1. All disputes are subject to INDORE Jurisdiction. 2. Our responsibility ceases after materials are delivered & we are not responsible for any loss or any damage 3. Goods once sold will not be taken back. Name of Signatory 4. Interest @ 18% will be charged on amount remaining unpaid after 45 days of invoice date. Designation 5. All replacements will be subject to our inspection & approval. E. & O. E. Acknowledgement from customer: Invoice Generated by: HEMLATA Advisor Name: I/We hereby give consent that all personal or other information (information's) provided herein or otherwise can be used for the business purposes or for performance of agreement between us, if any and shall not be disclosed to any third party except to the extent its disclosure is essential as per the applicable laws or for any business requirement. The above said information may be shared or transferred with HMSI or its affiliates or group companies within or outside India for business purposes only. However, the same shall be transmitted, handled & destroyed as per the applicable law or in a manner that will preserve its confidentiality. Further, all or any of the information's provided herein or otherwise can be withdrawn/corrected by giving notice. Customer Signature Free Service Schedule Kms* Days* 1st Free Service 750-1000 15~30 * Kms or Days, whichever comes earlier 2nd Free Service 5500-6000 165~180 3rd Free service 11500-12000 350~365 Paid Service Frequency Every 6000 Kms or Within 6 months Please Note : Above Service conditions are applicable for domestic BSVI vehicles only HONDA Experience More Benefits, More Joy joyclub With Honda Joy Club ---PAGE END--- SHYAM SANGAM AGENCIES GATEPASS Customer Name: BAJAJ ALLIANZ GENERAL INSURANCE Ref No: SERINV-MP02AC03-2021-009941 COMPANY . Invoice No.: MP02AC0320009941 dated 15/03/2021 Registration No.: MP09UB6545 Invoice Amount: 16707 Customer's Signature Frame No.: ME4JF505EGU126711 Jobcard/Order Ref.: JC-MP02AC03-01- 2021-009729 dated 15/03/2021 Model Name: ACTIVA 3G Gatepass No.& Date: Security In-Charge Vehicle/ Goods received in good condition and to our satisfaction Customer Feedback Form Instant Feedback Instant Redressal Dear Sir/Ma'am We are thankful to you for spending little time for us while filling this feedback form. Your valuable inputs will enable us for continuous improvement of our service quality. Thanking you Once Again. Customer Name: BAJAJ ALLIANZ GENERAL INSURANCE COMPANY . Date : 15/03/2021 Customer Address: 4TH FLOOR, COMMERCE HOUSE, OPP. GANGAUR SWEETS, JANJIRWALA SQ., INDORE , INDORE,MP, India Zipcode: 452001 TEL. No. /MOBILE: 7440401218 Frame No.: ME4JF505EGU126711 Model Name: ACTIVA 3G Jobcard No: JC-MP02AC03-01-2021-009729 Reg. No.: MP09UB6545 SL. PARTICULARS EXCELLENT VERY GOOD GOOD FAIR POOR NO. 1 Overall Job card opening process [ ] [ ] [ ] [ ] [ ] 2 Overall Service advisor performance [ ] [ ] [ ] 3 Overall Workshop facilities [ ] [ ] [ ] 4 Overall Quality of service/repair [ ] [] [ 1 [ ] 5 Overall Service Delivery [ ] [ 1 [ ] [ ] ANY OTHER SUGGESTIONS/ COMMENTS: Customer Signature INSTANT REDRESSAL OF CONCERN CRM Remark CRM Signature Customer Signature WE APPRECIATE YOUR VALUABLE TIME WHICH YOU HAVE INVESTED IN OUR SERVICE TRACKER. YOUR ---PAGE END---