TAX INVOICE Issued under GST Invoice Rules Original :For Recipient Duplicate :For Supplier BAJAJ ALLIANZ GENERAL Invoice No : IRDRWG2021008993 INSURANCE CO.LTD Invoice Date :15/01/2021 1st Floor, Tower 1 Commer Zone,Samrat Ashok Model : TATA TIAGO Path Jail Road, Yerwada PUNE Chassis No : MAT626281JKA10716 Maharashtra(27) Insurance Co : BAJAJ ALLIANZ GENERAL INSURANCE GSTIN : 27AABCB5730G1ZX Insurance Type : Place of Supply: 27-Maharashtra Insurance Expiry Date : Kms. : 51145 Vehicle Regn. No : MH12QF7387 Job Card No. : JC-RdrMtr-WP2-2021-007630 Job Card Date : 26/12/2020 Service Request Type : Accident Customer P.O. No - Date : Payment Method : CREDIT Warranty Expired :Y Dealer PAN:AAWFR7876H Dealer GSTIN : 27AAWFR7876H1Z5 Total Insuran SGST/UTGS Disc Campai CGST Total Amt s Part#IJob Amt Extra ce Taxabl T HSN/SAC Particulars Type UoM Qty Rate Amt/Ite gn Disc Disc % (Incl. No Code (Base Chg Liability[e Amt[RateAmounRateAmoun Taxes) m % Price) % % t % t FRONT 8708.99.05424885063 2,168. 2,168.7 1 BUMPER Paid Each 1 2,168.75 0 14 303.6214 303.62 2,776.00 0 01 75 5 SKIN HEAD 8512.20.15424544001 3,521. 3,521.1 2 LAMP Paid Each 1 3,521.19 0 9 316.91 9 316.91 4,155.00 0 02 19 9 ASSY, RH FRONT 8708.99.05424885063|BUMPER 3 Paid Each 1 943.75 943.75 0 943.75 14 132.12 14 132.12 1,208.00 0 06 BOTTOM GRILL FRONT 8708.99.05424885063 2,974. [2,974.2 4 BUMPER Paid Each 1 2,974.22 0 14 416.39 14 416.39 3,807.00 0 03 22 2 TOP GRILL CED ASSY 8708.99.05424881001 2,204. [2,204.6 5 FENDER Paid Each 1 2,204.69 0 14 308.66 14 308.66 2,822.00 0 1621 69 9 COMP RH FOG LAMP [1,135.5 8512.20.15424544001 1,135 6 ASSY, Paid Each 1 1,135.59 0 9 102.20 9 102.20 1,340.00 0 06 FRONT 59 9 8708.10.95424885063|FOG LAMP 7 Paid Each 1 446.09 446.09 0 446.09 14 62.45 14 62.45 571.00 0 14 RING RH ASSY SIDE BRACKET 8708.99.0 5424885001 8 FRONT Paid Each 1 113.28 113.28 0 113.28 14 15.86 14 15.86 145.00 0 09 BUMPER RH ASSY MBR RAD 8708.99.05427622002 9 SUPPORT Paid Each 375.00 375.00 0 375.00 14 52.5014 52.50 480.00 0 02 VERTICAL RH STG I FITMENT CHARGES* 1,200.0 10 998714 OTFIT TOTAL PAID 1 0 0 1200 0.00 9 108.00 9 108.00 1,416.00 0 CUTTING & WELDING FITMENT 1,100.0 11 998714 OTFIT PAID 1 0 o 1100 0.00 9 99.00 9 99.00 1,298.00 ---PAGE END--- TOTAL LABOUR FITMENT CHARGES* 8,285.0 12 998714 OTFIT PAID 1 0 0 8285 0.00 9 745.65 9 745.65 9,776.30 TOTAL 0 PAINTING FITMENT CHARGES* 13 998714 OTFIT TOTAL PAID 1 0 0 300 0.00 300.00 9 27.00 9 27.00 354.00 DENTING & REPAIRING Sub Total: 24,767.56 Total Tax Amount : 5,380.74 Parts Net Taxable Amount : 13,882.56 Final Labour Invoice Amount : 12,844.30 Final Parts Invoice Amount : 17,304.00 @ 9% CGST on Labour: 979.65 @ 9% SGST on Labour: 979.65 @ 9% CGST on Parts: 419.11 @ 9% SGST on Parts: 419.11 @ 14% CGST on Parts: 1,291.61 @ 14% SGST on Parts: 1,291.61 Gross Amount : 30,148.30 Adjustments : -0.30 Rupees Thirty Thousand One Hundred Fourty Eight Only. Grand Total : 30,148.00 Note: 1) Insurance Liability % will only come for Insurance Job cards. 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 WAGHOLI shall have jurisdiction in any proceedings relating to this contract. 3) ! have inspected the vehicle MH12QF7387 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 MAT626281JKA10716 4) I hereby consent and authorize RUDRA MOTORS-3007530 / PUNE 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 RUDRA MOTORS-3007530 Customer's Signature Authorized signatory ---PAGE END--- RUDRA MOTORS-3007530 * GATEPASS * Customer Name : BALWINDER SINGH Invoice Ref. : IRDRWG2021008993 dated 15/01/2021 Account Name : IBM Invoice Amount : Rs. 30,148.00 Vehicle No : MH12QF7387 Job Card / Order ref : JC-RdrMtr-WP2-2021-007630 dated 26/12/2020 Chassis No : MAT626281JKA10716 Gate Pass No & Date : Model Name : TATA TIAGO Vehicle I Goods received in good condition and to our satisfaction. ---PAGE END---