Goods & Services Tax Invoice Insurance Invoice ( Part ) HYUNDAI SUJAYA ENTERPRISES PVT. LTD. NEAR RELIANCE PETROL PUMP,CIDCO ROAD GUT NO.65,66,WASARANI, NANDED Ph: 9765733311 GST No: 27AALCS1794D1Z4 Bajaj Allianz General Insurance Company Limited 952/954, Appasaheb Marathe Marg, Nr Chaitny Tower,FReg No : MH26BE0423 Invoice No : W2216G202100326 Prabhadevi. Mumbai-400025 VIN MALA841DLHM238533 Date : 09.01.2021 : MUMBAI Mileage : 152192 R/ONo : R202005370 Maharashtra Place of Supply : Maharashtra Payment : Credit GST No: 27AABCB5730G1ZX S.No. Part No. Part Description HSN Tax % Qty Rate/Unit Ins ShareAmount 1 1140410356P BOLT 73181500 18% 4.00 15.26 100.00% 61.04 2 55310B4050 SHOCK ABSORBER ASSY-REAR 87088000 28% 1.00 1,531.24 100.00% 1,531.24 3 1244106207B SCREW-TAPPING 73181400 18% 6.00 12.72 100.00% 76.31 4 55100B4050 TORSION AXLE COMPLETE 87089900 28% 1.00 7,186.72 100.00% 7,186.71 5 58310B4700 BRAKE ASSY-RR,LH 87083000 28% 1.00 2,267.18 100.00% 2,267.18 6 5295017000 NUT-HUB 73181600 18% 4.00 260.16 100.00% 1,040.65 7 59760B4000 CABLE ASSY-PARKING BRAKE,LH 87089900 28% 1.00 959.38 100.00% 959.37 8 86613B4400 BRACKET-RR BUMPER SIDE 87089900 28% 1.00 166.40 100.00% 166.40 9 55326B4000 BUMPER-RUBBER 87088000 28% 1.00 532.82 100.00% 532.82 10 58737B4700 HOSE-REAR WHEEL LH 87089900 28% 1.00 435.16 100.00% 435.15 11 527501G101 HUB ASSY-RR WHEEL 87089900 28% 2.00 2,847.66 100.00% 5,695.31 12 NPNB BRAKE OIL 250ml DOT-4 38190010 18% 2.00 93.22 100.00% 186.44 Special Comment:-The below mentioned Non-Genuine Fitments may Hamper your Safety and/or Result in Poor Performance of your vehicle. HMIL is not Responsible for any untoward incident due to the same. Kindly return the vehicle to its Original Condition as per HMIL specifications. Observation: No Accessory Fitment Additional Information: Pending Jobs Sub Total 20,138.62 Coupon Discount 0.00 TCS Tax 0.00 Discount 0.00 AMC Discount 0.00 CGST@9% ON Part Value of 1364.44 122.80 SGST@9% ON Part Value of 1364.44 122.80 CGST@14% ON Part Value of 18774.18 2,628.38 SGST@14% ON Part Value of 18774.18 2,628.38 Total 25,640.98 Grand Total (Rounded) 25641 Rupees Twenty Five Thousand Six Hundred Forty One Rupees Only For SUJAYA ENTERPRISES PV (Authorized Signatory) Thank you for making Hyundai a Leader in Customer Service for three years in a row. ---PAGE END---