Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier Insurance Invoice TAX INVOICE LANDMARK AUTOMOBILES PVT. LTD. PAN : AACCW1601N; GSTIN: 23AACCW1601N1ZI; CIN: U50100GJ2018PTC101082 Add: UG-1 Onam Plaza, Near industry house, AB road, Indore Pin - 452001 - MP, Indore, Madhya Pradesh, India - 452001 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Name Bajaj Allianz General Insurance Co. Name VINOD KUKREJA Veh. Reg. No. MP09CW1188 Invoice No. SR34920-5992 Ltd. Phone +919669990009 Model CITY PE Invoice Date 04-12-2020 04:00 PM GSTIN 23AABCB5730G1Z5 GSTIN Chassis No. MAKGM669FH4302998 RO No. SER-RO-DD349-2021-5359 Address 4th Floor,Commerce House, 7 Race Ship to Engine No. L15Z15317143 RO Type BP Course Road Indore Indore Madhya Wrnty Start 30-06-2017 Visit Date 01-12-2020 04:27 PM Pradesh 452001 India Place of Supply Madhya Pradesh State Invoice Type Mileage 29766 State Code 23 State Code PAN 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 I Item % % Amt % Amt Disc Amt Amount % Amt % Amt FR BUMPER NEW ACCIDENTAL REMOVAL AND L RRFTCHGS 998714 Paid 1 500.00 0 0 100.00 500.00 0.00 0.00 0.00 500.00 9 45.00 9 45.00 590.00 REFITMENT CHARGES PAINT CHGS FRONT PNTFRBMPR3 0.00 L 998714 BUMPER FACE - Paid 1 8120.00 0 0 100.00 8120.00 0.00 0.00 8120.00 9 730.80 9 730.80 9581.60 c 3COAT 71101T9DK10 870810 P FACE.FR BUMPER Paid 1 NOS 2265.62 0 0 100.00 2265.62 0.00 0.00 0.00 2265.62 14 317.19 14 317.19 2899.99 ZZ 90 870810 SPACER R.FR BPR P 71193T9DK00 Paid 1 NOS 88.59 0 0 100.00 88.59 0.00 0.00 0.00 88.59 14 12.40 14 12.40 113.40 90 SIDE 870810 SPACER L.FR BPR Paid NOS P 71198T9DK00 1 88.59 0 0 100.00 88.59 0.00 0.00 0.00 88.59 14 12.40 14 12.40 113.40 90 SIDE Recommendations: Supply Type : B2B ---PAGE END--- HONDA Original for Recipient Duplicate for Transporter Triplicate for Supplier Insurance Invoice TAX INVOICE LANDMARK AUTOMOBILES PVT. LTD. PAN : AACCW1601N; GSTIN: 23AACCW1601N1ZI; CIN: U50100GJ2018PTC101082 Add: UG-1 Onam Plaza, Near industry house, AB road, Indore Pin - 452001 - MP, Indore, Madhya Pradesh, India - 452001 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Name Bajaj Allianz General Insurance Co. Name VINOD KUKREJA Veh. Reg. No. MP09CW1188 Invoice No. SR34920-5992 Ltd. Phone +919669990009 Model CITY PE Invoice Date 04-12-2020 04:00 PM GSTIN 23AABCB5730G1Z5 GSTIN Chassis No. MAKGM669FH4302998 Ro No. SER-RO-DD349-2021-5359 Address 4th Floor,Commerce House, 7 Race Ship to Engine No. L15Z15317143 RO Type BP Course Road Indore Indore Madhya Wrnty Start 30-06-2017 Visit Date 01-12-2020 04:27 PM Pradesh 452001 India Place of Madhya Pradesh State Invoice Type Mileage 29766 Supply State Code 23 State Code PAN SUMMARY Delivery against Cash/D.D ONLY may kindly be drawn in favor of Parts Details Amount() Labor Details Amount(&) "LANDMARK AUTOMOBILES PVT. LTD." Taxable Amt 2442.80 Taxable Amt 8620.00 o For any query / feedback, you may kindly contact: CGST @ 14% 341.99 CGST @ 9% 775.80 Customer Relations Manager - 7225060818 SGST @ 14% 341.99 SGST @ 9% 775.80 Service Manager - 7225060819 3126.78 Total Labor Amt 10171.60 Total Parts Amt o Visit Customer Service website: https://www.hondacarindia.com/Honda- Total Amount 13298.38 Services Net Amount 13298.38 Grand Total (Rounded - Off) 13298.00 (-0.38) Amount in Words: Rupees Thirteen Thousand Two Hundred Ninety Eight 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 LANDMARK AUTOMOBILES PVT. LTD. satisfaction (Customer's Signature and Date) Service Advisor : Ramraj Yadav (Authorized Signatory) Supply Type : B2B ---PAGE END---