TAX INVOICE Issued under GST Invoice Rules Original :For Recipient Duplicate :For Supplier Mr. SHIVA SINGH Invoice No : ICALMA2021004697 H.NO. 160, BANDHAIYA MOHALLA Invoice Date :21/11/2020 NORTH MILLONIGANJ , JABALPUR Model : TATA TIAGO JABALPUR, JABALPUR Chassis No : MAT626344GKK39381 JHIRI, 482002 Insurance Co : BAJAJ ALLIANZ GENERAL INSURANCE Madhya Pradesh(23) CO.LTD Phone No (Res,Off,Mob): 8817187070, , 9755406009 Kms. : 30340 Customer GSTIN : Vehicle Regn. No : MP20CG0370 A/C Code : 1-JEIPZ04 Job Card No. : JC-CommAuJ-MM-2021-004345 Place of Supply: 23-Madhya Pradesh Job Card Date : 20/11/2020 Service Request Type : Accident Customer P.O. No - Date : Payment Method : CREDIT Warranty Expired :Y Dealer PAN:AACCC4267E Dealer GSTIN : 23AACCC4267E1Z1 PAN : Total Insuran SGST/UTGS Disc Campai CGST Total Amt s Part#/Job Amt Extra ce Taxabl T HSN/SAC Particulars Type UoM Qty Rate Amt/Itegn Disc Disc % (Incl. No Code (Base Chg Liability|ee AmttRate[AmounRateAmoun m % Taxes) Price) % % t % t WINDSHIEL D 3214.90.9 8855WORK|AADHESIVE 1,845.7 Paid Each 2 922.88[1,845.76 0 9 166.12 9 166.12 2,178.00 0 0001 GLASS 6 SEALENT - SUMA 3910.00.1 ADHFEVIK 2 FEVI KWIK Paid Each 2 18.64 37.29| 0 37.29 9 3.36 9 3.36 44.00 0 W ASSY 7007.19.05424671001 5,240. 5,240.6 3 WINDSHIEL Paid Each 1 5,240.68 0 9 471.66 9 471.66 6,184.00 0 01 68 8 D GLASS REPLACE FRONT WINDSCRE 1,326.0 4 998714 671000 EN PAID 1 1326 1326 0.00 9 119.34 9 119.34 1,564.68 0 GLASSWIN DGLASS R/R Sub Total: 8,449.73 Total Tax Amount : 1,520.95 Parts Net Taxable Amount : 7,123.73 Final Labour Invoice Amount : 1,564.68 Final Parts Invoice Amount : 8,406.00 @ 9% CGST on Labour: 119.34 @ 9% SGST on Labour: 119.34 @ 9% CGST on Parts: 641.14 @ 9% SGST on Parts: 641.14 Gross Amount : 9,970.68 Adjustments : 0.32 ---PAGE END--- 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 JABALPUR shall have jurisdiction in any proceedings relating to this contract. 3) ! have inspected the vehicle MP20CG0370 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 MAT626344GKK39381 4) I hereby consent and authorize COMMERCIAL AUTOMOBILES PVT. LTD / JABALPUR 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 COMMERCIAL AUTOMOBILES PVT. LTD Customer's Signature Authorized signatory ---PAGE END--- COMMERCIAL AUTOMOBILES PVT. LTD * GATE PASS * Customer Name : SHIVA SINGH Invoice Ref. : ICALMA2021004697 dated 21/11/2020 Vehicle No : MP20CG0370 Invoice Amount : Rs. 9,971.00 Chassis No : MAT626344GKK39381 Job Card / Order ref : JC-CommAuJ-MM-2021-004345 dated 20/11/2020 Model Name : TATA TIAGO Gate Pass No & Date : Vehicle / Goods received in good condition and to our satisfaction. ---PAGE END---