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 Lessor/Bill to Bajaj Allianz General Insurance Co. Lessee/Ship to VIVAN ACIDCHEM PVT. LTD. Veh. Reg. No. MP09CT7978 Invoice No. SR34920-8968 Ltd. Phone +919826064024 Model CITY DE Invoice Date 23-02-2021 03:32 PM GSTIN 23AABCB5730G1Z5 GSTIN 23AAFCV1293E1ZJ Chassis No. MAKGM85RGG4200622 RO No. SER-RO-DD349-2021-8179 Address HIG-10,Shivaji Nagar opposite Pragati Ship to Engine No. N15A13406388 RO Type BP petrol Pump Bhopal Madhya Pradesh Wrnty Start 18-07-2016 Visit Date 15-02-2021 03:28 PM 462016 India Place of Supply Madhya Pradesh State Mileage 86585 State Code 23 State Code IRN Number 0bbb57144aeb7219d332cc382cca57179ee004e8321fea85ab02eb16d89096e2 PAN PAN IRN Version 1.1 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 / Item % % Amt % Amt Disc Amt Amount % Amt % Amt FRT DAMAGE - (Body & Paint Work) AC GAS CHARGING (EVACUATE, 67.50 ACGSCHRG 998714 Paid 750.00 0 0 100.00 750.00 0.00 0.00 0.00 750.00 9 67.50 9 885.00 RECHARGE & LEAK TEST OF SYSTEM) AC GAS CHARGING (EVACUATE, ACGSCHRG 998714 Paid 750.00 0 0 100.00 750.00 0.00 0.00 0.00 750.00 9 67.50 9 67.50 885.00 RECHARGE&LEAK TEST OF SYSTEM) AC GAS CHARGING (EVACUATE, L ACGSCHRG 998714 Paid 750.00 0 0 100.00 750.00 0.00 0.00 0.00 750.00 9 67.50 9 67.50 885.00 RECHARGE & LEAK TEST OF SYSTEM) Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier ACCIDENTAL REMOVAL AND Paid 0.00 0.00 L RRFTCHGS 998714 1 3500.00 0 0 100.00 3500.00 0.00 3500.00 9 315.00 9 315.00 4130.00 REFITMENT CHARGES L ACDNTRPR 998714 ACCIDENTAL REPAIR Paid 1 3250.00 0 0 100.00 3250.00 0.00 0.00 0.00 3250.00 9 292.50 9 292.50 3835.00 PAINT CHGS FRONT PNTFRBMPR3 L 998714 BUMPER FACE - Paid 1 8120.00 0 0 100.00 8120.00 0.00 0.00 0.00 8120.00 9 730.80 9 730.80 9581.60 c 3COAT 60400T9DK00 870899 NOS 15979.1 P BULKHEAD COMP.FR Paid 1 15979.18 0 0 100.00 0.00 0.00 0.00 15979.18 14 2237.09 14 2237.09 20453.35 ZZ 00 8 841590 CONDENSER SUB 12812.6 P 80110T9DK01 Paid 1 NOS 12812.66 0 0 100.00 0.00 0.00 0.00 12812.66 14 1793.77 14 1793.77 16400.20 00 ASS 6 870891 NOS P 1901055SE01 RADIATOR COMP Paid 1 4732.42 0 0 100.00 4732.42 0.00 0.00 0.00 4732.42 14 662.54 14 662.54 6057.50 00 P 870891 NOS 100.00 0.00 14 14 193.41 190155XVE01 SHROUD COMP Paid 1 1381.49 0 0 1381.49 0.00 0.00 1381.49 193.41 1768.31 00 870891 P 38611RNYE01 FAN COOLING Paid 1 NOS 1936.97 0 0 100.00 1936.97 0.00 0.00 0.00 1936.97 14 271.18 14 271.18 2479.32 00 870891 NOS P 1902055SE01 FAN COOLING Paid 1 1980.96 0 0 100.00 1980.96 0.00 0.00 0.00 1980.96 14 277.33 14 277.33 2535.63 00 841590 PIPE 1799.03 P 80341T9DK02 Paid 1 NOS 0 0 100.00 1799.03 0.00 0.00 0.00 1799.03 14 251.86 14 251.86 2302.76 00 COMP.RECEIVER 71101T9DK00 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 382000 P 08C56G0210 RADIATOR LIQUID 1L Paid 4 NOS 265.60 0 0 100.00 1062.40 0.00 0.00 0.00 1062.40 9 95.62 9 95.62 1253.63 00 870899 Paid 7 NOS 482.23 0.00 14 67.51 14 P 91501TR0003 CLIP.INN FENDER 68.89 0 0 100.00 0.00 0.00 482.23 67.51 617.25 00 870810 NOS 0.00 P 71140T9AT00 UP BEAM R.FR BUMP Paid 1 381.04 0 0 100.00 381.04 0.00 0.00 381.04 14 53.35 14 53.35 487.73 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 P 71198T9DK00 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 731815 P 90103SDAA00 SCREW.TAPPING 5X2 Paid 4 NOS 37.78 0 0 100.00 151.12 0.00 0.00 0.00 151.12 9 13.60 9 13.60 178.32 00 870899 P 91505TM8003 CLIP.BUMPER Paid 10 NOS 84.66 0 0 100.00 846.60 0.00 0.00 0.00 846.60 14 118.52 14 118.52 1083.65 00 870899 Paid NOS 0.00 0.00 14 14 P 71121T9DK50 BASE.FR GRILLE 1 2464.73 0 0 100.00 2464.73 0.00 2464.73 345.06 345.06 3154.85 00 870899 Paid NOS P 75700TF0000 EMBLEM.H-MARK 92 1 145.58 0 0 100.00 145.58 0.00 0.00 0.00 145.58 14 20.38 14 20.38 186.34 00 731819 PUSH NUT 3MM Paid NOS 0 7.46 P 90301ST0003 2 41.45 0 100.00 82.90 0.00 0.00 0.00 82.90 9 9 7.46 97.82 00 870899 318.57 P 71122T9AT40 UPR MLDG.FR GRILLE Paid 1 NOS 2275.48 0 0 100.00 2275.48 0.00 0.00 0.00 2275.48 14 14 318.57 2912.61 00 870899 NOS P 76841TSVK01 SET TANK WASHER Paid 1 362.41 0 0 100.00 362.41 0.00 0.00 0.00 362.41 14 50.74 14 50.74 463.88 00 870899 Paid NOS 100.00 274.73 0.00 274.73 14 38.46 14 P 76806TG1T01 MOTOR WASHER 1 274.73 0 0 0.00 0.00 38.46 351.65 00 Recommendations: Supply Type : B2B ---PAGE END--- 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 VIVAN ACIDCHEM PVT. LTD. Veh. Reg. No. MP09CT7978 Invoice No. SR34920-8968 Ltd. Phone +919826064024 Model CITY DE Invoice Date 23-02-2021 03:32 PM GSTIN 23AABCB5730G1Z5 GSTIN 23AAFCV1293E1ZJ Chassis No. MAKGM85RGG4200622 RO No. SER-RO-DD349-2021-8179 Address HIG-10,Shivaji Nagar opposite PragatiShip to Engine No. N15A13406388 RO Type BP petrol Pump Bhopal Madhya Pradesh Wrnty Start 18-07-2016 Visit Date 15-02-2021 03:28 PM 462016 India Place of Supply Madhya Pradesh State Mileage 86585 State Code 23 State Code IRN Number 0bbb57144aeb7219d332cc382cca57179ee004e8321fea85ab02eb16d89096e2 PAN PAN IRN Version 11.1 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 51594.73 Taxable Amt 17120.00 o For any query / feedback, you may kindly contact: CGST @ 9% 116.68 CGST @ 9% 1540.80 Customer Relations Manager - 7225060818 SGST @ 9% 116.68 SGST @ 9% 1540.80 Service Manager - 7225060819 o Visit Customer Service website: https://www.hondacarindia.com/Honda-Services CGST @ 14% 7041.76 Total Labor Amt 20201.60 SGST @ 14% 7041.76 Total Parts Amt 65911.61 TCS Tax @ % 0.00 Total Amount 86113.21 Net Amount 86113.21 Grand Total (Rounded - Off) 86113.00 (-0.21) Amount in Words: Rupees Eighty Six Thousand One Hundred Thirteen 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 : RavindraSingh Thakur (Authorized Signatory) Supply Type : B2B ---PAGE END---