Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier 0 Insurance Invoice TAX INVOICE LANDMARK AUTOMOBILES PVT. LTD. PAN : AACCW1601N; GSTIN: 24AACCW1601N1ZG; CIN: U50100GJ2018PTC101082 Add: Signature,68/3, FP : 36,Near Iskon Mall,Dumas Road,Surat, Surat - 395007., Surat, Gujarat, India - 395007 Phone: +919909905927 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Lessor/Bill to Bajaj Allianz General Insurance Co. Lessee/Ship to NITIN KUMAR KANTI LAL PATEL Veh. Reg. No. GJ19AM6354 Invoice No. SR34520-20518 Ltd. Phone +919898554956 Model WR-V DE Invoice Date 11-02-2021 07:22 PM GSTIN 24AABCB5730G1Z3 GSTIN Chassis No. MAKGL274GH4006025 RO No. SER-RO-DD345-2021-17088 Address 4th Floor, Turquoise Nr. Panchvati Ship to O, PATEL FALIYA KANI Surat 394350 Engine No. N15A15007706 RO Type BP Circle C.G Road, Ellisbridge Gujarat Wrnty Start 24-07-2017 Visit Date 25-01-2021 02:29 PM Ahmedabad Gujarat 380006 India Place of Supply Gujarat State Gujarat Invoice Type Mileage 52157 State Code 24 State Code 24 IRN Number 891abb51ef4b4ab27b4dd26ece c007154fa52fb5274fa415b1947 4517e137406 PAN IRN Version 1.1 P/L Labor Code / HSN I Description Issue Qty UoM Job Value Disc Dis Insurer Insured Insurer Taxable CGST SGST / UTGST Amount(?) Part# SAC Type IRTLP I Item % % Amt % Amt Disc Amt Amount % Amt % Amt BASIC CAR CARE SANIT -GL27-BP - (Value Added Services) BASIC CAR CARE Paid 0.00 0.00 22.50 22.50 L VASBCC 998714 1 250.00 0 0 100.00 250.00 0.00 250.00 9 9 295.00 (SANITIZATION) BODY JOB - (Body & Paint Work) Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier 0 RRFTRRBMP Paid 650.00 100.00 650.00 650.00 58.50 58.50 L 998714 R/RFT REAR BUMPER 1 0 0 0.00 0.00 0.00 9 9 767.00 R RRFTBOOTLI Paid 42.75 L 998714 R/RFT BOOT LID 1 475.00 0 0 100.00 475.00 0.00 0.00 0.00 475.00 9 42.75 9 560.50 D RRFTRRWSD R/RFT REAR W/SHLD L 998714 Paid 1 2550.00 0 0 100.00 2550.00 0.00 0.00 0.00 2550.00 9 229.50 9 229.50 3009.00 GLS GLASS RPLCRBMSK REPLACE REAR 100.00 252.00 252.00 L 998714 Paid 1 2800.00 0 0 2800.00 0.00 0.00 0.00 2800.00 9 9 3304.00 T BUMPER SKIRT R/RFT TAIL LAMP 31.50 L RRFTTLLMP 998714 Paid 1 350.00 0 0 100.00 350.00 0.00 0.00 0.00 350.00 9 9 31.50 413.00 (EACH) RPRRHQTRP REPAIR RHS QTR Paid 100.00 L 998714 1 3700.00 0 0 3700.00 0.00 0.00 0.00 3700.00 9 333.00 9 333.00 4366.00 NL PANEL L RPRRFLR 998714 REPAIR REAR FLOOR Paid 1 - 2500.00 0 0 100.00 2500.00 0.00 0.00 0.00 2500.00 9 225.00 9 225.00 2950.00 04717TXKK00 870810 P FACE R.RR BPR COR Paid 1 NOS 1294.01 0 0 100.00 1294.01 0.00 0.00 0.00 1294.01 14 181.16 14 181.16 1656.33 Zz 90 870810 100.00 P 71501TXKK00 FACE.RR BUMPER Paid 1 NOS 3084.44 0 0 3084.44 0.00 0.00 0.00 3084.44 14 431.82 14 431.82 3948.08 90 870899 UNDERGUARD.RR P 71504TXKK00 Paid 1 NOS 2751.33 0 0 100.00 2751.33 0.00 0.00 0.00 2751.33 14 385.19 14 385.19 3521.70 00 BUMPER P 870899 EMBLEM.H-MARK 92 Paid NOS 100.00 225.78 14 14 31.61 75701TRYM00 1 225.78 0 0 0.00 0.00 0.00 225.78 31.61 289.00 00 (GLOBAL) 870899 EMBLEM.RR CAR Paid 247.76 100.00 247.76 0.00 247.76 14 14 P 75722TXKK00 1 NOS 0 0 0.00 0.00 34.69 34.69 317.13 00 NAME 870899 EMBLEM.RR GRADE P 75723T5SK40 Paid 1 NOS 158.41 0 0 100.00 158.41 0.00 0.00 0.00 158.41 14 22.18 14 22.18 202.76 00 VX 870899 NOS 14 16.12 16.12 P 75731T6EK00 EMBLEM.RR I-DTEC Paid 1 115.11 0 0 100.00 115.11 0.00 0.00 0.00 115.11 14 147.34 00 870899 PROTECTOR R.RR P 74410TXKK00 Paid 1 NOS 1843.28 0 0 100.00 1843.28 0.00 0.00 0.00 1843.28 14 258.06 14 258.06 2359.40 00 W/ARCH 66100TXKK00 870899 0 P PANEL COMP.REAR Paid 1 NOS 4812.00 0 100.00 4812.00 0.00 0.00 0.00 4812.00 14 673.68 14 673.68 6159.36 zz 00 870899 14 P 73214T5SK00 RUBBER WSHLD DAM Paid 2 NOS 109.42 0 0 100.00 218.84 0.00 0.00 0.00 218.84 30.64 14 30.64 280.12 00 P 870899 Paid NOS 100.00 210.73 0.00 0.00 14 29.50 29.50 73226SZW000 DAM.STD 5X5 1 210.73 0 0 0.00 210.73 14 269.73 00 392690 100.00 P 91501T5AJ01 FASTENER C.WSHLD Paid 4 NOS 125.86 0 0 503.44 0.00 0.00 0.00 503.44 9 45.31 9 45.31 594.06 99 870899 FASTENER NOS 14 14 P 91502S70003 Paid 2 119.25 0 0 100.00 238.50 0.00 0.00 0.00 238.50 33.39 33.39 305.28 00 B.RR.WINDSH 870899 P 91536SS0J01 FASTNER A WSHILD Paid 2 NOS 63.89 0 0 100.00 127.78 0.00 0.00 0.00 127.78 14 17.89 14 17.89 163.56 00 P 68100TXKK00 870899 100.00 5429.66 14 760.15 14 760.15 TAIL GATE COMP Paid 1 NOS 5429.66 0 0 0.00 0.00 0.00 5429.66 6949.96 ZZ 00 350610 3M-ALL AROUND 144.00 144.00 P IA260165146 Paid 1 NOS 1600.00 0 0 100.00 1600.00 0.00 0.00 0.00 1600.00 9 9 1888.00 00 AUTO BODY SEALANT 3M-SUPER FAST 350699 Paid NOS 0.00 P IA260165310 URETHANE 1 1600.00 0 0 100.00 1600.00 0.00 0.00 1600.00 9 144.00 9 144.00 1888.00 99 CARTRIDGE 310 ML 08Z02WASH0 340290 Windscreen Fluid P Paid 1 NOS 46.57 0 0 100.00 46.57 0.00 0.00 0.00 46.57 9 4.19 9 4.19 54.95 1 99 P 71530TXKK00 870810 BEAM COMP.RR Paid 100.00 0.00 14 469.49 469.49 1 NOS 3353.47 0 0 3353.47 0.00 0.00 3353.47 14 4292.44 ZZ 90 BUMPER Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier 870899 GARN ASSY. RR Paid NOS 100.00 0.00 0.00 0.00 14 14 P 74890TXKK31 1 2257.79 0 0 2257.79 2257.79 316.09 316.09 2889.97 00 LICENCE 392690 NOS 0.00 0.00 0.00 P 91503SZ3003 CLIP.BPR A Paid 5 49.63 0 0 100.00 248.15 248.15 9 22.33 9 22.33 292.82 99 PAINT JOB - (Body & Paint Work) PNTRRPNLC PAINT CHGS REAR 100.00 998714 Paid 1 1936.00 0 0 1936.00 0.00 0.00 0.00 1936.00 9 174.24 9 174.24 2284.48 MP PANEL COMP INNER PAINT CHGS REAR L PNTRRBMPR 998714 Paid 1 3325.00 0 0 100.00 3325.00 0.00 0.00 0.00 3325.00 9 299.25 9 299.25 3923.50 BUMER FACE PAINT CHGS TAIL 0 L PNTTAILGAT 998714 Paid 1 4648.00 0 100.00 4648.00 0.00 0.00 0.00 4648.00 9 418.32 9 418.32 5484.64 GATE PAINT CHGS REAR PNTRRSDPNL L 998714 SIDE PANEL OUTER Paid 1 4648.00 0 0 100.00 4648.00 0.00 0.00 0.00 4648.00 9 418.32 9 418.32 5484.64 OT (RR QTR) LH/RH PAINT CHGS REAR PNTRRLWRP L 998714 LOWER PANEL SET Paid 1 3360.00 0 0 100.00 3360.00 0.00 0.00 0.00 3360.00 9 302.40 9 302.40 3964.80 NL (REAR FLOOR) Recommendations: 0 LBR & SPR CONF WITH JAYDEEP BAJAJ INS CO 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: 24AACCW1601N1ZG; CIN: U50100GJ2018PTC101082 Add: Signature,68/3, FP : 36,Near Iskon Mall,Dumas Road,Surat, Surat - 395007., Surat, Gujarat, India - 395007 , Phone: +919909905927 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Name Bajaj Allianz General Insurance Co. Name NITIN KUMAR KANTI LAL PATEL Veh. Reg. No. GJ19AM6354 Invoice No. SR34520-20518 Ltd. Phone +919898554956 Model WR-V DE Invoice Date 11-02-2021 07:22 PM GSTIN 24AABCB5730G1Z3 GSTIN Chassis No. MAKGL274GH4006025 Ro No. SER-RO-DD345-2021-17088 Address 4th Floor, Turquoise Nr. Panchvati Ship to O, PATEL FALIYA KANI Surat 394350 Engine No. N15A15007706 RO Type BP Circle C.G Road, Ellisbridge Gujarat Wrnty Start 24-07-2017 Visit Date 25-01-2021 02:29 PM Ahmedabad Gujarat 380006 India Place of Supply Gujarat State Gujarat Invoice Type Mileage 52157 State Code 24 State Code 24 IRN Number 891abb51ef4b4ab27b4dd26ecec0071 54fa52fb5274fa415b19474517e13740 6 PAN IRN Version [1.1 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 30367.05 Taxable Amt 31192.00 o For any compliment or complaint, please call: Customer Relations Manager: CGST @ 9% 359.83 CGST @ 9% 2807.28 09099061349 Service manager:09909905927 Or Email: SGST @ 9% 359.83 SGST @ 9% 2807.28 crm_surat@landmarkindia.net 3691.64 36806.56 CGST @ 14% Total Labor Amt SGST @ 14% 3691.64 Total Parts Amt 38470.01 TCS Tax @ % 0.00 Total Amount 75276.57 Net Amount 75276.57 Grand Total (Rounded - Off) 75277.00 (+0.43) Amount in Words: Rupees Seventy Five Thousand Two Hundred Seventy Seven 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 S PV P (Customer's Signature and Date) Service Advisor : Chirag Panchal (Authorized Signatory) Supply Type : B2B ---PAGE END---