TAX INVOICE
                                                                                        Issued under GST Invoice Rules
                                                                                                                                                                 Original : For Recipient
                                                                                                                                                                 Duplicate : For Supplier


 BAJAJ ALLIANZ GENERAL INSURANCE                   Invoice No : AY2021/0087                                  Model:TATA TIAGO
 COMPANY                                                               Invoice Date : 29/09/2020                                    Chassis No:MAT626289JKNA8846
 15/54-B,2ND FLOOR, VIRENDRA SMRATI              Service Request Type : Accident                         Vehicle Regn.No:JH02AW9083
 COMPLEX, CIVIL LINES                                           Job Card No. : JC-AyushM-AY-2021-001429
 ADAMPUR INDWARA                                              Job Card Date : 28/09/2020
 LUCKNOW                                                               Kms:27901
 LUCKNOW                                                               Dealer Name:AYUSH MOTORS (India) Pvt.
 UP,                                                                          Ltd.
 India                                                                         Dealer GSTIN :09AAGCA1314E1Z7
 Customer GSTIN : 09AABCB5730G1ZV
 Place of Supply : Uttar Pradesh

                                                                                                   Total   Extr|                                               CGST        SGST/UTGST
                                                                                                    Amt                    DiscLiablit
                                Part #/Job Descriptio[Billing[g|UO Qt                           a Disc/It                Taxable
 S No     HSN/SAC                                                          Rate                                  %                                                                        Total Amt
                                   Code          n       Type M  y               (Base   Chr  em          y %     Amt    Rate    Amt
                                                                                                                                                                                      Rate    Amt
                                                                                                   Price)    g                                             %
                                                 FITMENT
                                                CHARGES
                                                (ACCIDEN
                                                    TAL
                                                  LABOR
                                                CHARGES)
                                                                Insura                                     3,50
    1         998714        OTFIT      (AMIT                     1    0.00        0              0.00          100  3,500.00  9.00   315.00   9.00   315.00  4,130.00
                                                                  nce                                       0.00
                                                CHAMBIAL
                                                844778785
                                                 1)CL NO.
                                                 OC211103
                                                187000001
                                                    641-
                                                CED ASSY
                                542488100 FENDER  InsuraEac                 2204.687
    2       8708.99.00                                                       2,204.69                     0.00          100  2,204.6914.00  308.66  14.00  308.66  2,822.00
                                   11821    COMP RH  nce   h                        5
                                                 WITH SRL
                                                 WINDING
                                                  GLASS
                                287172502   FRONT   InsuraEac                  1379.661
    3       7007.11.00                                                       [1,379.66                      0.00          100  1,379.66 9.00   124.17   9.00   124.17  1,628.00
                                     302       DOOR-    nce   h                       02
                                                  TINTED
                                                     RH
                                                   ASSY
                                                   ORVM
                                542481100                 InsuraEac                  3683.898        0.00
    4       7009.10.10                  ELECTRIC                     [3,683.90                                       100  3,683.90  9.00   331.55   9.00   331.55  4,347.00
                                     121                       nce   h                       31
                                                WITH SRL
                                                     RH
Parts Net Taxable Amount:         7,268.25                                                                           Labour Net Taxable Amount:                          3,500.00
Final Parts Invoice Amount:        8,797.00                                                                                 Final Amount on Labour:                          4,130.00
@9% CGST on Parts:455.72                                                                                                                               @ 9% CGST on Labour:315.00
@14% CGST on Parts:308.66
                                                                                                                                                                            @ 9% SGST on Labour:315.00



 @9% SGST on Parts:455.72
 @14% SGST on Parts:308.66


                                                                                                                                                                                      Sub Total:        10,768.25

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                                                                                                                                                                 Gross Amount:       12,927.00
                                                                                                                                                          Adjustment Amount:              -0.00
Rupees Twelve Thousand Nine Hundred Twenty Seven Only.                                                                         Grand Total :       12,927.00
        Tax Payable under Reverse Charge - No
 Terms and Conditions:                                                                                                                                                        E. &0.E
  1) Goods once sold will not be taken back .
  2) Only the courts of BANGALORE shall have jurisdiction in any proceedings relating to this contract.
  Vehicle / Goods received in good condition and to our satisfaction.
                                                                                                                                                     For AYUSH MOTORS (India) Pvt. Ltd

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