SAI RAM AUTOMOBILES 2-1-1,OPP LIC BULDING,G.N.T ROAD, , TUNI, EAST GODAVARI, 533401, State Code: 37 Contact: 8297798222, 8297798111, 255811, , GSTIN No: 37AAQFS2698E1ZL Authorised Service Center: Hero MotoCorp Ltd. TAX INVOICE Original For Recipient Duplicate For Transporter Credit Triplicate For Supplier Place of Supply AP,37 Customer Name BAJAJ ALLIANZ GENERAL INSURANCE COMPANY Invoice No 20194BB21V6273 LIMITED Address 3RD FLOOR, Invoice Date 03-02-2021 16:54:16 PEEJAY PLAZA,VIP ROAD,CBM COMPOUND Job Card No 20194-02-RJC-0121-6102 VISAKHAPATNAM, AP 530003 Model GLAMOUR VIN MBLJA06AMHGB23951 Vehicle Reg No AP05DX2319 Kms 45850 Joyride Expiry Date State Code 37 Insurance Expiry Date GSTIN No. 37AABCB5730G1ZW Next Service Due Date 21-08-2018 (On or Before) C/o Contact Name POLAVARAPU DAVEEDU Contact Address 6-4-1/1A, BADAVA STREET, TUNI, AP, 533401 GoodLife Card # / Category / Points :: 2019417840000108 / Gold / 2752 Billing Qty Total Taxable CGST. SGST.. Total S.No. Description of Goods /Services HSN Code [UOM] Rate Discount ..Type.. Value. Value Rate.IAmount...Rate....Amount! Amount Parts Details 25K170S-BALL RACES KIT Paid PC 322.03 322.03 0.00 9% 28.98 9% 28.98 84821051 1 322.03 380.00 (ACHR/GLMR) 2 SLIPPIN-20194-SLIPPIN Paid 1 PC 1.56 1.56 0.00 1.56 14% 0.22: 14% 0.22 2.00 80100KTRA20S-FENDER Paid PC 429.69 429.69 0.00 429.69 14% 60.16 14% 60.16 550.00 3 87141090 1 COMP RR 4 50803KTR840S-GUARD LEG 87141090 Paid 1 PC| 292.97 292.97 0.00 292.97 14% 41.02 14% 41.02 375.00 52400KTR841S-CUSHION Paid PC 5 87141090 2 664.06 |1,328.12 0.00|1,328.12 14% 185.94 14% 185.94 1,699.99 ASSY. REAR 77250AAN700RS-L SIDE Paid PC 96.25 6 87141090 1 687.50 687.50 0.00 687.50 14% 96.25 14% 880.00 COWL(BLKNH-1(TY-1) 77240AAN700RS-R SIDE PC 7 87141090 Paid 1 687.50 687.50 0.00 687.50 14% 96.25 14% 96.25 880.00 COWL(BLKNH-1(TY-1) 3370AAANH01S-UNIT TAIL Paid PC| 292.37 292.37 0.00 292.37 9% 26.31 9% 26.31 345.00 8 85122010 1 LIGHT(W/O BULB) 18340KTRA00S-COVER TAIL PC] 9 87141090 Paid 1 136.72 136.72 0.00 136.72 14% 19.14 14% 19.14 175.00 CAP 77266KTRA00S-COWLRR Paid PC| 0.00 14% 14% 8.20 10 87141090 1 58.59 58.59 58.59 8.201 75.00 UNDER 18355KTRA21S-COVER PC| 11 87141090 Paid 1 367.19 367.19 0.00 367.19 14% 51.41: 14% 51.41 470.00 MUFFLER 12 45450KTRA20S-CABLE Paid PC| 85.94 0.00 14% 12.03 87141090 1 85.94 85.94 12.03 14% 110.00 COMP FR BRAKE 13 22870KTR940S-CABLE Paid PC] 66.41 66.41 66.41 14% 9.30 9.30 85.00 87141090 1 0.00 : 14% COMP CLUTCH 17910KTRA20S-CABLE Paid PC] 85.94 85.94 0.00 85.94 14% 12.03 14% 12.03 110.00 14 87141090 1 COMP THROT 15 3345AKTRA21S-WINKER Paid PC 144.07 0.00 9% 12.97 9% 12.97 85122010 1 144.07 144.07 170.00 ASSY L FR 16 61312149300S- Paid PC 3.13 3.13 0.00 14% 14% 0.44 4.01 87141090 1 3.13 0.44 BOOTHEADLIGHT BRACKET 17 53171KCC900S-COVER R. Paid PC 8.59 0.00 14% 2.41 14% 2.41 21.99 87141090 2 17.18 17.18 HANDLE LEVER 52147KTC900S-RUBBER Paid PC 0.00 9% 9% 5.34 70.00 18 40169990 2 29.66 59.32 59.32 5.34 BUSH RR.FORK PIVOT 53178AAFH00S-LEVER PC| 19 87141090 Paid 1 54.69 54.69 0.00 54.69 14% 7.66 14% 7.66 70.00 COMP.L STRG.HNDL. 52110AAN410S-SWINGARM Paid PC! 0.00 20 87141090 1 703.13 703.13 703.13 14% 98.44 14% 98.44 900.01 COMP RR 90551178000S-WASHER Paid PC| 9% 21 73181500 1 2.12 2.12 0.00 2.12 9% 0.19: 0.19 2.50 SPECIAL ---PAGE END--- RY10W AMBER 43434286000S-RUBBER Paid PC] 9% 0.31 23 40169950 1 3.39 3.39 0.00 3.39 9% 0.31 4.00 STOPR.ARM CUSH. 53105KRC900S-END STRG. PC] 24 87141090 Paid 1 12.50 12.50 0.00 12.50 14% 1.75 14% 1.75 16.00 HANDLE 25 90101KTR900S-BOLT Paid PC! 4.24 12.72 0.00 12.72 9% 1.14 9% 1.14 15.01 73181500 3 SPECIAL 5 X 8 26 34906447710S-BULB TAIL & Paid PC[ 16.95 33.90 0.00 33.90 9% 3.05 9% 3.05 40.00 85122010 2 STOP LIGHT 27 90320GC3000S-NUT SPRING 76169990 Paid 3 PC] 2.97 8.91 0.00 8.91 9% 0.80 9% 0.80 10.51 28 77202KCC900S-RUBBER Paid PC] 4.24 4.24 0.00 4.24 9% 0.38 40169990 1 9% 0.38 5.00 SEAT MOUNTING 29 84702KCC900S-COLLR, Paid PC] 9% 9% 0.42 73151100 1 4.66 4.66 0.00 4.66 0.42 5.50 STAY NUMBER PLATE 90101GE0000S-SCREW Paid PC! 0.00 9% 9% 1.91 30 73181500 5 4.24 21.20 21.20 1.91 25.02 HINGE PATCH 32161404000S-BAND B1 PC| 31 39269099 Paid 1 5.08 5.08 0.00 5.08 9% 0.46 9% 0.46 5.99 WIRE 50100KTRA20S-FRAME Paid PC|6,710.94 [6,710.94 939.53 32 87141090 0.00|6,710.94 14% 939.53 14% 8,590.00 BODY COMP 83500AAN700RS-R SIDE PC| 33 87141090 Paid 1 699.22 699.22 0.00 699.22 14% 97.89: 14% 97.89 895.00 COVER(BLKNH-1(TY-1) 34 SIDEHOOKGLMR-20194- 8714 Paid PC| 78.13 78.13 0.00 78.13 14% 10.94 14% 10.94 1 : 100.01 SIDEHOOKGLMR Total 13,442.25 0.00 13,442.25 |1,835.16 1,835.16 17,112.56 Labour Details 102032-ACCIDENTAL Paid 1 9987 1 1,000.00 1,000.00 0.0011,000.00 9% 90.00 9% 90.00 1,180.00 LABOUR 2 102028-BOLT REMOVAL 9987 Paid 1 380.00 380.00 0.00 380.00 9% 34.20 9% 34.20 448.40 102013-Fr. FORK - RH 3 9987 Paid 400.00 400.00 0.00 400.00 9% 36.00 9% 36.00 472.00 ALIGNMENT 301010-BODY COMP 4 9987 Paid 1,350.00 /1,350.00 0.00|1,350.00 9% 121.50 9% 121.50 1,593.00 FRAME (R/R) 307001-BALL RACE KIT Paid 5 9987 200.00 200.00 0.00 200.00: 9% 18.00 9% 18.00 236.00 (R/R) 307011-STEM COMPSTRG Paid 6 9987 200.00 200.00 0.00 200.00 9% 18.00 9% 18.00 236.00 (Dismantle/ Assemble ) 301006-SET CENTER RR 7 9987 Paid 1 135.00 135.00 0.00 135.00 9% 12.15 9% 12.15 159.30 COWL(R/R) 8 102001-ALLIGNMENT 9987 Paid 1 900.00 900.00 0.00 900.00 9% 81.00 9% 81.00 1,062.00 102026-CHAIN CASE 9 9987 Paid 800.00 800.00 0.00 800.00: 9% 72.00 9% 72.00 944.00 THREADING 303003-CABLE COMP 10 9987 Paid 45.00 45.00 0.00 45.00 9% 4.05 9% 4.05 53.10 FRONT BRAKE (R/R) Total 5,410.00 0.00 5,410.00 486.90 486.90 6,383.80 CGST(Parts) @ 9% on Amount 935.20 84.17 CGST(Parts) @ 14% on Amount 12,507.05 1,750.99 SGST(Parts) @ 9% on Amount 935.20 84.17 SGST(Parts) @ 14% on Amount 12,507.05 1,750.99 TT Net Amount 23,496.36 STAY SAFE StAY A HERO Round Off -0.36 Wear a mask Maintain Wash & sanitize social distancing hands regularly Invoice Amount Payable 23,496.00 Total Invoice Value (In figure) 23,496.00 Total Invoice Value (In Words) Rs. Twenty Three Thousand Four Hundred Ninety Six Only Tax Payable under Reverse Charge-No For SAI RAM AUTOMOBILES Authorised Signatory Note: 1.E &0.E 2. This is a computer generated invoice 3. All disputes subject to jurisdiction of TUNI Jurisdiction 4. Goods once sold will not be taken back or replaced 5. Received above detailed vehicle in good condition I give Hero MotoCorp Ltd. (HMCL) and its agents/partners consent to contact me for any marketing or promotional communications through any medium and enable WhatsApp assistance. I understand HMCL privacy ---PAGE END--- Gate Pass Gate Pass Dt &Time 03-02-2021 16:54:16 Vehicle In Dt 26/01/2021 GatePass No 20194-02-RSRB-0121-6189 Invoice No 20194BB21V6273 Reg No AP05DX2319 Invoice Amt 23,496.00 VIN MBLJA06AMHGB23951 Received above detailed vehicle in good condition. Customer Signatory Authorised Signatory ---PAGE END---