TAX INVOICE Issued under GST Invoice Rules Original :For Recipient Duplicate :For Supplier RAMESH S Invoice No : ISAYPU2021000267 RURAL FARMERS Invoice Date :18/06/2020 MUGUTAGERI VILLAGE, KUNDA, Model : TATA TIAGO KODAGU, 571216 Chassis No : MAT626281JKD37634 VIRAJPET, KODAGU Insurance Co : BAJAJ ALLIANZ INS. CO. LTD. KUNDA, Kms. : 25461 Karnataka(33) Vehicle Regn. No : TN21BH0465 India Job Card No. : JC-SayAau-PP1-2021-000182 Phone No (Res,Off,Mob): 9793174207, Job Card Date : 06/06/2020 Customer GSTIN : Service Request Type : Accident A/C Code : 1-F9FRUMC Customer P.O. No - Date : Place of Supply: 33-Tamil Nadu Payment Method : CREDIT Warranty Expired :N Dealer PAN:AARCS4599N Dealer GSTIN : 33AARCS4599N1ZB 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 Chg Amt/Itegn DiscDisc % (Incl. No Code (Base Liability|e AmtRate|AmounRateAmoun m % Taxes) Price) % % t % t ASSY. MEMBER 8708.99.05424622001 RADIATOR Paid Each 518.75 518.75 0 518.75 14 72.62 14 72.62 664.00 0 8221 SUPPORT TOP RH CROSS MEMBER 8708.99.05424622001AASSY, 2,256.2,256.25 2,256.2 2 Paid Each 1 0 14 315.8814 315.88 2,888.00 0 0121 FRONT 25 5 BUMPER MTG ASSY MBR RADIATOR 8708.99.05424622001 3 SUPPORT Paid Each 1 714.84 714.84 0 714.84 14 100.0814 100.08 915.00 0 3021 BOTTOM IN RH FRONT 8708.99.05424885063 2,046. 2,046.0 4 BUMPER Paid Each 1 2,046.09 0 14 286.45 14 286.45 2,619.00 0 01 SKIN 09 9 ASSY MEMBER 1,270.3 8708.99.05424622001 1,270. 5 RADIATOR Paid Each 1 1,270.31 0 14 177.84 14 177.84 1,626.00 0 0921 31 1 SUPPORT TOP COM CED ASSY 8708.99.05424887001 6,850. 6,850.0 6 HOOD Paid Each 1 6,850.00 0 14 959.00 14 959.00 8,768.00 0 0221 00 0 SHELL ASSY. 8708.99.05424887001 7 HOOD Paid Each 1 302.34 302.34 0 302.34 14 42.33 14 42.33 387.00 0 07 HINGE LH ASSY. 8708.99.05424887001 8 HOOD Paid Each 1 302.34 302.34 0 302.34 14 42.33 14 42.33 387.00 0 08 HINGE RH ASSY MBR RADIATOR 8708.99.05424622001 9 MTG Paid Each 1 696.88 696.88 0 696.88 14 97.56 14 97.56 892.00 0 43 BOTTOM COMP FEM ---PAGE END--- LAMP 0 02 ASSY, RH 80 0 FRONT [2,974.2 8708.99.0 |55424885063 2,974. 11 BUMPER Paid Each 1 2,974.22 0 14 416.3914 416.39 3,807.00 0 03 TOP GRILL 22 2 FRONT 8708.99.05424885063BUMPER 12 Paid Each 1 943.75 943.75 0 943.75 14 132.1214 132.12 1,208.00 0 06 BOTTOM GRILL TOP GRILL 8708.99.05424885063 13 ADDON Paid Each 1 427.34 427.34 0 427.34 14 59.8314 59.83 547.00 0 04 PART CED ASSY [2,204.6 8708.99.05424881001 2,204. 14 FENDER Paid Each 1 2,204.69 0 14 308.6614 308.66 2,822.00 0 1521 COMP LH 69 9 8708.10.95424885063FOG LAMP Each 446.09 15 Paid 1 446.09 446.09 0 14 62.45 14 62.45 571.00 0 14 RING RH ASSY ORVM 7009.10.15424811001 3,683.[3,683.90 3,683.9 16 ELECTRIC Paid Each 1 0 9 331.55 9 331.55 4,347.00 0 20 WITH SRL 90 0 LH ASSY 8708.10.95424881001WHEEL 17 Paid Each 1 572.66 572.66 0 572.66 14 80.17 14 80.17 733.00 0 11 ARCH FRONT RH 8708.99.05425887001STAY ROD Paid Each 284.38 14 14 39.81 18 1 284.38 0 284.38 39.81 364.00 0 13 CLIP,STAY 8708.99.05424887082 19 ROD Paid Each 1 11.72 11.72 0 [11.72 14 1.64 14 1.64 15.00 0 34 CLAMP 8512.20.15424544001FOG LAMP 1,114.4 1,114 100.30 20 ASSY; Paid Each 1 1,114.41 0 9 100.30 9 1,315.00 0 06 41 1 FRONT ASSY SIDE BRACKET 8708.99.05424885001 21 FRONT Paid Each 1 113.28 113.28 0 113.28 14 15.86 14 15.86 145.00 0 09 BUMPER RH ASSY SIDE BRACKET 8708.99.05424885001 22 FRONT Paid Each 1 113.28 113.28 0 113.28 14 15.86 14 15.86 145.00 0 08 BUMPER LH 4010.35.9 5715151463BELT POLY 23 Paid Each 1 534.75 534.75 0 534.75 9 48.13 9 48.13 631.00 0 01 V 5PK ASSY SUCTION 8415.90.05424831401|HOSE 1,122. 1,122.6 24 Paid Each 1 [1,122.66 0 14 157.17 14 157.17 1,437.00 0 05 PETRO X0 66 6 MY15 COMP END HOSE 4009.31.05715501058|(RADIATOR 24.79 25 Paid Each 1 275.42 275.42 0 275.42 9 24.79 9 325.00 0 03 TO.WATER PUMP) 8708.99.05707501001RADIATOR 3,829.[3,829.69 [3,829.6 14 26 Paid Each 1 0 14 536.16 536.16 4,902.00 0 20 ASSY 69| 9 ASSY 8415.90.05424833001CONDENSE 9,314.[9,314.84 9,314.8 27 Paid Each 1 0 14 1,304.08 14 1,304.08 11,923.00 0 02 R PETROL 84 4 X0 MY15 FAN 8708.99.0G570750100MOTOR [6,165.6 6,165. 28 ASSY WITH Paid Each 1 6,165.62 0 14 863.19 14 863.19 7,892.00 0 119 SHROUD- 62 2 Tiago 6805.20.9 8855WORK|3M Dry 43.22 29 Paid Each 1 43.22 0 43.22 9 3.89 9 3.89 51.00 ---PAGE END--- Disc 6" 80grit 3M Dry 6805.20.9 8855WORK|Sanding 30 Disc 6" Paid Each 1 43.22 43.22 0 43.22 9 3.89 9 3.89 51.00 0 0019M 180grit 3M Dry 6805.20.9 8855WORKSanding 31 Paid Each 2 43.22 86.44 0 86.44 9 7.78 9 7.78 102.00 0 0021M Disc 6" 320grit 3M Dry 6805.20.98855WORKSanding 7.78 32 Paid Each 2 43.22 86.44 0 86.44 9 9 7.78 102.00 0 0022M Disc 6" 400grit 3M Dry 6805.20.98855WORKSanding File 33 Paid Each 1 66.95 66.95 0 66.95 9 6.03 9 6.03 79.00 0 0028M sheet (M) 120grit DISCHARG [1,003.9 8708.99.05424834069 1,003. 34 E HOSE Paid Each 1 1,003.91 0 14 140.55 14 140.55 1,285.00 0 17 ASSY 91 8708.99.05424241001A-MOUNT 1,778.1,778.91 1,778.9 35 Paid Each 1 0 14 249.0514 249.05 2,277.00 0 09 ASSY 91 1 ASSY [5,240.6 7007.19.0[5424671001 5,240. 36 WINDSHIEL Paid Each 1 5,240.68 0 9 471.66 9 471.66 6,184.00 0 01 D GLASS 68 8 WINDSHIEL D 3214.90.98855WORKADHESIVE 37 Paid Each 1 922.88 922.88 0 922.88 9 83.06 9 83.06 1,089.00 0 0001 GLASS SEALENT - SUMA 3214 ADHANABOANABOND Paid Each 1 19.53 19.53 19.53 14 2.7314 2.73| 25.00 38 0 25 666T (25gm) RUBBER 4009.42.027905010583|HOSE(CYL. 16.02 39 Paid Each 1 177.97 177.97 0 177.97 9 9 16.02 210.00 0 21 HEAD VENT) 2903.11.1ACGASR13AC GAS Kgs 40 Paid 0.65580.68 377.44 0 377.44 9 33.97 9 33.97 445.38 0 4 R134A R134 A OIL OILCOMPR(COMPRES 2,423. 41 3403 Paid Ltr 0.1 242.37 0 242.37 9 21.81 9 21.81 286.00 R134 SOR OIL 73 AC) PUSH ON 8708.99.02874995063 42 NUT M6X12 Paid Each 5 13.28 66.41 0 66.41 14 9.3014 9.30 85.00 0 17 (OD18) X TREE 8708.29.02678995063 43 42 CLIP Paid Each 10 10.16 101.56 0 101.56 14 14.22 14 14.22 130.00 0 BLACK ASSY 8301.20.05424811001HOOD 44 Paid Each1271.19 271.19 0 271.19 9 24.41 9 24.41 320.00 0 14 LATCH COMP FITMENT CHARGESF RONT BUMBER, FENDER 21,913. 45 998714 OTFIT BOTH,FRT PAID 0 0 21913 0.00 9 1,972.17 [1,972.1725,857.34 DOOR, 00 REAR DOOR PAINT CHRG'S FITMENT CHARGESR [3,350.0 46 998714 OTFIT &R PAID o 03350 0.00 9 301.509 301.50 3,953.00 FENDER, 0 ---PAGE END--- E : 2 R3 1 : 6 6 : : : : : : : : : E + E : E : E 5 1 : : E 2I EE:E1E5E1E RE EB1 1:E :115HE E =B :: S H:E a 53 3 1 m E E : : : : : : : : EEEE 8 - : 2 : : 0 0 3 0 0 : : : : 0 0 0 0 : 2 N 2 1 : : : : :: : :: : : EE B 0E 0 E 0E 1 oN:6 ONE : : : 6 6 6 6 6 6 6 6 : 1 3 E : 1 : : : : : : 6 6 6 6 6 6 6 6 E E 4 3 E : 1 E EE EEE : : : : 1 : E 2 : E E : E ---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 PERUMUGAI shall have jurisdiction in any proceedings relating to this contract. 3) * Statistically generated based on Average kilometer's run per day. For SAYAR AAUTOMOTIVE PVT. LTD. Customer's Signature Authorized signatory ---PAGE END--- SAYAR AAUTOMOTIVE PVT. LTD. * GATE PASS * Customer Name : RAMESH S Invoice Ref. : ISAYPU2021000267 dated 18/06/2020 Account Name : RURAL FARMERS Invoice Amount : Rs. 120,458.00 Vehicle No : TN21BH0465 Job Card / Order ref : JC-SayAau-PP1-2021-000182 dated 06/06/2020 Chassis No : MAT626281JKD37634 Gate Pass No & Date : Model Name : TATA TIAGO Vehicle / Goods received in good condition and to our satisfaction. ---PAGE END---