TAX INVOICE
                                                                                           Issued under GST Invoice Rules               Original :For Recipient
                                                                                                                                                           Duplicate :For Supplier
  Ms. BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.                            Invoice No : ISILHY2021000752
  BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.                                   Invoice Date :19/06/2020
  4TH FLOOR,NE PLAZA                                                                           ModeI : TATA WINGER
  ERRAMANZIL X ROADS                                                                         Chassis No : MAT460010DUF03413
  BESIDE BMW SHOWROOM                                                                   Insurance Co :
  KHAIRATABAD                                                                                       Kms. : 83254
  HYDERABAD-500082                                                                              Vehicle Regn. No : AP28TD5330
  Telangana(36)                                                                                         Job Card No. : JC-SriLax-HP1-2021-001147
  India                                                                                                        Job Card Date : 19/06/2020
  Phone No (Res,Off,Mob): 9999999999                                                     Service Request Type : Accident
  Customer GSTIN : 36AABCB5730G1ZY                                                  Customer P.O. No - Date :
                                                                                                                  Payment Method : CASH
                                                                                                                  Warranty Expired :N
                                                                                                                  Dealer PAN:
                                                                                                                  Dealer GSTIN : 36ABVFS7539L1Z3
                                                                                                                  Next Service Date * : 19/12/2020
  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                        Amt/Itegn Disc Disc %                                                                 (Incl.
No                    Code                                                               (Base   Chg                                       Liability[e AmtRateAmoun]RateAmoun
                                                                                                                          m         %                                                                                Taxes)
                                                                                                 Price)                                                     %                %      t      %      t
                                      WINDSHIEL
      7004.20.12845671023                                                  5,837.                                                                        5,837.2
 1                                  D GLASS       Paid    Each    1            [5,837.29               0                                                       9     525.36  9     525.36  6,888.00
            1            01                                                            29|                                                                       9
                                      BS2/3/4
                                      MISCELLAN
                                      EOUS
                                      ACTIVITY.
 2    998714      990001                       PAID                1       800      800             0.00                                        800.00   9       72.00  9      72.00     944.00
                                      W/S GLASS
                                      R&R
                                      CHARGES



                                                                                                                                                                            Sub Total:                          6,637.29
                                                                                                                                                               Total Tax Amount :                          1,194.71
  Parts Net Taxable Amount :             5,837.29                                                                   Final Labour Invoice Amount :                             944.00

  Final Parts Invoice Amount :            6,888.00
                                                                                                                                                          @ 9% CGST on Labour:                            72.00
                                                                                                                                                          @ 9% SGST on Labour:                            72.00
  @ 9% CGST on Parts:                            525.36
  @ 9% SGST on Parts:                            525.36
                                                                                                                                                                          Adjustments :                             0.00
  Rupees Seven Thousand Eight Hundred Thirty Two Only.                                                                            Grand Total :                       7,832.00

  Loyalty Info :
  Member # : xxxxx                                                                                Tier # :                                                          Balance Points :

Note:
          1) Insurance Liability % will only come for Insurance Job cards.

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once the transaction is processed. You can Redeem your points when you get your vehicle serviced next time. Or call 1800 209 8188/1800 209 7979 to
redeem for exciting gifts. Contact dealer Loyalty Desk or visit www.tatamotorsease.com/www.tatadelight.com for more details.
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 HYDERABAD shall have jurisdiction in any proceedings relating to this contract.
  3) * Statistically generated based on Average kilometer's run per day.
                                                                                                                                                                      For SRI LAXMI NARASIMHA MOTORS

  Customer's Signature                                                                                                                                                                 Authorized signatory

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                                                                                          SRI LAXMI NARASIMHA MOTORS
                                                                                                        * GATEPASS *
Customer Name :       BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.       Invoice Ref. :                      ISILHY2021000752 dated 19/06/2020
Account Name :         BAJAJ ALLIANZ GENERAL INSURANCE CO LTD.        Invoice Amount :                  Rs. 7,832.00
Vehicle No :                AP28TD5330                                                                   Job Card / Order ref :           JC-SriLax-HP1-2021-001147 dated
                                                                                                                                                                         19/06/2020
Chassis No :              MAT460010DUF03413                                                    Gate Pass No & Date :
Model Name :            TATA WINGER
Vehicle / Goods received in good condition and to our satisfaction.

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