TAX INVOICE Issued under GST Invoice Rules Original :For Recipient Duplicate :For Supplier Ms. . BAJAJ ALLIANZ GENERAL INSURANCE COMPANY Invoice No : IKM0DO2021000111 LIMITED Invoice Date :30/07/2020 TCS, Model : TATA TIAGO 952/954, APPASAHEB MARATHE MARG, NEAR CHAITNYA Chassis No : MAT626281GKF17647 TOWER Insurance Co : BAJAJ ALLIANZ INS. CO. LTD. PRABHADEVI, MUMBAI- 400025. TEL NO 02266628666 Kms. : 6530 MUMBAI SUBURBAN, MUMBAI SUBURBAN Vehicle Regn. No : MH05CV2762 MUMBAI, 400025 Job Card No. : JC-KrishM-KM-2021-000110 Maharashtra(27) Job Card Date : 29/07/2020 Phone No (Res,Off,Mob): 8828877904, 8828877904, 8828877904 Service Request Type : Accident Customer GSTIN : 27AABCB573G1ZX Customer P.O. No - Date : A/C Code : 1-1S8RQEBU Payment Method : CASH Place of Supply: 27-Maharashtra Warranty Expired :Y Dealer PAN: Dealer GSTIN : 27AAHFK2649E1ZC 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 Liabilitye AmttRateAAmounRateAmoun m % Taxes) Price) % % t % t ASSY 7007.19.05424671001 5,240. 5,240.6 1 WINDSHIEL Paid Each 1 5,240.68 0 9 471.66 9 471.66 6,184.00 0 01 D GLASS 68 8 7007.11.05424745023TAILGATE 3,220. [3,220.3 2 Paid Each 1 34|3,220.34 0 9 289.83 9 289.83 3,800.00 0 01 GLASS 4 WINDSHIEL D 3214.90.9 8855WORK|ADHESIVE 2,768.6 3 Paid Each 3 922.88[2,768.64 0 9 249.18 9 249.18 3,267.00 0 0001 GLASS 4 SEALENT - SUMA ASSY ORVM 7009.10.15424811001 3,683. 3,683.9 4 ELECTRIC Paid Each 1 90[3,683.90 0 9 331.55 9 331.55 4,347.00 0 21 WITH SRL 0 RH WINDING 7007.19.05424725023|GLASS 1,404. 1,404.2 5 Paid Each 1 1,404.24 0 9 126.38 9 126.38 1,657.00 0 01 FRONT 24 4 DOOR LH WINDING 7007.19.05424735023|GLASS 1,153. 1,153.3 6 Paid Each 1 1,153.39 0 9 103.81 9 103.81 1,361.00 0 01 REAR 39 9 DOOR LH FITMENT 7 12,000. 998714 OTFIT CHARGES PAID 1 o 012000 0.00 9 1,080.00 9 1,080.0014,160.00 00 PAINTING FITMENT CHARGES 3,530.0 8 998714 OTFIT PAID 1 o o3530 0.00 9 317.70 9 317.70 4,165.40 STRIPPING 0 & REPAIR SERVICE 9 998714 3MSPLUS PAID 1 300 300 0.00 300.00 9 27.00 9 27.00 354.00 PLUS - 3M ---PAGE END--- Total Tax Amount : 5,994.21 Parts Net Taxable Amount : 17,471.19 Final Labour Invoice Amount : 18,679.40 Final Parts Invoice Amount : 20,616.00 @ 9% CGST on Labour: 1,424.70 @ 9% SGST on Labour: 1424.70 @ 9% CGST on Parts: 1,572.41 @ 9% SGST on Parts: 1,572.41 Adjustments : -0.40 Rupees Thirty Nine Thousand Two Hundred Ninety Five Only. Grand Total : 39,295.00 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 DOMBIVALI shall have jurisdiction in any proceedings relating to this contract. 3) * Statistically generated based on Average kilometer's run per day. For KRISHNA MOTORS Customer's Signature Authorized signatory ---PAGE END--- KRISHNA MOTORS * GATEPASS * Customer Name : BAJAJ ALLIANZ GENERAL INSURANCE Invoice Ref. : IKM0DO2021000111 dated 30/07/2020 COMPANY LIMITED Account Name : TCS, Invoice Amount : Rs. 39,295.00 Vehicle No : MH05CV2762 Job Card / Order ref : JC-KrishM-KM-2021-000110 dated 29/07/2020 Chassis No : MAT626281GKF17647 Gate Pass No & Date : Model Name : TATA TIAGO Vehicle / Goods received in good condition and to our satisfaction. ---PAGE END---