HONDA Original for Recipient Duplicate for Transporter Triplicate for Supplier Insurance Invoice TAX INVOICE LANDMARK AUTOMOBILES PVT. LTD. PAN : AACCW1601N; GSTIN: 23AACCW1601N1ZI; CIN: U50100GJ2018PTC101082 Add: UG-1 Onam Plaza, Near industry house, AB road, Indore Pin - 452001 - MP, Indore, Madhya Pradesh, India - 452001 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Lessor/Bill to Bajaj Allianz General Insurance Co. Lessee/Ship to PALASH MOTWANI Veh. Reg. No. MP09WF2654 Invoice No. SR34920-7967 Ltd. Phone +919867740203 Model 5TH GEN CITY PE Invoice Date 29-01-2021 03:44 PM GSTIN 23AABCB5730G1Z5 GSTIN Chassis No. MAKGN252HLN000673 RO No. SER-RO-DD349-2021-6888 Address HIG-10,Shivaji Nagar opposite Pragati Ship to 16, KALINDI KUNJ PIPLIYAHANA, Engine No. L15ZD1102988 RO Type BP petrol Pump Bhopal Madhya Pradesh INDORE Indore 452001 Madhya Wrnty Start 21-09-2020 Visit Date 16-01-2021 02:49 PM 462016 India Pradesh Place of Supply Madhya Pradesh State Madhya Pradesh Invoice Type Mileage 5162 State Code 23 State Code 23 IRN Number 20b774e605632a90c690ead9a9 540bf0fbfb084f7469297e976d58 a174b6d428 PAN IRN Version 1.1 P/L Labor Code / HSN / Description Issue Qty UoM Job Value Disc Dis Insurer Insured Insurer Taxable CGST SGST / UTGST Amount(?) Part# SAC Type /RTLP / Item % % Amt % Amt Disc Amt Amount % Amt % Amt ACCIDENTAL TYPE - (Body & Paint Work) ACDNTRPR 998714 ACCIDENTAL REPAIR Paid 1 3250.00 0 0 100.00 3250.00 0.00 0.00 0.00 3250.00 9 292.50 9 292.50 3835.00 PNTFRBMPR3 PAINT CHGS FRONT 998714 BUMPER FACE - Paid 8120.00 0 0 100.00 8120.00 0.00 0.00 0.00 8120.00 9 730.80 9 730.80 9581.60 c 3COAT Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier AC GAS CHARGING (EVACUATE, 0.00 0.00 L ACGSCHRG 998714 Paid 1 750.00 0 0 100.00 750.00 0.00 750.00 9 67.50 9 67.50 885.00 RECHARGE & LEAK TEST OF SYSTEM) AC GAS CHARGING (EVACUATE, 750.00 L ACGSCHRG 998714 Paid 1 750.00 0 0 100.00 0.00 0.00 0.00 750.00 9 67.50 9 67.50 885.00 RECHARGE & LEAK TEST OF SYSTEM) AC GAS CHARGING (EVACUATE, Paid L ACGSCHRG 998714 1 750.00 0 0 100.00 750.00 0.00 0.00 0.00 750.00 9 67.50 9 67.50 885.00 RECHARGE & LEAK TEST OF SYSTEM) 80100T08K01 Replace,CONDENSER( Paid 998714 1 756.00 0 0 100.00 756.00 0.00 0.00 0.00 756.00 9 68.04 9 68.04 892.08 6161M2 A) 1901062FT011 L 998714 Replace,RADIATOR(A) Paid 1 756.00 0 0 100.00 756.00 0.00 0.00 0.00 756.00 9 68.04 9 68.04 892.08 141G7 Replace,MOTOR, 190305R1003 Paid 0 0.00 L 998714 RADIATOR COOLING 1 216.00 0 100.00 216.00 0.00 0.00 216.00 9 19.44 9 19.44 254.88 1151B1 FAN(A) RRFTFRTBMP R/RFT FRONT L R 998714 Paid 1 650.00 0 0 100.00 650.00 0.00 0.00 0.00 650.00 9 58.50 9 58.50 767.00 BUMPER 60400T08K00 870899 14023.4 P BULKHEAD COMP.FR Paid 1 NOS 14023.43 0 0 100.00 0.00 0.00 0.00 14023.43 14 1963.28 14 1963.28 17949.99 ZZ 00 3 870899 COVER ASSY.ENG P 74110T08K00 Paid 1 NOS 1966.40 0 0 100.00 1966.40 0.00 0.00 0.00 1966.40 14 275.30 14 275.30 2516.99 00 UNDER 841590 Paid NOS 12812.5 0.00 14 14 P 80100T08K01 CONDENSER ASSY 1 12812.50 0 0 100.00 0.00 0.00 12812.50 1793.75 1793.75 16400.00 00 0 870891 Paid NOS 0.00 P 1901062FT01 RADIATOR COMP 1 4732.81 0 0 100.00 4732.81 0.00 0.00 4732.81 14 662.59 14 662.59 6058.00 00 870810 LWR GRILLE.FR Paid NOS 0.00 P 71151T08K00 1 389.06 0 0 100.00 389.06 0.00 0.00 389.06 14 54.47 14 54.47 498.00 90 BUMPER 71161T00T00 870899 LWR GARN.LWR Paid NOS P 1 232.03 0 0 100.00 232.03 0.00 0.00 0.00 232.03 14 32.48 14 32.48 297.00 ZA 00 GRILLE 04711T08K00 870810 P FACE.FR BUMPER Paid 1 NOS 2265.62 0 0 100.00 2265.62 0.00 0.00 0.00 2265.62 14 317.19 14 317.19 2899.99 zz 90 382000 P 08C56G0210 RADIATOR LIQUID 1L Paid 4 NOS 265.60 0 0 100.00 1062.40 0.00 0.00 0.00 1062.40 9 95.62 9 95.62 1253.63 00 870891 Paid NOS 100.00 0.00 0.00 14 220.27 14 220.27 P 386115R1003 FAN.COOLING 1 1573.36 0 0 1573.36 0.00 1573.36 2013.90 00 870891 SHROUD COMP NOS 100.00 0.00 P 3861562FT01 Paid 1 1314.06 0 0 1314.06 0.00 0.00 1314.06 14 183.97 14 183.97 1682.00 00 870891 Paid P 190155R1003 SHROUD COMP 1 NOS 1073.76 0 0 100.00 1073.76 0.00 0.00 0.00 1073.76 14 150.33 14 150.33 1374.41 00 870891 200.03 P 190205R1003 FAN.COOLING Paid 1 NOS 1428.77 0 0 100.00 1428.77 0.00 0.00 0.00 1428.77 14 200.03 14 1828.83 00 870899 Paid NOS 14 14 P 91505TM8003 CLIP.BUMPER 10 84.66 0 0 100.00 846.60 0.00 0.00 0.00 846.60 118.52 118.52 1083.65 00 Recommendations: Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier Insurance Invoice TAX INVOICE LANDMARK AUTOMOBILES PVT. LTD. PAN : AACCW1601N; GSTIN: 23AACCW1601N1ZI; CIN: U50100GJ2018PTC101082 Add: UG-1 Onam Plaza, Near industry house, AB road, Indore Pin - 452001 - MP, Indore, Madhya Pradesh, India - 452001 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Name Bajaj Allianz General Insurance Co. Name PALASH MOTWANI Veh. Reg. No. MP09WF2654 Invoice No. SR34920-7967 Ltd. Phone +919867740203 Model 5TH GEN CITY PE Invoice Date 29-01-2021 03:44 PM GSTIN 23AABCB5730G1Z5 GSTIN Chassis No. MAKGN252HLN000673 RO No. SER-RO-DD349-2021-6888 Address HIG-10,Shivaji Nagar opposite PragatiShip to 16, KALINDI KUNJ PIPLIYAHANA, Engine No. L15ZD1102988 RO Type BP petrol Pump Bhopal Madhya Pradesh INDORE Indore 452001 Madhya Pradesh Wrnty Start 21-09-2020 Visit Date 16-01-2021 02:49 PM 462016 India Place of Supply Madhya Pradesh State Madhya Pradesh Invoice Type Mileage 5162 State Code 23 State Code 23 IRN Number 20b774e605632a90c690ead9a9540bf Ofbfb084f7469297e976d58a174b6d42 8 PAN IRN Version 11.1 SUMMARY Delivery against Cash/D.D ONLY may kindly be drawn in favor of Parts Details Amount() Labor Details Amount(&) "LANDMARK AUTOMOBILES PVT. LTD." Taxable Amt 43720.80 Taxable Amt 15998.00 o For any query / feedback, you may kindly contact: CGST @ 9% 95.62 CGST @ 9% 1439.82 Customer Relations Manager - 7225060818 SGST @ 9% 95.62 SGST @ 9% 1439.82 Service Manager - 7225060819 Total Labor Amt CGST @ 14% 5972.18 18877.64 o Visit Customer Service website: https://www.hondacarindia.com/Honda- 5972.18 SGST @ 14% Services Total Parts Amt 55856.38 TCS Tax @ % 0.00 Total Amount 74734.02 Net Amount 74734.02 Grand Total (Rounded - Off) Z 74734.00 (-0.02) Amount in Words: Rupees Seventy Four Thousand Seven Hundred Thirty Four Only Amount of Tax Subject to Reverse Charges 0 I certify that I have taken delivery of my Vehicle & work has been done to my entire For LANDMARK AUTOMOBILES PVT. LTD. satisfaction (Customer's Signature and Date) Service Advisor : SUSHANT THAKUR (Authorized Signatory) Supply Type : B2B ---PAGE END---