Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier Customer Invoice TAX INVOICE SHAMAN CARS INDIA PVT. LTD. PAN : AABCS4308P; GSTIN: 27AABCS4308P1Z1; CIN: Add: NANAVATI GODOWN NO 6, OPP SEWREE POLICE STN, NEXT TO STANDARD WEIGH BRIDGE REAY RD, Mumbai - 400 010, Mumbai, Maharashtra, India - 400010 Fax: +912267747767 , Phone: +912223724017 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Lessor/Bill to MEHTA & PADAMSEY INSURANCE Lessee/Ship to MEHTA & PADAMSEY INSURANCE Veh. Reg. No. MH01BY5210 Invoice No. SR154B20-2646 SURVEYORS & LOSS ASSESSORS SURVEYORS & LOSS ASSESSORS PRIVATE LIMITED PRIVATE LIMITED Phone +919322231077 Model CITY PE Invoice Date 25-03-2021 07:33 PM GSTIN 27AAACM3761H1ZI GSTIN 27AAACM3761H1ZI Chassis No. MAKGM66DDF4102818 RO No. SER-RO-DD154B-2021-1621 Address C BLK 3RD FOOR,FORT CHEMBERS Ship to C BLK 3RD FOOR,FORT CHEMBERS Engine No. L15Z12215609 RO Type BP TAMARIND LANE FORT Mumbai TAMARIND LANE FORT, Mumbai, Wrnty Start 16-05-2015 Visit Date 22-03-2021 12:57 PM Maharashtra India 400001 Maharashtra 400001 Place of Supply Maharashtra State Maharashtra Mileage 44361 State Code 27 State Code 27 IRN Number 6e98c870f4eb2c43c224ff4b0275819a7533f14c3da28b81997724ccbeb09058 PAN AAACM3761H PAN AAACM3761H IRN Version 1.1 P/L Labor Code / HSN / Description Issue Qty UoM Job Value / Disc Dis Insurer Insured Taxable CGST SGST / UTGST Amount() Part# SAC Type RTLP / Item % % Amt % Amt Amount % Amt % Amt 1 ACC REPAIR AS PER EST (BAJAJ) -(Body & Paint Work) L RRFTRRBMPR 998714 R/RFT REAR BUMPER Paid 200.00 0 0 0.00 0.00 100.00 200.00 200.00 9 18.00 9 18.00 236.00 R/RFT TAIL LAMP L RRFTTLLMP 998714 Paid 60.00 0 0 0.00 0.00 100.00 60.00 60.00 9 5.40 9 5.40 70.80 (EACH) R/RFT SILENCER L RRFTSLNCR 998714 (EACH) Paid 150.00 0 0 0.00 0.00 100.00 150.00 150.00 9 13.50 9 13.50 177.00 L RRFTSTMAT 998714 R/RFT SEAT AND MATS Paid 250.00 0 0 0.00 0.00 100.00 250.00 250.00 9 22.50 9 22.50 295.00 Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier 998714 R/RFT FUEL TANK Paid 0.00 100.00 22.50 22.50 L RRFTFULTANK 1 250.00 0 0 0.00 250.00 250.00 9 9 295.00 (WITH PIPES) L RPLCRRFLR 998714 REPLACE REAR FLOOR Paid 1 1800.00 0 0 0.00 0.00 100.00 1800.00 1800.00 9 162.00 9 162.00 2124.00 REPLACE REAR Paid L RPLCRBMSKT 998714 1 1200.00 0 0 0.00 0.00 100.00 1200.00 1200.00 9 108.00 9 108.00 1416.00 BUMPER SKIRT CAROLNRCHG L 998714 CAR-O-LINER CHGS Paid 1 850.00 0 0 0.00 0.00 100.00 850.00 850.00 9 76.50 9 76.50 1003.00 s PAINT CHGS REAR L PNTRRBMPRM 998714 BUMPER FACE - Paid 1 7690.00 1538 0 0.00 0.00 100.00 6152.00 6152.00 9 553.68 9 553.68 7259.36 METALLIC PAINT CHGS REAR PNTRRLWRPN LOWER PANEL SET L LM 998714 Paid 1 5730.00 4530 0 0.00 0.00 100.00 1200.00 1200.00 9 108.00 9 108.00 1416.00 (REAR FLOOR) - METALLIC PAINT CHGS REAR PNTRRPNLCM L 998714 PANEL COMP INNER - Paid 1 2960.00 1760 0 0.00 0.00 100.00 1200.00 1200.00 9 108.00 9 108.00 1416.00 PM METALLIC 04655T9CK00Z 8708990 14316.6 P PANEL SET.RR FLR Paid 1 NOS 14316.62 0 0 0.00 0.00 100.00 14316.62 14 2004.33 14 2004.33 18325.27 z 0 2 65770T9CK00Z 8708990 Paid NOS 932.96 932.96 932.96 130.61 P C/MBR COMP RR.RR 1 0 0 0.00 0.00 100.00 14 130.61 14 1194.19 Z 0 P 66100T9AT50Z 8708990 Paid NOS 100.00 14 14 PANEL COMP.REAR 1 5471.94 0 0 0.00 0.00 5471.94 5471.94 766.07 766.07 7004.08 z 0 71501T9DK00Z 8708109 Paid NOS P FACE.RR BUMPER 1 2541.28 0 0 0.00 0.00 100.00 2541.28 2541.28 14 355.78 14 355.78 3252.84 z 0 8708990 Paid NOS 14 14 P 91505TM8003 CLIP.BUMPER 4 84.66 0 0 0.00 0.00 100.00 338.64 338.64 47.41 47.41 433.46 0 OTLOSELBO00 3506100 P SEALENT BODY Paid 2 NOS 830.40 0 0 0.00 0.00 100.00 1660.80 1660.80 9 149.47 9 149.47 1959.74 1 0 OTLONS10006 3921190 NOISE SUPRESSION P Paid 4 NOS 400.00 0 0 0.00 0.00 100.00 1600.00 1600.00 9 144.00 9 144.00 1888.00 0 0 PAD 8708990 Paid 47.20 P 46391STKA01 CLIP.BRAKE PIPE 2 NOS 23.60 0 0 0.00 0.00 100.00 47.20 14 6.61 14 6.61 60.42 0 8708990 P 46391TF0951 CLIP.BRAKE PIPE Paid 3 NOS 25.99 0 0 0.00 0.00 100.00 77.97 77.97 14 10.92 14 10.92 99.80 0 65513T9CK00Z 8708990 Paid NOS 14 55.35 14 55.35 P STIFF.RR JACK UP 1 395.36 0 0 0.00 0.00 100.00 395.36 395.36 506.06 z 0 8708990 P 83853T5SK00 BOLT.SPARE TIRE A Paid 1 NOS 94.23 0 0 0.00 0.00 100.00 94.23 94.23 14 13.19 14 13.19 120.61 0 8708990 100.00 P 38387TZ5A01 ANT ASSY.LF Paid 1 NOS 437.96 0 0 0.00 0.00 437.96 437.96 14 61.31 14 61.31 560.59 0 BASIC CAR CARE SANIT -GM66-BP - (Value Added Services) BASIC CAR CARE Paid 0.00 0.00 250.00 L VASBCC 998714 1 250.00 0 0 100.00 250.00 9 22.50 9 22.50 295.00 (SANITIZATION) UB ANTI RUST TREATMENT-GM66-BP - (Value Added Services) UNDER BODY ANTI Paid L VASUBART 998714 1 3250.00 1750 0 0.00 0.00 100.00 1500.00 1500.00 9 135.00 9 135.00 1770.00 RUST TREATMENT Recommendations: 0 SURYE DONE BY NAUSHAD SIR ( CLAIM NO = 00014810 ) INTERIOR & EXTERIOR & EXTRA PANEL & FLOORING RUSTING NOT APPROVAL Supply Type : B2B ---PAGE END--- Original for Recipient HONDA Duplicate for Transporter Triplicate for Supplier Customer Invoice TAX INVOICE SHAMAN CARS INDIA PVT. LTD. PAN : AABCS4308P; GSTIN: 27AABCS4308P1Z1; CIN: Add: NANAVATI GODOWN NO 6, OPP SEWREE POLICE STN, NEXT TO STANDARD WEIGH BRIDGE REAY RD, Mumbai - 400 010, Mumbai, Maharashtra, India - 400010 Fax: +912267747767 , Phone: +912223724017 BILL TO SHIP TO VEHICLE INFO INVOICE INFO Name MEHTA & PADAMSEY INSURANCE Name MEHTA & PADAMSEY INSURANCE Veh. Reg. No. MH01BY5210 Invoice No. SR154B20-2646 SURVEYORS & LOSS ASSESSORS SURVEYORS & LOSS ASSESSORS PRIVATE LIMITED PRIVATE LIMITED Phone 919322231077 Model CITY PE Invoice Date 25-03-2021 07:33 PM GSTIN 27AAACM3761H1ZI GSTIN 27AAACM3761H1ZI Chassis No. MAKGM66DDF4102818 RO No. SER-RO-DD154B-2021-1621 Address C BLK 3RD FOOR,FORT CHEMBERS|Ship to C BLK 3RD FOOR,FORT CHEMBERS Engine No. L15Z12215609 RO Type BP TAMARIND LANE FORT Mumbai TAMARIND LANE FORT, Mumbai, Wrnty Start 16-05-2015 Visit Date 22-03-2021 12:57 PM Maharashtra India 400001 Maharashtra 400001 Place of Supply Maharashtra State Maharashtra Mileage 44361 State Code 27 State Code 27 IRN Number 6e98c870f4eb2c43c224ff4b0275819a7533f14c3da28b81997724ccbeb09058 PAN AAACM3761H PAN AAACM3761H IRN Version 11.1 SUMMARY Delivery against Cash/D.D ONLY may kindly be drawn in favor of Parts Details Amount() Labor Details Amount(&) "SHAMAN CARS INDIA PVT. LTD." Taxable Amt 27914.96 Taxable Amt 15062.00 o I/We hereby certify that my/our Regist. Certi. under the Maharashtra Value Added Tax Act. CGST @ 9% 293.47 CGST @ 9% 1355.58 2002 is in force on the date on which sales of goods specified in the Bill/Cash memorandum SGST @ 9% 293.47 SGST @ 9% 1355.58 is made by me/us and that the transaction of sales covered by this Bill/Cash memorandum has been effected by me and it should be accounted for in the turnover of sales while filling my CGST @ 14% 3451.58 Total Labor Amt 17773.16 returns. Our VAT TIN-No : 27160004710 V CST TIN-No : 27160004710 C . Service Tax SGST @ 14% 3451.58 Reg. No. AABCS4308PST002, PAN No : AABCS4308P Total Parts Amt 35405.07 9 Salvage from repair must be collected at the time of delivery. Else will be distroyed. TCS Tax @ % 0.00 Management shall not be responsible of consequences there after. Total Amount 53178.23 Net Amount 53178.23 Grand Total (Rounded - Off) Z 53178.00 (-0.23) Amount in Words: Rupees Fifty Three Thousand One Hundred Seventy Eight 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 SHAMAN CARS INDIA PVT. LTD. satisfaction (Customer's Signature and Date) Service Advisor : HUSSAIN SHAIKH (Authorized Signatory) "CUSTOMER ADVISORY: Honda recommends its customers against use of non-genuine/second hand spares during any repairs especially safety critical items like airbag system, brakes, electrical etc." Supply Type : B2B ---PAGE END---