INVOICE UNDER RULE 11 of Central Excise Rules

Indian Oil Corporation Limited

We hereby certify that the goods covered by this
document have suffered applicable Taxes on clearance
Doc.Name TAX INVOICE 20213230B002389 REPRINT
& number REPRINT

Form No AC4 31A SAP Entry no. 740886820 Date 30-Mar-21

Del Mode Road Delivered T.T.No. GA08U6300 Time 14:43
Cont Code 11011656 14:43
SHREE SHANTADURGA PEROLEUM Den@15 834.30 Rem.Date/Time
Supplier CONSIGNEE

Code 3230 (CIN:L23201MH1959GOI011388) 546784 GOA

Name & Address Goa Terminal - Vasco VESSEL/UNIT - VASCO DA GAMA
1 Buyer:0000319484
Destn. VASCO-DA-GAMA ARC OFFSHORE INDIA PRIVATE LIM
Goa 403802 16-42-41/4, BISIDE SAGAR PUBLI
PALLAM RAJU NAGAR
C.E.Regn. AAACI1681GXD264 KAKINADAKAKINADA
C.E.Range 32162
RANGE-I (VASCO CENTRAL EXCISE)
C.E.Division
DIVISION-IV
C.E Commissionerate GOA
AAACI1681GXD264
PAN AAACI1681G AALCA9587A
CST: P/CST/437 LST: 30561202245
Supplier TAN: DELI09652G PAYER - 319484 ARC OFFSHORE INDIA PRIVATE LIMITED

Item Material Code / Material Description Quantity Unit Rate Unit HSN code Total
10 52500 LOW SULPHUR HIGH FLASH HSD (MIL) 20.000 KL 2710 19 49*
BASIC DESTINATION PRICE 16.349 TO 84429.610 TO 1380339.69
ZFR5 Dely Charges Pre Tax 4659.47
ZGSC Green Cess Goa 0.500 % 6925.00
JIN6 A/R Vat Payable 23.000 % 320142.56
Tank no: T016 Density@15: 834.300 Total for material 1712066.72
Sample no: 30032021/T016/17
Bay No.: 03

ZRND Rounding Difference 0.28

Total 1712067.00
PL - cm DIP - Cm QTY - kl
184.0 137.8 5.00
184.9 141.1 5.00
183.3 140.6 5.00
183.2 138.1 5.00

Delivery no. 0520804198 / Sales Order 0337543825

PO ref: OCEAN SACHIEL

DUTY PAID : 5000

PREPARED
RECEIVED IN GOOD CONDITION
INR Seventeen lac twelve thousand sixty-seven only BY PAGE No 1 / 1 1.Original for Buyer

00705257
Certified that the particulars given above are true and correct and
the amount indicated represents the price actually charged and
that there is no flow of additional consideration directly or indirectly
from the buyer. CUSTOMER'S TRANSPORTER'S AUTH For:
PRE-AUTHENTICATED BY SIGNATURE / SEAL REP SIGNATURE/SEAL AUTHORISED BY RELEASED BY
INDIAN OIL CORPORATION LTD
REGD.OFFICE:Indian Oil Bhavan, G-9 Ali Yavar Jung Marg, Bandra (EAST) Mumbai - 400051