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 20213230B002394 REPRINT
& number REPRINT

Form No AC4 31A SAP Entry no. 740902490 Date 31-Mar-21

Del Mode Road Delivered T.T.No. GA06T6528 Time 10:37
Cont Code 10185801 10:37
KARMA AUTO PARK Den@15 834.10 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 16.431 TO 84429.610 TO 1387262.92
ZFR5 Dely Charges Pre Tax 4682.84
ZGSC Green Cess Goa 0.500 % 6959.73
JIN6 A/R Vat Payable 23.000 % 321748.26
JTC1 TCS u/s 206C(1H) 0.075 % 113.46
Tank no: T016 Density@15: 834.100 Total for material 1720767.21
Sample no: 31032021/T016/18

ZRND Rounding Difference -0.21

Total 1720767.00
PL - cm DIP - Cm QTY - kl
168.5 141.2 5.00
168.8 138.4 5.00
169.1 139.6 5.00
168.9 128.9 5.00

Delivery no. 0520823806 / Sales Order 0337543825

PO ref: OCEAN SACHIEL

DUTY PAID : 5000

PREPARED
INR Seventeen lac twenty thousand seven hundred RECEIVED IN GOOD CONDITION
BY PAGE No 1 / 1
sixty-seven only 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