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SAMVARDHANA MOTHERSON AUTO COMPONENT PVT.
LIMITED
EXPENSES REIMBURSEMENT
Date: 14.05.20
Name: Vishal Rajput Employee Code: S115
Designation: Sr. Engg Department: ENGG
S.No. Bill/Invoice No. Date Firm Name Particulars Amount
Sharma hardware and

1 21000074 09.04.2021 Spares of die
iron store
472
TOTAL 472
Employee Signature Approver1 Approver2
Plant Head COO

SAMVARDHANA MOTHERSON AUTO COMPONENT PVT. LIMITED
Date: 26.02.20
Name: Ramkrishna Kale Employee Code: S037
Designation: Manager Department: ME
Bill/Invoice
S.No. Date Firm Name Particulars Amount
No.
Lunch with customer -HMCMM (Total 4 Members)
1 RB002443 12.12.19 Manesar Club 1229
(Arun Prajapati,Dinesh Sharma,Anup,R.S.Kale)
TOTAL 1,229
Plant Head COO

Local Conveyance Reimbursement
Name: Ramkrishna Kale Date 18.02.20
Designation: Manager
S.No. Date From To Purpose Mode K.M. Amount Amount
Th. Body Stepper Motor Hole

1 13.02.20 SMAC MTTL NOIDA OLA TAXI 72 1149 1149
Tool correction
Th. Body Stepper Motor Hole

2 13.02.20 MTTL NOIDA SMAC OLA TAXI 72 1110 1110
Tool correction
TOTAL 2259
Employee Signature
Recommended/Not Recommended
Date: 25.09.18
Name: Ramkrishna Kale Employee Code: S037
Designation: Manager Department: ME
Bill/Invoice
S.No. Date Firm Name Particulars Amount
No.
1 9118052583 19.09.18 Sunbeam Auto Pvt.Ltd. Regulator Cover & Body Spectro/X-ray charges 2124
TOTAL 2,124
Plant Head COO

EXPENSES REIMBURSEMENT FORM
Date: 15.12.2016
Name: Kannan Employee Code: S003
Designation: Asst manager Department: QA
S.No. Bill No. Date Firm Name Particulars Amount
1 3522 2/12/2016 HINDUSTAN CHEMICALS NITRIC ACID - 2.5 LITERS 1,000

2 3522 2/12/2016 HINDUSTAN CHEMICALS SODIUM HYDROXIDE - 500ML 189
HINDUSTAN
3 3523 3/12/2016 BEEKAR -1000ML - 1 NO 421
CHEMICALS
HINDUSTAN
4 3523 3/12/2016 THERMOMETER - 1 NO 189
CHEMICALS
5 106461 18/11/2016 HALDIRAM- BAWAL LUNCH EXPENSES - 1 PERSON 217
LUNCH EXPENSES ON SUNDAY

6 751 27/11/2016 RAJASTHANI HOTEL 120
WORK - 2 PERSON

9 29214 13/12/2016 SUBWAY LUNCH EXPENSES - 1 PERSON 161
TOTAL 2,747.7
Employee Signature Approved/Not Approved
Recommended/Not Recommended Plant Head

MEDICAL BILLS- REIMBURSEMENT
Date 21.07.18
Employee Code No. : S037 Department: Mfg.Engg.
Name : RAMKRISHNA KALE Designation: MANAGER
S.No. Doctor/Medical Store Bill No. Date Patient Name Relationship Amount
1 Vimal Medical VMS705 05.06.17 Kalpana Wife 1403
2 Child Clinic 341 06.11.17 Gargi Daughter 1856
3 Child Clinic 337 12.12.17 Chaitanya Son 300
9 Saksham 1273 05.02.18 Kalpana Wife 450
10 Rock Pharmacy 30 03.04.18 Kalpana Wife 387
13 Medicine 2025 28.06.18 Gargi Daughter 4777
14 Jijau SSM2573 24.06.18 Kalpana Wife 421
15 National Path Lab 95 06.07.18 Gargi Daughter 1200
16 balaji pharmacy 9440 04.07.18 Ramkrishna Self 90
17 Bajaj Dental 165 11.07.18 Ramkrishna Self 3500
18 Rockland 9958 03.04.18 Kalpana Wife 800
TOTAL 18,833.00
Employee Signature: _____________________
For Office Use:
Entitlement as on ______________ Rs.

Current bill amount Rs.
Amount Payable Rs.
Balance Credit Rs.
Checked & Verified Recommended
___________________
F&A
CASH REIMBURSEMENT FORM
Date: 05.06.2018
Name: Varinder Pal Employee Code: S058
Designation: Engineer Department: PE
1 ….. 31.05.2018 Local M8 bolt (10*40) 4 nos. 40

2 …… 02.06.2018 Local Bolt (12*35) 6 nos. 90
TOTAL 130

Name: KANNAN Date 09.03.2017
DesignatioASST MANAGER
HAYATPUR
1 14.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA UBER TAXI 11.81 140 140
CHOWK
SECTOR 90
2 14.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA SHUTTLE BUS 11.81 50 50
GURGAON
SECTOR 90
3 17.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA OLA TAXI 14 230 230
GURGAON
SECTOR 90
4 17.02.2017 RAJIV CHOWK VISIT TO ERAE NOIDA OLA TAXI 14 257 257
GURGAON
TOTAL 537
Employee Signature
Date:
Name: Employee Code:
Designation: Department:
TOTAL -

Date: 09.03.2017
INDUSTRIAL
1 2987 11.01.2017 PLASTIC SEPERATOR SHEET 560
COMMERCIAL CENTER
MICRO STRUCTURE ANALYSIS
2 111079505 20.02.2017 SUNBEAM AUTO 1,380
TEST
TOTAL 1,940.0

Date: 29-3-2016
Name: Kannan Employee Code: T001
Designation: GET Department: Maintenance
1 2168 3/28/2016 Jai Durga Enterprises Thimble for washing machine 450
2 1268 3/17/2016 R S Traders 200mm ventilation fan 950
Balaji Building Material
3 1745 3/28/2016 dust for kaizen shop 400
supplier
4 2179 3/29/2016 Jai Durga Enterprises Harware items 2,504
5 M58129 3/22/2016 HSIIDC water meter testing fee 115

6 2462 3/22/2016 Ganesh Enterprises Water flow meter 2,300
Shri Ganpati Safety
7 1982 11/20/2015 Reflective arrow marks 1,250
Signages
Cash Voucher labour for ventilation fan 500
8 3/28/2016
Cash Voucher Labour for kaizen cement work 950
Cash Voucher electricity fuse 450
9 3/28/2016 Cash Voucher electricity fuse 500
Cash Voucher electricity fuse 300
TOTAL 10,669

Date: 24.04.2017
TRAVEL EXPENSES OF MAKINO BANGALORE AND WABCO CHENNAI TRIP FOR VACUUM PUMP ISIR SAMPLE
PREPERATION AND ISIR SUBMISSION - FROM 08.04.2017 TO 20.04.2017 . ADVANCE AMOUNT TAKEN - RS.10000/-

TRAVEL FROM BANGALORE
1 -- 10.04.2017 UBER TAXI RAILWAYS STATION TO HOTEL CHRIS 474
- WHITEFIELD
LODGING EXPENSES - 2 PERSONS - 2
2 NFGT0513 10.04.2017 OYO ROOMS 5,498
DAYS
3 -- 10.04.2017 AUTO TRAVEL TO HOTEL TO MAKINO 30
4 KOT#2119 10.04.2017 BY THE WAY DINNER EXPENSES- 2 PERSON 423.85
5 KOT#2131 11.04.2017 BY THE WAY DINNER EXPENSES - 1 PERSON 239

6 KAOY9714 12.04.2017 OYO ROOMS 2,137
DAY
8 YKFE0217 13.04.2017 OYO ROOMS 1,987
DAY
11 NO BILL 14.04.2017 STREET SHOP DINNER EXPENSES - 2 PERSON 100

TRAVEL FROM MAKINO TO MADIWALA
12 -- 14.04.2017 UBER TAXI 383
BUS STOP
13 -- 16.04.2017 HOTEL TEMPLE CITY DINNER EXPENSES 330
TRAVEL EXPNESES - MADURAI
14 -- 16.04.2017 SRI SAKTHI TOURS & TR 1,300
( BANGALORE) TO CHENNAI
LODGING EXPENSES - 1 PERSON - 3
15 ZIWR9350 16.04.2017 OYO ROOMS 2,810
DAYS
TRAVEL FROM CHENNAI BUS STAND
16 CRN659646893 17.04.2017 OLA CABS 354
TO HOTEL
17 NO BILL 17.04.2017 Auto Rikshaw TRAVEL LODGE TO WABCO 60
18 NO BILL 17.04.2017 WABCO CANTEEN LUNCH EXPENSES - 2 PERSONS 60
18 NO BILL 17.04.2017 Auto Rikshaw TRAVEL WABCO TO LODGE 60
19 238 17.04.2017 HOTEL SAI KRISHNA DINNER EXPENSES 40
20 51 18.04.2017 HOTEL SAI KRISHNA BREAKFAST EXPENSES 89
19 NO BILL 18.04.2017 WABCO CANTEEN LUNCH EXPENSES - 2 PERSONS 60
21 260 18.04.2017 HOTEL SAI KRISHNA DINNER EXPENSES 40

HOTEL BALAJI
21 278 19.04.2017 DINNER EXPENSES 135
WOODLANDS
LODGING EXPENSES - 1 PERSON - 1
19 PMAJ2801 19.04.2017 OYO ROOMS 974
DAY
20 42 20.04.2017 HOTEL SAI KRISHNA BREAKFAST EXPENSES 134
21 -- 20.04.2017 MANAVAI COMPUTERS ISIR FILES PRINTOUT EXPENSES 311

TRAVEL FROM WABCO TO CHENNAI
19 -- 20.04.2017 UBER TAXI 431
AIRPORT
20 CC00422082 20.04.2017 KFC RESTAURANT DINNER EXPENSES 150
TRAVEL FROM DELHI AIRPORT TO
21 -- 20.04.2017 UBER TAXI 794
SECTOR 90 GURGAON
TOTAL 20,352.3

Date: 8/1/2017
1 … 12-May BY METRO SMAC TO ERAE 150

2 … 12-May BY METRO ERAE TO SMAC 150
17 … 1-Jun BY METRO SMAC TO ERAE 150
18 … 1-Jun BY METRO ERAE TO SMAC 150
21 … 13-Jul BY METRO SMAC TO ERAE 150
22 … 13-Jul BY METRO ERAE TO SMAC 150
27 40 28-Jul DK Enterprises Cylinder Key 50
1143 8/1/2017 Rajasthan Hotel Food 120
Total 4070

EXPENSES ERAE REIMBURSEMENT FORM
Date: 10.07.2017
1 … 3.06.2017 BY AUTO PG (NOIDA) TO ERAE 20
2 … 3.06.2017 BY AUTO ERAE TO PG (NOIDA) 20

By Auto(10rs)Bus
27 … 16.06.2017 (30Rs),Metro(45Rs),Auto(20) SMAC TO ERAE 150
By Auto(10rs)Bus
Bus(45)
28 … 16.06.2017 (30Rs),Metro(45Rs),Auto(20) ERAE TO SMAC 150
Bus(45)

3.06.2017 to
45 201 SHRRE GANPATI PG RENT(For 10 Days Prashant) 3000
12.06.2017
By Auto(10rs)Bus
46 … 16.06.2017 SMAC TO ERAE
(30Rs),Metro(45Rs),Auto(20) Bus(45)
By Auto(10rs)Bus
47 … 16.06.2017 ERAE TO SMAC
By Auto(10rs)Bus
48 … 24.06.2017 SMAC TO ERAE
By Auto(10rs)Bus
49 … 24.06.2017 SMAC TO ERAE
50 … 25.06.2017 BY AUTO PG(Jagat Farm) TO ERAE
51 … 25.06.2017 BY AUTO ERAE TO PG(Jagat Farm)

By Auto(10rs)Bus
52 … 26.06.2017 SMAC TO ERAE
By Auto(10rs)Bus
53 … 26.06.2017 ERAE TO ERAE
60 … 30.06.2017 BY AUTO SMAC TO ERAE
61 … 30.06.2017 BY AUTO ERAE TO SMAC

By Auto(10rs)Bus
62 … 1.07.2017 PG(Jagat Farm) TO ERAE
By Auto(10rs)Bus
63 … 1.07.2017 ERAE TO PG(Jagat Farm)
64 … 3.07.2017 By Auto PG(Jagat Farm) TO ERAE
65 … 3.072017 By Auto ERAE TO PG(Jagat Farm)

By Auto(10rs)Bus
76 … 09.07.2017 SMAC TO ERAE
By Auto(10rs)Bus
77 … 09.07.2017 ERAE TO SMAC
(30Rs),Metro(45Rs),Auto(20) Bus(45) PG RENT(Prashant have
13.0617 to
78 195 Roomer house stay 10 Days+Sitanshu
7.07.2017
have stay 14 Days )

150
150
300
300
40
40
150
150
40
40
40
40
40
40
40
40
150
150
40
40
40
40
40
40
40
40
40
40
40
40
150
150
7,200
14,020.0
Approved/Not Approved
Plant Head
Date: 30.06.2017
1 6786682 27.05.2017 AMAZON PENDRIVE HP -16 GB 499

X RAY TEST - LEAK PART ANALYSIS -
2 111017087 29.05.2017 SUNBEAM 575
REAR CYLINDER
ERAE VISIT - SECTOR 90 TO IFFCO
3 CRN782298820 09.06.2017 OLA CABS 436
CHOWK METROL
IFFCO CHOWK TO BOTANICAL
4 --- 09.06.2017 DELHI METRO 50
GARDEN
BOTANICAL GARDEN TO ERAE
5 CRN782693274 09.06.2017 OLA CABS 412
GREATER NOIDA
6 397 09.06.2017 BARISTA CAFÉ FOOD EXPENSES 59
7 --- 09.06.2017 UP GOVT BUS GR. NOIDA TO BOTANICAL GARDEN 45
8 --- 09.06.2017 DELHI METRO BOTANICAL GARDEN TO IFFOCHOWK 50

HIHVACCF-03- IFFCO CHOWK TO SECTOR OP
9 09.06.2017 UBER TAXI 338
140 GURGOAN
X RAY TEST - LEAK PART ANALYSIS -
10 111022093 14.06.2017 SUNBEAM 575
FRONT HEAD
ERAE VISIT - SECTOR 90 TO SECTOR
11 CRN804192366 19.06.2017 OLA TAXI 282
15 GURGAON
ERAE VISIT- SECTOR 29 TO SECTOR
12 CRN806335972 19.06.2017 OLA TAXI 255
90 GURGAON
TOTAL 3,576.2

Date: 05.09.2017
Name: Anup Kumar Employee Code: S008
Designation: Sr.Engineer Department: QA
1 08.07.2017 Pen Marker 100
2 03.08.2017 Ratan Singh Pen Marker 20
3 05.08.2017 Black Marker 160
4 12.08.2017 Iron And paint Store Drill 3 mm 50
5 25.08.2017 coldrink 100
6 01.09.2017 Spary Paint 250
7 05.09.2017 Pen Marker 36
8 05.09.2017 Yellow Paint & Brush 200
TOTAL 916.0

Date: 07.04.2018
Name: Rohit Rajan Employee Code: S028
Designation: Engineer Department: Production Engineering

1 …… 05.04.2018 Mohta Brother Collet & Drill Purchase 450
2 …….. 03.04.2018 Powder Coating Supplier Audit Total 16 km by Bike 40
3 ……… 24.03.2018 YRA Base Frame Trial Hose Clamp Purchase 50
TOTAL 540.0

Name: Rohit Rajan S028 Date 24.08.2017
Designatioengineer
1 13.07.2017 HOME IFFCO CHAUK VISIT TO ERAE NOIDA AUTO 10 100 100
BOTANICAL
2 13.07.2017 IFFCO VISIT TO ERAE NOIDA METRO …. 45 45
GARDEN METRO
BUTANICAL
3 13.07.2017 PARI CHAUK VISIT TO ERAE NOIDA BUS 25 45 45
GARDEN
4 13.07.2017 PARI CHAUK TO ERAE INDIA VISIT TO ERAE NOIDA AUTO 4 40 40
5 13.07.2017 ERAE PARI CHAUK VISIT TO ERAE NOIDA AUTO 4 40 40
BOTANICAL
6 13.07.2017 PARI CHAUK TO VISIT TO ERAE NOIDA BUS 25 45 45
GARDEN METRO
BUTANICAL
7 13.07.2017 IFFCO CHAUK VISIT TO ERAE NOIDA METRO …… 45 45
GARDEN
8 13.07.2017 IFFCO HOME VISIT TO ERAE NOIDA AUTO 10 100 100
9 13.07.2017 FOOD/ SNACKS VISIT TO ERAE NOIDA ……. ….. 120 120
10.07.2017/ 11.07.2017/ 12.07.2017/

10 17.07.2017/ 22.07.2017/ 24.07.2017/ SMAC UNITED HITECH WABCO PART TRIAL BIKE 123 308 308
25.07.2017/ 26.07.2017/ 27.07.2017
11 23.08.2017 SMAC BHIWADI FIRE BRICK PURCHASE BIKE 70 175 175
12 23.08.2017 SMAC BHIWADI FIRE BRICK CASH ….. 200 200
13 LUNCH EXPENCE DHABA 380 380
TOTAL 1643
Employee Signature
APPROVED BY:
Date: 8/1/2017
Designation: Asst
Department: QA
manager

27 40 28-Jul DK Enterprises Cylinder Key 50
28 1143 8/1/2017 Rajasthan Hotel Food 120
Total 4070
Recommended/Not
Plant Head
Recommended
Date:
Name: Kamran Khan Employee Code:
Designation: GET Department:
S.No. Bill No. Date Firm Name Particulars

1 … 8-Aug By Auto SMAC TO Sunbeam
2 … 8-Aug By Auto Sunbeam TO SMAC
3 … 10-Aug By Auto SMAC TO Sunbeam
4 … 10-Aug By Auto Sunbeam TO SMAC
Total
Recommended/Not
Plant Head
Recommended
MITED
8/12/2017
TRA03
QA
Amount
30
30
30
30
120
oved/Not Approved
Plant Head
Date: 31.08.18
Name: D S Rawat Employee Code: S005
Designation: Dy Manager Department: Machine shop
1 2.08.18 Drill Bit 2.0 mm 100

2 18.08.18 Drill Bit 13.0mm 362
TOTAL 462

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SAMVARDHANA MOTHERSON AUTO COMPONENT PVT.

S.No. Bill/Invoice No. Date Firm Name Particulars Amount

Sharma hardware and

Employee Signature Approver1 Approver2

Plant Head COO

Employee Signature Approver1 Approver2

Plant Head COO

Name: Ramkrishna Kale Date 18.02.20

S.No. Date From To Purpose Mode K.M. Amount Amount

Th. Body Stepper Motor Hole

Th. Body Stepper Motor Hole

Employee Signature Approver1 Approver2

Plant Head COO

S.No. Bill No. Date Firm Name Particulars Amount

1 3522 2/12/2016 HINDUSTAN CHEMICALS NITRIC ACID - 2.5 LITERS 1,000

LUNCH EXPENSES ON SUNDAY

7 110563 28/11/2016 HALDIRAM- BAWAL LUNCH EXPENSES - 1 PERSON 233

8 111996 2/12/2016 HALDIRAM- BAWAL LUNCH EXPENSES - 1 PERSON 217

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

1 Vimal Medical VMS705 05.06.17 Kalpana Wife 1403

2 Child Clinic 341 06.11.17 Gargi Daughter 1856

3 Child Clinic 337 12.12.17 Chaitanya Son 300

4 Child Clinic 449 12.12.17 Chaitanya Son 307

5 Child Clinic 355 18.12.17 Gargi Daughter 300

6 Child Clinic 496 18.12.17 Gargi Daughter 216

7 Child Clinic 533 23.12.17 Chaitanya Son 1426

8 Child Clinic 384 23.12.17 Chaitanya Son 300

9 Saksham 1273 05.02.18 Kalpana Wife 450

10 Rock Pharmacy 30 03.04.18 Kalpana Wife 387

11 Saksham 1866 02.06.18 Kalpana Wife 500

12 Saksham 1843 26.06.18 Kalpana Wife 600

13 Medicine 2025 28.06.18 Gargi Daughter 4777

14 Jijau SSM2573 24.06.18 Kalpana Wife 421

15 National Path Lab 95 06.07.18 Gargi Daughter 1200

16 balaji pharmacy 9440 04.07.18 Ramkrishna Self 90

17 Bajaj Dental 165 11.07.18 Ramkrishna Self 3500

18 Rockland 9958 03.04.18 Kalpana Wife 800

Employee Signature: _____________________

For Office Use:

Entitlement as on ______________ Rs.

Checked & Verified Recommended

S.No. Bill No. Date Firm Name Particulars Amount

1 ….. 31.05.2018 Local M8 bolt (10*40) 4 nos. 40

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

Name: KANNAN Date 09.03.2017

S.No. Date From To Purpose Mode K.M. Amount Amount

S.No. Bill No. Date Firm Name Particulars Amount

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

S.No. Bill No. Date Firm Name Particulars Amount

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

S.No. Bill No. Date Firm Name Particulars Amount

4 2179 3/29/2016 Jai Durga Enterprises Harware items 2,504

5 M58129 3/22/2016 HSIIDC water meter testing fee 115

Employee Signature Approved/Not Approved

Recommended/Not Recommended Plant Head

S.No. Bill No. Date Firm Name Particulars Amount

4 KOT#2119 10.04.2017 BY THE WAY DINNER EXPENSES- 2 PERSON 423.85

5 KOT#2131 11.04.2017 BY THE WAY DINNER EXPENSES - 1 PERSON 239