Maa Vindhyavasini Motors,

Near Railway Crossing, Mirzapur Road,

gopiganj, Uttar Pradesh,
221303
Phone1:05414298326,
Mobile:9956327999,8953854777,
E-Mail:wm.mvm@hotmail.com.

PAN :
GSTIN : 09ADVPT5033G1Z0
CIN :

TAX INVOICE
BILLING TO SHIP TO / Place of supply
Insurance/Cust code Sk singh Customer Code XA58-201
Insurance/Cust name IFFCO TOKIO GENRAL Customer Name Yatharth Dwivedi
INSURANCE CO.LTD.
Insurer/Cust GSTIN 09AAACI7573H2Z9 Customer GSTIN
Billing Address IFFCO BHAWAN GOKHLR Delivery Address Bhadurganj prayagraj up
MARG,LUCKNOW
,LUCKNOW, Uttar Pradesh Allahabad, Uttar Pradesh
226001 211007
8687701717
Document Name AJC-XA5823-000011 Model BREZZA
Document Date 04-07-2022 Cust State Code 09
Branch XA58 Vehicle Regd No UP70DM2999
Insurance Policy No 12638507 Km Reading 82588
Insurance Claim No 12638507 Insurance Expiry Date 03-06-2022
Surveyor Name sk singh Surveyor Mobile Number 9415202261

LABOURS
S CODE DESCRIPTION HSN/SAC QTY RATE TOT DISC Tax Val CGST CGST SGST SGST IGST IGST AMOUNT
N VAL after DISC % % %
O with
DEP
1 ACCDB QTR PANEL 998729 1.00 2,201.00 2,201.00 0.00 2,201.00 9% 198.09 9% 198.09 0% 0.00 2,597.18
P0277 LH/RH -
METALLIC
PAINTING
2 ACCDB DENTING 998729 1.00 750.00 750.00 200.00 550.00 9% 49.50 9% 49.50 0% 0.00 649.00
P0111 QUARTER PANEL
LHS
3 ACCDB DENTING REAR 998729 1.00 1,500.00 1,500.00 200.00 1,300.00 9% 117.00 9% 117.00 0% 0.00 1,534.00
P0049 LH DOOR
4 ACCDB PAINTING DOOR- 998729 1.00 3,891.00 3,891.00 627.00 3,264.00 9% 293.76 9% 293.76 0% 0.00 3,851.52
P0405 FRONT LHS
METALLIC
5 ACCDB PAINTING DOOR- 998729 1.00 3,668.00 3,668.00 627.00 3,041.00 9% 273.69 9% 273.69 0% 0.00 3,588.38
P0407 REAR LHS
METALLIC
6 TL02 Head light assembly 998729 1.00 151.00 151.00 0.00 151.00 9% 13.59 9% 13.59 0% 0.00 178.18
Replacing
7 ACCDB PAINTING SIDE- 998729 1.00 700.00 700.00 300.00 400.00 9% 36.00 9% 36.00 0% 0.00 472.00
P0420 VIEW MIRROR
LHS METALLIC
8 PS0168 REPLACE LAMP 998729 1.00 149.00 149.00 0.00 149.00 9% 13.41 9% 13.41 0% 0.00 175.82
ASSY-OUTSIDE
MIRROR LH
9 ACCDB DENTING REAR 998729 1.00 1,500.00 1,500.00 200.00 1,300.00 9% 117.00 9% 117.00 0% 0.00 1,534.00
P0049 LH DOOR
10 ACCDB PAINTING 998729 1.00 2,624.00 2,624.00 400.00 2,224.00 9% 200.16 9% 200.16 0% 0.00 2,624.32
P0403 FENDER-FRONT
LHS METALLIC
11 ACCDB REPLACE FRONT 998729 1.00 250.00 250.00 0.00 250.00 9% 22.50 9% 22.50 0% 0.00 295.00
P0032 BUMPER
12 ACCDA REMOVE & REFIT 998729 1.00 500.00 500.00 250.00 250.00 9% 22.50 9% 22.50 0% 0.00 295.00
P00111 BUMPER GRILL
LOWER
13 ACCDA DENTING FENDER 998729 1.00 500.00 500.00 400.00 100.00 9% 9.00 9% 9.00 0% 0.00 118.00
P00114 LH
14 ACCDA REMOVE & REFIT 998729 1.00 500.00 500.00 300.00 200.00 9% 18.00 9% 18.00 0% 0.00 236.00
P0092 WIPER TANK
15 ACCDB PAINTING 998729 1.00 2,936.00 2,936.00 400.00 2,536.00 9% 228.24 9% 228.24 0% 0.00 2,992.48
P0415 BUMPER-FRONT
METALLIC
16 ACCDB REMOVE & REFIT 998729 1.00 250.00 250.00 0.00 250.00 9% 22.50 9% 22.50 0% 0.00 295.00
P0025 FRONT BUMPER,
BRACKET
17 PS0280 REMOVE AND 998729 1.00 449.00 449.00 0.00 449.00 9% 40.41 9% 40.41 0% 0.00 529.82
REFIT WIPER
MOTOR LINKAGE
18 PS0057 INTERCOOLER 998729 1.00 999.00 999.00 400.00 599.00 9% 53.91 9% 53.91 0% 0.00 706.82
REPLACE &
FITTING
19 ACCDB RADIATOR 998729 1.00 1,000.00 1,000.00 400.00 600.00 9% 54.00 9% 54.00 0% 0.00 708.00
P0186 SUPPORT O/F
20 CH03 Engine guard fitting 998729 1.00 151.00 151.00 0.00 151.00 9% 13.59 9% 13.59 0% 0.00 178.18
SUB TOTAL 20.00 4,704.00 19,965.00 1,796. 1,796. 0.00 23,558.70
85 85
TOTAL GST on LABOURS 3,593.70
TOTAL Discount on LABOURS 4,704.00
TOTAL of LABOURS 23,558.70

SPARES
S CODE DESCRIPTION HSN/SAC QTY PER Taxable DISC Tax Val CGS CGST SGS SGST IGS IGST AMOUN
N QTY Value after DISC T% T% T% T
O RATE
1 1AM71 BUMPER,FRONT 87081090 1.00 2,219.00 2,219.00 0.00 2,219.00 14% 310.66 14% 310.66 0% 0.00 2,840.32
711M82 UPPER
P00-5P
K
2 1AM71 HOLDER BUMPER 87089900 1.00 75.00 75.00 0.00 75.00 14% 10.50 14% 10.50 0% 0.00 96.00
732M82 SIDE R
P01
3 1AM71 GRILLE,RADIATO 87081090 1.00 598.00 598.00 0.00 598.00 14% 83.72 14% 83.72 0% 0.00 765.44
721M82 R LOWER
P00-5P
K
4 1AM71 BEZELFRONT FOG 87089900 1.00 86.00 86.00 0.00 86.00 14% 12.04 14% 12.04 0% 0.00 110.08
751M82 LAMPR
P10-5P
K
5 1AM35 UNIT HEADLAMP 85122010 1.00 3,801.00 3,801.00 0.00 3,801.00 9% 342.09 9% 342.09 0% 0.00 4,485.18
321M82 LH
P00
6 1AM84 MIRROR ASSY, 87089900 1.00 2,197.00 2,197.00 0.00 2,197.00 14% 307.58 14% 307.58 0% 0.00 2,812.16
702M67 OUT RR VIEW LH
L10-5P
K
7 1AM38 TANK WASHER 87089900 1.00 250.00 250.00 0.00 250.00 14% 35.00 14% 35.00 0% 0.00 320.00
450M82
P00
8 1AM38 WASHER PUP 87081090 1.00 290.00 290.00 0.00 290.00 14% 40.60 14% 40.60 0% 0.00 371.20
410M53
M10
9 1AM13 COOLER 87089900 1.00 3,418.00 3,418.00 0.00 3,418.00 14% 478.52 14% 478.52 0% 0.00 4,375.04
620M55 COMP,INTER
R50
10 1AM41 RUBBER SUPPORT 87081090 2.00 59.00 118.00 0.00 118.00 14% 16.52 14% 16.52 0% 0.00 151.04
721M79
420
11 1AM72 COVERENGINE 87089900 1.00 743.00 743.00 0.00 743.00 14% 104.02 14% 104.02 0% 0.00 951.04
411M64 UNDER
M00
12 1AM71 MEMBER 87082900 1.00 1,032.00 1,032.00 0.00 1,032.00 14% 144.48 14% 144.48 0% 0.00 1,320.96
100M82 COMP,RADIATOR
P00 SUPPORT
13 1AM58 MEMBER 87089900 1.00 946.00 946.00 0.00 946.00 14% 132.44 14% 132.44 0% 0.00 1,210.88
270M82 COMP,FRONT
P00 BUMPER
14 1AM01 BOLT,RR. 87081090 9.00 4.69 42.21 0.00 42.21 14% 5.91 14% 5.91 0% 0.00 54.03
500M10 TORQUE STOPPER
253
15 1AM09 CLIP 87089900 7.00 7.00 49.00 0.00 49.00 14% 6.86 14% 6.86 0% 0.00 62.72
409M08
006
16 1AM09 1AM09409M07L01 87082900 5.00 4.00 20.00 0.00 20.00 14% 2.80 14% 2.80 0% 0.00 25.60
409M07 CLIP
L01
SUB TOTAL 35.00 0.00 15,884.21 2,033.74 2,033.74 0.00 19,951.69
TOTAL GST on SPARES 4,067.48
TOTAL Discount on Spares 0.00
TOTAL of SPARES 19,951.69
GRAND TOTAL 43,510.00

Excess and Salvage Charges

SN CODE DESCRIPTION HSN/SAC QTY TOT VAL DISC Tax Val CGS CGST SGS SGST IGS IGST AMOUNT
O after DISC T % T% T%
SUB TOTAL 0.00 0.00 0.00 0.00 0.00 0.00
TOTAL of Excess and Salvage Charges 0.00

Total Labour Amount Total Parts Amount Total Labour & Parts Excess and Salvage Charges Payable Total Amount
Amount
23,558.70 19,951.69 43,510.39 0.00 43,510.00

TERMS & CONDITIONS

1. This workshop is owned and operated by Maa Vindhyavasini Motors (“Workshop”). The Workshop is open for 7 days a week, except for day/s that are
pre-disclosed as weekly off or special holiday, by this Workshop.

2. The Workshop is an authorised franchisee of TVS Automobile Solutions PVT. LTD. (“TASPL”). You (“Customer”/ “you”) hereby agree and authorize
the Workshop and TASPL and all of its divisions, affiliates, subsidiaries, related parties and other group companies (collectively the “TVS Entities”;
Workshop and TVS Entities are collectively called “we”/ “us” / “our”) to access your basic data / contact details provided herewith, i.e. your name, address,
telephone number, e-mail address, birth date and / or anniversary date. You hereby consent to, agree and acknowledge that we may call/ email/
SMS/Whatsapp/Telegram you on any of the basic contact details shared by you, in order to assist you with the services availed by you or keep you informed
regarding our service or product details, or send you any marketing and our other product or service related communication and our other offers. You confirm
that you are providing the details herein at your sole discretion and confirm that you have full capacity and authority to provide the abovementioned details
and these details are true and accurate. You promise that neither the Workshop nor any TVS Entity shall be held responsible or liable for any claim arising out
of accessing or using your basic data / contact details shared by you. You also consent to being assigned a unique identity within the TVS Group, to be shared
amongst all TVS Entities, for the purpose outlined in this paragraph. You also agree and understand that the Workshop, TVS Entities or their agency appointed
for this purpose will retain the data provided hereunder for as long as reasonably required for the purposes mentioned above, or until you withdraw consent,
after which they will delete all your data from their records and will forget you completely. You also agree that if at any point of time, you wish to stop
receiving such communications from TVS Group, you will call at TVS’s designated call center* and register your preference.
*Call Centre Number: 1800224008 or email us at:- customercare@tvs.in

3. This Workshop shall take reasonable care of your vehicle while it is at the Workshop. However, this Workshop shall not be responsible for any loss or
damage caused to the vehicle in case such loss is caused due to reason of fire, theft, accident or any other cause beyond the control of the Workshop.

4. The Customer is advised to collect his/her personal articles before handing over the vehicle to the Workshop. We shall not be responsible for any missing
item, which has not been registered in the job card.

5. For a vehicle in an accident, if towing services are availed from the Workshop, the Customer will be liable to pay the cost for such towing, at actuals.
6. Workshop will release the vehicle only upon receiving complete payment from the Customer or upon receipt of delivery order from the insurance
company. However, principal liability to pay will always be of the Customer, under all circumstances.

7. This Workshop may conduct test drive on the vehicle for purpose of inspecting the damages and testing the repairs done and/ or also drive the vehicle for
delivery to the Customer, at Customer’s risk. In case of damage due to any accident, repairs will be carried out under the insurance of the vehicle.

8. While best efforts will be made by the Workshop to identify full extent of damages suffered by the vehicle brought to the Workshop for repair and
accordingly repairs and replacement of damaged parts will be carried out. However, the Customer understands and acknowledges the fact that the repaired
vehicle may not be restored to its original condition or cannot be made like new vehicles. Few parts or systems of the vehicle may fail after some time of usage
because of certain unidentifiable or unforeseen effect of damage occurred due to any accident or natural calamity, if any, show up after some time. Such
failures shall not be treated as deficiency in quality of repair / service done by the Workshop.

9. THE CUSTOMER SHALL INSPECT THE VEHICLE TO ITS SATISFACTION BEFORE TAKING IT BACK FORM THE WORKSHOP. NEITHER
THE WORKSHOP NOR TASPL MAKES ANY WARRANTY WITH RESPECT TO THE SERVICES, WHETHER EXPRESS OR IMPLIED, AND
SPECIFICALLY DISCLAIMS ANY IMPLIED WARRANTIES, WHETHER OF MERCHANTABILITY, SUITABILITY, FITNESS FOR A PARTICULAR
PURPOSE, OR OTHERWISE FOR ITS SERVICES. NEITHER THE WORKSHOP NOR TASPL MAKES ANY WARRANTIY WHETHER EXPRESS,
IMPLIED OR STATUTORY, AS TO THE DESCRIPTION, QUALITY, MERCHANTABILITY, COMPLETENESS OR FITNESS FOR ANY PURPOSE
OF ANY SERVICES OR INFORMATION PROVIDED TO THE CUSTOMER, OR AS TO ANY OTHER MATTER ALL OF WHICH WARRANTIES
ARE HEREBY EXCLUDED AND SPECIFICALLY DISCLAIMED.

10. Customer is requested to collect the old spare part (in case of replacement) after the job is completed. In case the old spar e part is not collected by the
Customer at the time of delivery of the vehicle, the Workshop has the right to dispose it off, in the manner it deems fit, and shall not be held responsible
thereafter.

11. In case the delivery of the vehicle has not been taken within 3 days from the day the service is completed, Rs. 100 per day per vehicle as parking charges
would be levied. The charges will have to be paid by the Customer along with the bill at the time of taking delivery of the vehicle. The Workshop reserves the
right to recover all expenses and take all steps, including disposal of the vehicle in the manner it deems fit or initiating legal actions, if the Customer fails to
take the delivery within 7 days of receipt of notice or information of completion of the service.

12. If required by the Workshop, Customer undertakes to make deposit of 50% of the estimated amount of repair charges in advance in case of major repairs
(as determined by the Workshop), whether under insurance claims or otherwise.

13. Every effort is made to adhere to the commitments made by this Workshop to the Customer. However, the estimated date/time of delivery could change
depending upon the availability of spare parts (if need be), additional jobs requested and delays caused due to unforeseen circumstances.

14. Vehicle can be delivered only on production of customer copy of the Repair Order Form. However, the Workshop may deliver the vehicle to the
Customer or any representative of the Customer, whose signature appears on the Repair Order form or who is authorised by the Customer.

15. Workshop will levy an estimation charge of Rs. 500/- or 10% of the total labour charges, whichever is higher if the job is not entrusted to the Workshop
after obtaining the estimate from Workshop. The amount will have to be paid along with the parking charges if any, prior to delivery of the vehicle on his/her
behalf.

16. Further, an interest of 24% p.a will be levied on the invoice value in case the Customer or owner of vehicle does not pay on the outstanding within 2 days
from the date of the invoice.

17. Amounts referred under these “Terms and Conditions” are exclusive of taxes.

18. The Customer shall be bound by these Terms and Conditions including their respective successors and lawful assigns. These Ter ms and Conditions shall
be governed by and construed in accordance with the laws of India and any dispute arising out of this engagement or these terms shall be subject to the
exclusive jurisdiction of the Indian courts.

For Maa Vindhyavasini Motors

Customer Signature Authorized Signature