Damage Assessment Center in Medina DA Center - ‫ر ز ا د ر‬

MEDINA Center City - ‫د ا ر ز‬

18/12/2021 11:30:46 AM Print Date - ‫ر اط‬
16/12/2021 12:12:59 PM DA Date – ‫ر ا د ر‬
‫ـ ـر ـر ـ ــد ــر ا ــرار ا‬
16/12/2021 12:23:27 PM DA Completed Date – ‫ر إ لا‬
DA1612211841 DA Report No - ‫ر م ا ر ر‬
Final Damage
MD141221101 Accident No - ‫ر م ا دث‬
Assessment Report
Najm Accident Attended by - ‫رة ا دث ن طر‬
Sub Case Type - ‫دث‬ ‫رة‬ ‫ا‬ ‫ا‬
1/2 Pages - ‫ر م‬

‫ا وان‬ ‫د‬ ‫ن‬ Vehicle Owner Name / ‫كا ر‬ ‫ا م‬

‫ا ك‬
1084218575 ID / ‫ر م ا و‬ Owner

Vehicle Details
0547993211 Mobile No / ‫ر م ا وال‬

‫و تا ر‬
Honda Vehicle Manufacturer / ‫ا ر‬
‫ا ورد‬ Model / ‫ا ود ل‬
‫تا ر‬
Gray 2019 Color & Year / ‫ا ون وا‬
Vehicle Info
T G D 9176 Plate No / ‫رما و‬
1HGCV1634KA600959 Chasis No / ‫ل‬ ‫رما‬
Zaki Ibrahim Ahmed Fallatah Auto Mechanica Estimated By / ‫ا د ر وا ط‬

Assessment Details
Workshop ‫أ ور ا دي ا‬
Labor Estimation
2000.00 (A) Estimation Cost / ‫ا د ر‬ ‫ا‬

‫و تا در‬
‫ط ا ر‬
1,593.90 (B) Spare Parts Cost /‫ر‬ ‫ط ا‬
Spare Parts

‫ا‬ ‫أ‬
3593.90 (A+B) Total Cost / ‫ا‬ ‫ا‬
Final Estimation

‫ظت‬
‫ور‬ ‫نا‬ ‫ر‬ ‫حا با‬ ‫با‬ ‫ما‬
Comments

‫ا د وا ط‬ ‫طر ا د‬ (%) ‫ا ؤو‬

Payment By Payment Method Liability(%)
Tawuniya Cooperative Insurance Company By Insurance Company 100
Damage Assessment Center in Medina DA Center - ‫ر ز ا د ر‬
MEDINA Center City - ‫د ا ر ز‬
18/12/2021 11:30:46 AM Print Date - ‫ر اط‬
16/12/2021 12:12:59 PM DA Date – ‫ر ا د ر‬
‫ـ ـر ـر ـ ــد ــر ا ــرار ا‬
16/12/2021 12:23:27 PM DA Completed Date – ‫ر إ لا‬
DA1612211841 DA Report No - ‫ر م ا ر ر‬
Final Damage
MD141221101 Accident No - ‫ر م ا دث‬
Assessment Report
Najm Accident Attended by - ‫رة ا دث ن طر‬
Sub Case Type - ‫دث‬ ‫رة‬ ‫ا‬ ‫ا‬
2/2 Pages - ‫ر م‬

‫م‬ ‫ر دا‬ ‫ط ا‬ ‫ا‬ ‫ا‬

‫ا‬ ‫ا‬ ‫م‬ ‫ا‬ ‫ا‬ ‫ا‬ ‫ورد ط ا ر‬
Parts Final Value After Overall Discount Total cost Spare part dealer
Overall Discount %
Amal Tamm Co
1,593.90 0% 3643.00
For service, call us at 920010431

‫ك‬ ‫م وا‬ ‫دا‬ ‫ا‬

‫ك‬ ‫ا‬ ‫م‬ ‫ا‬ ‫ا‬ ‫ر ا و دة‬ ‫ا دد‬ ‫ط ا ر‬
Total After Discount
Consumption% Discount % Total Unit price Quantity Spare part
& Consumption

‫ر‬ ‫ب‬
561.60 75% 10% 2496.00 2496.00 1
1
‫ر‬ ‫د ور‬
1032.30 0% 10% 1147.00 1147.00 1
1