Printed:26-Sep-2023

Vehicle Delivery Order (VDO)

Policy Number:D080190839 | Claim Number:202301534031

VDO Date: 26-Sep-2023 10:45 AM

V
Name of Owner: MR VINOD KUMAR Engine No.: D13A2437805 Workshop Name: ANAND MOTOR

Registration No.: PB19L2135 Surveyor Name: Workshop Gst Number: 03ABHFA9402C1Z1

Date of Reg.: 19-May-2015 Claim coordinator: Dalwinder Singh Date of Accident: 21-Sep-2023
VDO
Vehicle Make & Model: MARUTI SUZUKI,SWIFT DZIRE Chassis No: MA3FJEB1S00599470 Vehicle Age(Years) : 8

Payment to: Workshop

Please find the below tentative estimation for the subject vehicle as per the visible damages found on the vehicle. Any further replacement / repair of part required during the course of repair shall be verified and
included in the estimation.
We request you to take prior approval from the insurer for all kept open part approval, if any. Please find the below tentative preliminary assessment for the subject vehicle. Any further replacement / repair of part
required during the course of repair shall be verified and included in the assessment subject to admissibility of the claim. We request you to take prior approval from the insurer for all parts put on hold and are
pending for approval.

Important Notes:
• After completion of repairs,you shall submit the vehicle for reinspection and also produce the salvage of parts replaced.
• Please have the final tax invoice raised in favour of Go Digit Insurance Limited up to the Insurer liability and remaining balance be invoiced in favour of the Insured.

For any further clarification(s) regarding your claim, please feel free to reach out to Dalwinder Singh at 9511906063 or dalwinder.singh@godigit.com. Alternatively, you can call our call centre toll free
number 1800-258-5956.

PARTS

TAXABLE TAX TOTAL DEP R&R REPAIR PAINTING

S.NO JOB MATERIAL DESCRIPTION HSN QTY. RATE TAX (%) DEP.(%)
AMOUNT AMOUNT AMOUNT AMOUNT CHARGES CHARGES CHARGES

1 Replace Plastic FRONT BUMPER 87081090 1.0 ₹ 1539.0 ₹ 1539.0 28.0 ₹ 430.92 ₹ 1969.92 50.0 ₹ 984.96 ₹ 300.0 ₹ 0.0 ₹ 3000.0

2 Replace Metal HOOD PANEL 8708 1.0 ₹ 3292.0 ₹ 3292.0 28.0 ₹ 921.76 ₹ 4213.76 40.0 ₹ 1685.5 ₹ 300.0 ₹ 0.0 ₹ 3000.0

3 Replace Plastic HEAD LAMP ASSY LH 8512 1.0 ₹ 2165.0 ₹ 2165.0 18.0 ₹ 389.7 ₹ 2554.7 50.0 ₹ 1277.35 ₹ 0.0 ₹ 0.0 ₹ 0.0

Sub Total ` 6996.0 ` 1742.38 ` 8738.38 ` 3947.81 ` 600.0 ` 0.0 ` 6000.0

LABOUR TYPE TAXABLE AMOUNT TAX AMOUNT TOTAL AMOUNT DEP AMOUNT

Remove & Refittng ` 600.0 ` 108.0 ` 708.0 ` 0.0

Repair ` 0.0 ` 0.0 ` 0.0 ` 0.0

Paint Material ` 1500.0 ` 270.0 ` 1770.0 ` 885.0

Paint Labour ` 4500.0 ` 810.0 ` 5310.0 ` 0.0

Total ` 7788.0

FINAL CALCULATION AMOUNT (`)

Total Liability ` 16526.38

Compulsory Deductible ` 1000.0

Voluntary Deductible ` 0.0

Salvage Deductions ` 0.0

Non Standard Amount ` 0.0

Towing Amount `0

Digit Liability ` 10693.57

ASSESSMENT NOTES

1. Any additional amount over and above the approved assessment, shall be borne by the Insured.

2. The final liability has been arrived as full and final settlement after consent from the Insured. Do get back to us within the next 24 hours for any queries or clarification(s).

We presume that the approved parts those are replaced in respect of this claim shall be handed over to the Insured at the time of delivery of the vehicle. Please note that this is the sole responsibility of the workshop to maintain all required records in
3. accordance with prevailing regulatory / taxation requirements of handing over such replaced parts to the insured. Please note that Go Digit General Insurance Limited would not be responsible for any dispute arising from anyone including insured, taxation or
regulatory authorities related to handing over such replaced parts by the workshop to the insured.