Raman Kumar

Sheet1 ICICI LOMBARD GENERAL INSURANCE COMPANY LIMITED CLAIM NO:

MOT01040069 VEHICLE: HYUNDAI HYUNDAI VERNA SANTRO REG NO: PB-11-AE-1940 TEMP

CSM: KULJIT SINGH

GARAGE:D P G HYUNDAI

MILEAGE:

DATE:

SURVAYOR: Sal e Tax

12.50%

Sr.

Part Name

Re Sale Tax

Enter Vehicle Year

0

Comments: SALVAGE

5.0%

1 FRT BUMPER

P

N

1

2448 2,448.00

-

2,448.00 1,224.00

1,224.00

2 HEAD LAMP

P

N

2

3324 6,648.00

-

6,648.00 3,324.00

3,324.00

Labour Work Es Es Es Total O/F DT PT ti ti A ti A Labour Amt Ap m m p m p pr at at pr at pr - e- e- - e- 35,000.00 - - - - - -

3 GRILLCTR

P

N

1

3202 3,202.00

-

3,202.00 1,601.00

1,601.00

-

-

-

-

-

-

-

-

4 FOG LAMP

P

N

1

2958 2,958.00

-

2,958.00 1,479.00

1,479.00

-

-

-

-

-

-

-

-

5 RADIATOR GRILL

P

N

1

1476 1,476.00

-

1,476.00

738.00

738.00

-

-

-

-

-

-

-

-

6 RADIATO SUPPORT

P

N

1

9224 9,224.00

-

9,224.00 4,612.00

4,612.00

-

-

-

-

-

-

-

-

7 WINDSHI WAS BOTTLEP

N

1

700

700.00

-

8 SIDE BRKT

P

N

1

796

796.00

9 FENDER LINING

P

N

2

674 1,348.00

P

N

1

11 INSULATOR BONNET P

N

1

12 BONNET LATHC

M

N

1

13 SIDE VIEW MIRRO

P

N

2

14 WHEEL RIM

M

N

2

15 WHEEL COVER

P

N

2

16 REGONATORP

P

N

1

17 DOOR HANDLE

P

N

1

18 LOCK SET

P

N

1

19 DOOR MULDING

P

N

1

1214 1,214.00

-

1,214.00

7596 7,596.00 3336 3,336.00

10 COWL TOP GRILLE

Typ e Tax Qt Part

20 DOOR TRIM

P

N

1

21 DOOR TRIM

P

N

1

22 ROOF PANEL HEAD LINING P N

1

23 DOOR REGULATOR

2

P

N

24 GLASS MOULDING

P

N

1

25 DOOG GLASSS

G

N

1

26 SASH

P

N

1

Part Amt

Total Parts Amt

Tot al Tax

Gross Amt

Depr

Net Amt

Salvage

700.00

350.00

350.00

-

-

-

-

-

-

-

-

-

796.00

398.00

398.00

-

-

-

-

-

-

-

-

-

1,348.00

674.00

674.00

-

-

-

-

-

-

-

-

1286 1,286.00

-

1,286.00

643.00

643.00

-

-

-

-

-

-

-

-

3476 3,476.00

-

3,476.00 1,738.00

1,738.00

-

-

-

-

-

-

-

-

272.00

-

-

272.00

13.60

-

-

-

-

-

-

-

2894 5,788.00

-

5,788.00 2,894.00

2,894.00

-

-

-

-

-

-

-

-

1150 2,300.00

-

2,300.00

-

2,300.00

115.00

-

-

-

-

-

-

-

850 1,700.00

-

1,700.00

850.00

850.00

-

-

-

-

-

-

-

-

654.00

-

654.00

327.00

327.00

-

-

-

-

-

-

-

-

1300 1,300.00

-

1,300.00

650.00

650.00

-

-

-

-

-

-

-

-

- 10,200.00 5,100.00

5,100.00

-

-

-

-

-

-

-

-

607.00

607.00

-

-

-

-

-

-

-

-

-

7,596.00 3,798.00

3,798.00

-

-

-

-

-

-

-

-

-

272

654 10200

###

272.00

3,336.00 1,668.00

1,668.00

-

-

-

-

-

-

-

-

- 10,831.00 5,415.50

5,415.50

-

-

-

-

-

-

-

-

3215 6,430.00

-

6,430.00 3,215.00

3,215.00

-

-

-

-

-

-

-

-

1144 1,144.00

-

1,144.00

572.00

572.00

-

-

-

-

-

-

-

-

368.00

-

368.00

-

368.00

-

-

-

-

-

-

-

-

2375 2,375.00

-

2,375.00 1,187.50

1,187.50

-

-

-

-

-

-

-

-

10831

368

###

Page 1

Sheet1 27 RR GLASS DICKY

G

N

1

28 SWITCH ASSY

P

N

29 RR PANEL TRIM

P

N

30 WIPER LH RR

M

31 WIPER MOTOR

P

2485 2,485.00

-

2,485.00

-

2,485.00

-

-

-

-

-

-

-

-

2

524 1,048.00

-

1,048.00

2

3100 6,200.00

-

524.00

524.00

-

-

-

-

-

-

-

-

6,200.00 3,100.00

3,100.00

-

-

-

-

-

-

-

N

2

1584 3,168.00

-

3,168.00

-

-

3,168.00

158.40

-

-

-

-

-

-

N

1

7390 7,390.00

-

-

7,390.00 3,695.00

3,695.00

-

-

-

-

-

-

-

-

-

2,876.00 1,438.00

1,438.00

-

-

-

-

-

-

-

-

32 WIPER BLADE

P

N

1

2876 2,876.00

33 CENTRE CONSOLE

P

N

1

3085 3,085.00

-

3,085.00 1,542.50

1,542.50

-

-

-

-

-

-

-

-

34 HEAD REST

P

N

1

1557 1,557.00

-

1,557.00

778.50

778.50

-

-

-

-

-

-

-

-

35 FRT STRUT

M

N

2

3690 7,380.00

-

7,380.00

-

7,380.00

369.00

-

-

-

-

-

-

-

-

9,276.00

-

9,276.00

463.80

-

-

-

-

-

-

-

36 ARM SUS

M

N

2

4638 9,276.00

37 LINK ASSY FR RH

M

N

1

2658 2,658.00

-

2,658.00

-

2,658.00

132.90

-

-

-

-

-

-

-

38 TIE ROD

M

N

1

1506 1,506.00

-

1,506.00

-

1,506.00

75.30

-

-

-

-

-

-

-

39 BALL JOING

M

N

1

1834 1,834.00

-

1,834.00

-

1,834.00

91.70

-

-

-

-

-

-

-

9445 9,445.00

-

9,445.00 4,722.50

4,722.50

-

-

-

-

-

-

-

-

40 ENGING COVER

P

N

1

41 INTER COOLER

P

N

1

16430

###

- 16,430.00 8,215.00

42 DIESEL TANK

M

N

1

11409

###

- 11,409.00

43 GLSAS TRIM

P

N

1

1571 1,571.00

-

1,571.00

44 SPEATKER BAR

P

N

1

3174 3,174.00

45 ENTINA

P

N

1

3098 3,098.00

46 ROOF MOULDING

P

N

2

7576

47 DOOR LATCH

M

N

2

48 BRAKE LIGHTP

P

N

1

49 TAIL MAP

P

N

50 RR BUMPER RAIL

P

N

51 RR SLIDE BKRT

M

52 RR RAIL ENERGY

8,215.00

-

-

-

-

-

-

-

-

-

11,409.00

570.45

-

-

-

-

-

-

-

785.50

785.50

-

-

-

-

-

-

-

-

-

3,174.00 1,587.00

1,587.00

-

-

-

-

-

-

-

-

-

3,098.00 1,549.00

1,549.00

-

-

-

-

-

-

-

-

- 15,152.00 7,576.00

7,576.00

-

-

-

-

-

-

-

-

4281 8,562.00

-

8,562.00

-

8,562.00

428.10

-

-

-

-

-

-

-

678.00

-

678.00

339.00

339.00

-

-

-

-

-

-

-

-

2

4606 9,212.00

-

9,212.00 4,606.00

4,606.00

-

-

-

-

-

-

-

-

1

2122 2,122.00

-

2,122.00 1,061.00

1,061.00

-

-

-

-

-

-

-

-

N

1

1350 1,350.00

-

1,350.00

-

1,350.00

67.50

-

-

-

-

-

-

-

P

N

1

2906 2,906.00

-

2,906.00 1,453.00

1,453.00

-

-

-

-

-

-

-

-

53 RR SHOCKER

M

N

1

3910 3,910.00

-

54 RR AXLE TUBE

M

N

1

55 RR HUB

M

N

1

50 PANEL ASSY RR DR RH M

N

51 PANEL ASSY TRUNK LID M 52 PANEL ASSY BACK

M

678

###

3,910.00

-

3,910.00

195.50

-

-

-

-

-

-

-

- 10,055.00

-

10,055.00

502.75

-

-

-

-

-

-

-

7500 7,500.00

-

7,500.00

-

7,500.00

375.00

-

-

-

-

-

-

-

1

8595 8,595.00

-

8,595.00

-

8,595.00

429.75

-

-

-

-

-

-

-

N

1

4872 4,872.00

-

4,872.00

-

4,872.00

243.60

-

-

-

-

-

-

-

N

1

2798 2,798.00

-

2,798.00

-

2,798.00

139.90

-

-

-

-

-

-

-

53 HINGE ASSY TRUNK LID M

N

2

1398 2,796.00

-

2,796.00

-

2,796.00

139.80

-

-

-

-

-

-

-

54 PANLE ASSY SIDE BODY M

N

1

- 20,743.00

-

20,743.00

1,037.15

-

-

-

-

-

-

-

55 PANEL FENDER

N

1

1885 1,885.00

-

1,885.00

-

1,885.00

94.25

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

-

### 201,759.00 5,643.45

-

-

-

-

-

-

35,000.00

124 LABOUR

M

N

10055

20743

###

###

TOTAL

Page 2

Sheet1 ESTIMATED Parts Lab

LABOUR 35,000.00 201,759.00

Salvage

5,643.45

-

EXCESS

500.00

PAYMENT TO GARAGE

SR Y TAX

4,284.00

WCT

-

WCTP

-

TOTAL LABOUR 39,284.00 CSM/SURVEYOR VIKAS SIGN MEHNDROO :

Total Payable 234,900 Labour Parts

39,284 201,759

Depreciation86,037.00 Excess Salvage

5,643.45

Insurance 234,899.55 Invoice

795,929.00

Difference 561,029.45

Page 3