KWITANSI BENGKEL

Nama : Tuan Imam No polisi

Alamat : Kp.sudi mampir, GG H.imang Type
no.81 Rt/Rw 003/001 Bj.Gede No Rangka
No Hp : 0857-4295-5546 No Mesin
KM

No PKB : 2307046 No Kwitansi

S/A : Hendar Mekanik
PIC

Activity Service

1 Maintenance 24 komponen

Uraian Biaya

Service :
Part Tag
*Drum brake shoe 04495-YZ143-001 :
*Brake pad disc 04491-YZ030-001 :
*Denso plug spark 9004A-91068 :
*Hand brake kit 45503-BZ180-BZ181 :
*Bohlam Rem Stanlee 21/5W :
Material
*Brake Fluid Prestone DOT 3 :
*Engine Oil Mobil super premium 15w-40 API SN :
*Engine Flush Prestone engine flush :
Misc charges T/A :
Sub total :
Disc 15% :
Ppn 11% :
Total :

Bsd,03 July 2023

Dikeluarkan Oleh

Kasir
PT.Global Carfix Indonesia
CARfix Hub TPI-POOL BSD
No.TLP 021-55727769

: B 1398 ERX
: Sigra R 1.2
: MHKS6GJ6JLJ085828
: 3NRH513094
: 91949

: KJ202307147
: Hendra
: Nana

Rate

Rp 255,000

Rp 270,858
Rp 327,250
Rp 35,299
Rp 185,000
Rp 12,500

Rp 32,300
Rp 330,000
Rp 54,815
Rp 82,000
Rp 1,585,022
Rp 237,753
Rp 174,352
Rp 1,521,621
 CV.New Margajaya Perkasa
Body Repair & Paint Specialis
Hub TPI-POOL BSD

No. Faktur : OR2307022 Tanggal : 01 Juli 2023

No. PKB : BR23037022 No. Polisi : B 1398 ERX
Asuransi : Pribadi Merk/Type : Daihatsu / Sigra R 1.2
Alamat : Kp.sudimampir GG H.imang No.81 Tahun/Warna : 2021 / Grey
Rt/Rw 003/001 Bj.Gede No. Rangka : MHKS6GJ6JLJ085828
No. Polis : T/A No. Mesin : 3NRH513094
No. Klaim : T/A Pemilik : Perorangan / Bpk.Imam

Kterangan Part / Jasa Qty Harga Disc Part %

*Bumper Fr 0.8 300,000 -

*Bumper Rr 0.8 300,000 -
*Quarter Panel Rh 1 380,000 -
*Quarter Panel Lh 1 380,000 -
*Door RR Rh 1 380,000 -
*Engine Hood 1.5 450,000 -
*Poles All body - 350,000 -

Sub total :
PPN 11% :
Own Risk :
Materai :
Biaya Derek :
Disc Jasa 15% :
Jumlah Dibayar :
hatsu / Sigra R 1.2

KS6GJ6JLJ085828

orangan / Bpk.Imam

Jumlah

300,000
300,000
380,000
380,000
380,000
450,000
350,000

2,540,000
279,400
-
-
-
381,000
2,438,400