Annexure-IV

Standard Vehicle Invoice Format

Name of Firm : PAN No. / GST No. :

Bank A/c No. :

From Full Address :
IFSC :

Mobile No. : Bank & Branch:

Tax Invoice of Vehicle Hiring

for the period from xx.xx.xxxx to xx.xx.xxx

Invoice No. : Dated :

Name of office :

Full Address :
To
Ref. Order no. : Contract period :

Vehicle Model: Vehicle Reg. no. :

SN Particulars Date Kms Run Remark

i Initial reading xx.xx.xxxx

ii Final reading xx.xx.xxxx

iii Total Run in billing period (ii-i) xx.xx.xxxx 0

iv Run for personal use xx.xx.xxxx

v Actual Run for MPPGCL (iii-iv) xx.xx.xxxx 0

No. of Driver(s)
Rate (₹/Month)
A Particulars Amount in ₹ (a*b)
(a)
(b)
1 Monthly Fixed Charges [as per order] - 0

2 Monthly Driver's Wages [As per prevailing Rates of Skilled Labour] 0

Sub-total of Monthly Fixed Charges A(1+2) 0

Rate (₹/Km) Actual run in Amount (3) in ₹
B Particulars
(a) Kms (b) (a*b)
3 Monthly Variable Charges [as per above reference order] 0 0

4 Price Variation due to change in fuel prices

Base Rate of (+)Escalation / (-) Price Variation Actual run in

Rate of Petrol/ Diesel per Litre De-escalation in ₹ Factor Amount (4) in ₹
Petrol/ Diesel Kms
(a) (c)= (a-b) (d) (c*d*e)
(b) (e)

i On Dtd. 01/…./20….

ii On Dtd. 15/…./20….
0 0 0
iii Last Dtd. …/…./20…
Average Rate (a) =
0
(i+ii+iii)/3
Sub-total of Monthly Variable Charges & Price Variation B (3+4) 0
No. of events
Rate (₹)
C Particulars Date Location (6) Amounts in ₹ (a*b)
(a)
(b)
5 Toll Charges - 0

6 Outstation Night Halt Charges 250 0

Sub-total of Toll Charges & Night halt charges C (5+6) 0

D Particulars Amounts in ₹

7 Penalty [As per annexed working sheet] 0

Sub-total of Penalty D 0

Total Payable Amount

Sub-total of
Sub-total of Toll
Sub-total of Monthly Monthly Variable Sub-total of
Charges & Night Sub-total GST on E Total
Fixed Charges Charges & Price Penalty
halt charges
Variation
A B C D E=A+B+C-D F G=E+F

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Declaration:
The invoice being claimed for the vehicle no. …............................... is not claimed any where else and it is not running anywhere else than the
1
one mentioned in the order referred above and being claimed in the present invoice.
The vehicle is complying all the terms & conditions as stipulated in the order and also fulfilling all statutory compliances as per the order,
2
including that of driver.

Seal and Sign of the Contractor

 Working of Penalty

1. For Failure to provide a vehicle & driver on any day & to perform satisfactory duties-
No of days vehicle not
Penalty = (Monthly fixed + Driver No. of days in the month
2X provided Amount
Charges) for which billing is done A=2XBXC/D
I A B C D

A 2X 0 30 0

No of days driver absent/ Monthly Driver Charges No. of days in the month
Penalty = 2X Amount
Unsatisfactory Duties for which billing is done
A=2XBXC/D
II A B C D

A 2X 30 0

Sub Total
I+II = 0
(1)

2. Failure to maintain copies of valid documents, spare wheel and associated tools kit in the vehicles

Monthly Fix No. of days in ½ of daily fixed No. of default event in Penalty
Per Day Fix Charge C=A/B
Charge (A) the month (B) D=C/2 the month (E) DxE

0 30 0 0 0

3. Failure to upkeep the vehicle in neat and clean condition: Late reporting/ Change of vehicle/ Driver without
permission

Monthly Fix No. of days in ½ of daily fixed No. of default event in Penalty
Per Day Fix Charge C=A/B
Charge (A) the month (B) D=C/2 the month (E) DxE

0 30 0 0 0

4. No cell phone with driver

No. of Events (A) Rate of Penalty (B) Penalty (AxB)
250.00
0

Total
1+2+3+4 = 0
Penalty D

Seal and Sign of the Contractor