File No:

Date: //

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Subject:

Ref:

 

FMR Code :

ITEM DETAILS & PRICE:

Item Name	Quantity	Rate(Exclussive of GST)	GST(%)	Total Amount(Incl. GST)	Delivery Destinations
Form 1 for MH ( )	4350	59.370	18	304,746.21	As per annexure A
CONSENT FORM ( )	4350	74.060	18	380,149.98	As per annexure A
Grand Total				684,896.19

Annexure A:

Sl	Item Name	Specification	Rate(Exclussive of GST)	GST(%)	Total quantity to be supplied	Total Amount	Delivery Destinations
1	Form 1 for MH		59.370	18	4350	304746.21
2	CONSENT FORM		74.060	18	4350	380149.98

Memo No:

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