DATE : 04-Feb-2019

DEALER DETAILS
ZONE

DEALER NAME

APPLICATION DETAILS

SEGMENT

CATEGORY OF ENQUIRY
TYPE OF ENQUIRY(REPLACEMENT/
REPOWERING/ PROJECT/DOEM)
BASIC APPLICATION

DESCRIPTION OF APPLICATION

ENGINE DETAILS

ENGINE MODEL

BHP @ RPM

KVA Rating (if Genset Application)

QTY

ENGINE SERIAL NUMBER

ENGINE SO NUMBER

RUNNING HOURS OF ENGINE

PRESENT DETAILS OF THE ENGINES

CUSTOMER DETAILS

CUSTOMER NAME

CUSTOMER CONTACT DETAIL

OTHER DETAILS

EXPECTED DATE OF FINALIZATION

REASON FOR THE SHIFT

 DEALER DETAILS

PPLICATION DETAILS

ENGINE 6BT

NEW PURCHASE

FOR MOTOR GRADER KOMATSU GD 511A

HP-140 AND RPM 2000

ENGINE DETAILS

6BT
2000

CUSTOMER DETAILS

GAUTAM PUSHTI

8588808882

OTHER DETAILS
 ENGINE ORDER INFORMATION FORM
1 Customer Order No. & Date

2 Bill to ( Indenter ) Address

3 Ship to ( Consignee) Address

4 Engine Model / Application

5 Quantity
6 Shop Order No.
Cooling Type (G Drive engines / Special
7
requirement)
8 Inspection Required? (Yes / No).
9 Price per Unit Ex-works Pune
10 Tranfer price
11 DBU Commission from Plant
12 Dealer Commission to be provided
13 Name of Dealer
14 GST Rate
15 GSTIN No.
16 Name of Transporter
17 Freight Terms (To Pay / Paid)
18 Insurance By (Customer / DBU)
19 Road Permit available / required.
20 Delivery Required by
L/D Clause applicable (Yes / No)
21
If yes, effective date.
22 Payment Terms

23 Commercial Documents to be sent to : (Which

DBU Area/Zonal Office)
24 Warranty Applicable
25 ZONE
26 Repower/Replacement /DOEM / NA
27 Bank Guarantee involved (Yes / No)
28 Source (IEBU / PGBU / TCL/ NA)
29 Excise Duty
30 Customer Class
31 Document to be sent to :
· DBU Commercial Invoice · Engine Test Record
· Original for Recepient copy of Invoice · Inspection Report / Inspection Note.
· G.C. Note · Sales Tax Certificate
· Engine Test Certificate · VAT Certificate
· Warranty Certificate · Bank Guarantee
· NSO-25 Form
· Copy of Purchase Order
· Octroi Exemption Certificate

Name of Manager : J K Sahu Signature Date : 10-10-2017

File No.