Factura/Invoice Serie/Series: MIKA Numar/Invoice No.

: 118095
Data (Z, L, A)/Date (D, M, Y) 09-12-2021
Furnizor/Supplier: MIKA PRO SOLUTION SRL Cumparator(denumire, forma juridica)/Buyer (name,
Nr. ord.registru com./an/Registration No.: J40/11782/2020 legal form)
C.I.F./UIC (Unique Identification Code): RO43060286 Mihaela Ungureanu
Cod TVA/VAT No: RO43060286 CNP/Personal identification number: -
Capital social subscris si varsat/Subscribed and paid Tara/Country: RO
capital: 200 Adresa/Address: Str. Frasinului Nr. 25, Ploiesti, Prahova
Cont/Account: RO92BTRLRONCRT0569232801 Cont/Account:
Banca/Bank: BANCA TRANSILVANIA S.A. Banca/Bank:
Tara/Country: Romania
Sediul/Headquarter: str. sold Ionita Zambila, nr.4, bl. 7D

Nr.crt Produse/Descriere servicii UM Cantitate Valoare per Rata TVA Valoare Valoare TVA
No. Products/Services Description Quantity unitate (fara -%- Value VAT Value
TVA) VAT Rate
Unit Value -%-
(without VAT)
0 1 2 3 4 5 6(3x4) 7
1 Briceag Butterfly Skull pentru buc 1 25,00 19 25,00 4,75
antrenament, fara tais, 22 cm, negru pcs
[CTM-18]

2 Valoare taxa livrare buc 1 15,97 19 15,97 3,03

pcs

Semnatura si Date privind expeditia / Delivery data Total din 19% 40,97 RON 7,78 RON
stampila Numele delegatului / Delegate name care accize:
furnizorului / Total of Total 40,97 RON 7,78 RON
Supplier ............................................................................. which
signature and B.I./C.I. seria / ID series ..... nr. / no ................... excises:
stamp eliberat(a) / issued .............................................. Semnatura
Mijlocul de transport / Delivery method ............... de primire
nr / no .................................................................. Receival
signature
Expedierea s-a efectuat in prezenta noastra la
data de / The delivery was made in our presence Total de plata
on ............................ ora / hour ........................... (col 6 + col 7)
Semnaturile / Signatures ..................................... Total
(col 6 + col 7) 48,75 RON

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