Damage Assessment Center in Medina DA Center - ‫ر ز ا د ر‬

MEDINA Center City - ‫د ا ر ز‬

18/07/2023 02:31:18 PM Print Date - ‫ر اط‬
10/07/2023 10:01:38 AM DA Date – ‫ر ا د ر‬
‫ـ ـر ـر ـ ــد ــر ا ــرار ا‬
10/07/2023 10:26:19 AM DA Completed Date – ‫ر إ لا‬
DA1007231172 DA Report No - ‫ر م ا ر ر‬
Final Damage
MD090723165 Accident No - ‫ر م ا دث‬
Assessment Report
Najm Accident Attended by - ‫رة ا دث ن طر‬
Sub Case Type - ‫دث‬ ‫رة‬ ‫ا‬ ‫ا‬
1/2 Pages - ‫ر م‬

‫دا رف‬ Vehicle Owner Name / ‫كا ر‬ ‫ا م‬

‫ا ك‬
1040458943 ID / ‫ر م ا و‬ Owner

Vehicle Details
0538122025 Mobile No / ‫ر م ا وال‬

‫و تا ر‬
TOYOTA Vehicle Manufacturer / ‫ا ر‬
‫رى‬ Model / ‫ا ود ل‬
‫تا ر‬
Gray 2022 Color & Year / ‫ا ون وا‬
Vehicle Info
N A R 7303 Plate No / ‫رما و‬
JTNB14HK5N3156829 Chasis No / ‫ل‬ ‫رما‬
Rawidan Murshid Al Harbi Center for Car Estimated By / ‫ا د ر‬ ‫ا‬
Maintenance
‫أ ور ا دي ا‬
1600.00 (A) Estimation Cost / ‫ا د ر‬ ‫ا‬ Labor Estimation

Assessment Details
240.00 VAT (15%) / ‫ا‬ ‫ا‬ ‫ر‬

‫و تا در‬
1859.25 (B) Spare Parts Cost /‫ر‬ ‫ط ا‬
‫ط ا ر‬
Spare Parts
278.89 VAT (15 %) / ‫ا‬ ‫ا‬ ‫ر‬

3459.25 (A+B) Total Cost / ‫ا‬ ‫ا‬

‫ا‬ ‫أ‬
(A+B+VAT) Total Cost including VAT / ‫ا‬ Final Estimation
3978.14
‫ا‬ ‫ر ا‬ ‫ا‬
‫ظت‬
Comments

‫ا د وا ط‬ ‫طر ا د‬ (%) ‫ا ؤو‬

Payment By Payment Method Liability(%)
Tawuniya Cooperative Insurance Company By Insurance Company 100
Damage Assessment Center in Medina DA Center - ‫ر ز ا د ر‬
MEDINA Center City - ‫د ا ر ز‬
18/07/2023 02:31:18 PM Print Date - ‫ر اط‬
10/07/2023 10:01:38 AM DA Date – ‫ر ا د ر‬
‫ـ ـر ـر ـ ــد ــر ا ــرار ا‬
10/07/2023 10:26:19 AM DA Completed Date – ‫ر إ لا‬
DA1007231172 DA Report No - ‫ر م ا ر ر‬
Final Damage
MD090723165 Accident No - ‫ر م ا دث‬
Assessment Report
Najm Accident Attended by - ‫رة ا دث ن طر‬
Sub Case Type - ‫دث‬ ‫رة‬ ‫ا‬ ‫ا‬
2/2 Pages - ‫ر م‬

‫ا‬ ‫ر‬ ‫ا‬ ‫ا‬ ‫ر د‬ ‫ط ا‬ ‫ا‬ ‫ا‬

‫م‬ ‫ا‬
‫ا‬ ‫ا‬ ‫ا‬ ‫ر‬ ‫ما‬ ‫ا‬ ‫ا‬ ‫ا‬ ‫ورد ط ا ر‬
‫ا‬
Sparepart Final value (15%) Parts Final Value After Total cost Spare part dealer
Overall Discount
with VAT (15%) Overall Discount %
2138.14 278.89 1859.25 0% 2479.00 Areej Al Wadi Trading Est

‫ك‬ ‫م وا‬ ‫دا‬ ‫ا‬

‫ك‬ ‫ا‬ ‫م‬ ‫ا‬ ‫ا‬ ‫ر ا و دة‬ ‫ا دد‬ ‫ط ا ر‬
Total After Discount
Consumption% Discount % Total Unit price Quantity Spare part
& Consumption

‫ر‬ ‫ر رف ا‬
514.50 0% 25% 686.00 686.00 1
5380233200
‫ر‬ ‫دام ا‬ ‫ظ‬
78.75 0% 25% 105.00 105.00 1
5253633060
‫دام ا‬
696.00 0% 25% 928.00 928.00 1
521193T963
‫ر‬ ‫د ور ف ا‬
337.50 0% 25% 450.00 450.00 1
8148233140
‫ر‬ ‫ط ر رف ا‬
232.50 0% 25% 310.00 310.00 1
5380633090