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1 Reimbursement Invoice Details

RI Number & Logistics Reference

Document Type

RI Number *

RI Date *

Due Date

Job / BL Reference No

Payment Terms

Place of Supply

2 Claimed By (Pure Agent)

Select Profile

Company / Business Name

Address

GSTIN

PAN

3 Reimbursement To (Principal / Client)

Select Client

Client / Buyer Name

Billing Address

GSTIN / Tax ID

PAN Number

Logistics & Freight Shipment Details Agilis / Shipping

Shipper

Consignee

Shipper Address

Consignee Address

Port of Origin / Loading

Port of Discharge

Final Destination

Vessel / Flight

Voyage Number

Shipper Ref. No

ETD

ETA

Master BL No

House BL No

Job Number

Job Date

Container Numbers

Container Type

Packages

Weight (Kgs)

Volume (CBM)

IGM Number

Item Number

Sub Item Number

Exchange Rate (ROE)

4 Reimbursable Expenses & Out-of-Pocket Items

Currency:

#	Reimbursable Expense Description	Amount ($)
1		$
2		$
3		$

5 Summary & Total Claim

Total Actual Expenses: ₹ 93,500.00

Total Reimbursement Payable (INR): ₹ 93,500.00

In Words: Ninety Three Thousand Five Hundred Rupees Only

6 Bank Remittance & Settlement Account

Bank Name

A/C Number

IFSC Code

UPI ID

Note (Shown in Header under Note)

Pure Agent Declaration & Terms

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Reimbursement Invoice Live Preview Template: logistics-agilis

AGILIS LOGISTICS INDIA LLP

Office No. 308, 3rd Floor, Solitaire Corporate Park, S G Highway, Makarba, Ahmedabad, Gujarat - 380051

PAN NO: AAQFA1234K GST NO: 24AAQFA1234K1Z8 TEL: +91 79 4000 1234 EMAIL: info@agilislogistics.in

REIMBURSEMENT INVOICE

Original for Recipient

Agent

: AL KAUTHAR AL MOMTAZ GENERAL TRADING LLC

P.O. Box 89456, Deira, Gold Souq Area, Dubai, Dubai

TEL: +971 4 2345678

GST: N/A (UAE VAT: 100234567800003)

Shipper

: AGILIS LOGISTICS INDIA LLP

Consignee

: AL KAUTHAR AL MOMTAZ GENERAL TRADING LLC

P.O. Box 89456, Deira, Gold Souq Area, Dubai, Dubai

Port of Origin

: - ETD : -

Final Destination

: - ETA : -

Vessel

: -

Voyage Number

: -

IRN

Invoice No

: RI-0003

Date

: 26-Sep-2026

Payment Due Date

: 11-Oct-2026

Job Number

: -

Job Date

: -

Master Number

: -

House Number

: -

Number of Packs

: -

Weight (Kgs)

: -

Volume (CBM)

: -

Note

: dgddggfgdfgdfgdgf

#	Reimbursable Expense Description	Amount ($)
1	Bill of Lading (BL) Documentation Fee	3,500.00
2	Cloud Infrastructure & DevOps Support	45,000.00
3	Cloud Infrastructure & DevOps Support	45,000.00

Claim Total in Words (USD): Ninety Three Thousand Five Hundred Rupees Only

Bank Account Details for Remittance:

A/C Name: AGILIS LOGISTICS INDIA LLP

Bank Name: HDFC BANK

A/C No: 50200012345678

IFSC Code: HDFC0000006

SWIFT Code: HDFCINBBXXX

UPI ID: agilislogistics@hdfcbank

Branch: Ashram Road Branch, Ahmedabad

Total Actual Expenses: $ 93,500.00

TOTAL (USD): $ 93,500.00

Terms & Conditions:

1. Cheque/DD should be drawn in favor of 'AGILIS LOGISTICS INDIA LLP'. 2. Any discrepancy must be notified to us in writing within 7 days from invoice date. 3. Payment must be received within the agreed credit period; otherwise interest @ 18% p.a. will be charged. 4. All claims are subject to Ahmedabad Jurisdiction. 5. All port charges, storage, and detention are to consignee's account.

* THIS IS A COMPUTER GENERATED DOCUMENT AND DOES NOT REQUIRE A PHYSICAL SIGNATURE

For AGILIS LOGISTICS INDIA LLP

Authorized Signatory

Authorized Signature

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