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1 11) Slovnaft Mestský úrad Rožňava '4. Dotiodna: č, ybul Č, daamu:...1--,5-,1 Y Pdloko. Spracovidet: ĺaĺ- Zoznam faktúr / Invoice summary Nie je daňový doklad / Not valid for VAT purposes Korešpondenčná adresa / Mailing address: eíslo zoznamu / List number: Šafariková Rožňava Vystavil / Issuer: VIčie hrdlo 1, Bratislava IČO / Registration no: IČ pre DPH / VAT registration no: SK Číslo zákazníka / Customer code: IČO / Registration no: IČ pre DPH / VAT registration no: Spásob platby / Terms of payment: Bankový prevod / Bank transfer Názov banky / Name of bank: VŠEOBECNÁ ÚVEROVÁ BANKA A.S. Číslo účtu / Bank account number: /0200 IBAN: SK SWIFT: SUBASKBX Dátum splatnosti / Payment due: Prosíme Vás pri úhrade súhrnnej čiastky faktúr uvádzat' do VS / Please use the code in the comment cell of the transfer as payment identification number. V prípade otázok nás kontaktujte prosím na čísle , 7549 / ln case of any question please call on the , Krajina Country Číslo faktúry Invoice number Miestna mena Local currency Suma fa v miestnej mene s DPH Total in local currency inc VAT Mena platby Currency to pay Suma fa s DPH v mene platby Total in currency to pay inc VAT Romania RON 135,25 EUR 30,51 Hungary HUF ,00 EUR 81,31 Slovakia EUR 68,19 EUR 68,19 Súhrnná čiastka / Total amount: EUR 180,01

2 Számla / Faktúra Számla számalčíslo faktúry : Osszesítč száma/císlo zoznamu: Számla kelte/dátum vystavenia: Telj. dátum/dátum dodania: Fizetési határidä/dátum splatnosti : Elszám.id.Nyúčtovacie obdobie: Szállító/Dodávateľ: MOL Nyrt Budapest, Október huszonharmadika u. 18 Adóig.szám/DIC: EU Adóig.szárn/IČ pre DPH: HU Nyomtatási hely/faktúru vystavil : Bratislava, VICie hrdlo 1 Adóig.szám/DIC: EU Adóig.szám/IC pre DPH: SK Vev6/Kupujúci: Rožňava, Šafariková 29 EU Adóig.szám/IC pre DPH: Csoportazon. szám/ic DPH skupiny: Vev6kérd/Cislo zákaznika : Vámtarifaszám Megnevezés ME Mennyiség Nettó egys.ár Nettó érték ÁFA% ÁFA érték Bruttó érték PpKN Produkt Mj Množstvo Jednotková Základ dane DPH% Hodnota DPH Suma celkom cena DIESEL n L 53,06 333, % Jävedéki adó/excise duty 110, EMATRICA D1 HETI DB 1, , % Adó mérték Adóalap Adó Számla érték Valuta Sadzba dane Základ dane Daň Fakturovaná suma Mena 27% HUF Osszesen/Total HUF Fizetendó čisszesen/čiastka faktúry: ,00 HUF * * Az dsszeg megfelel/hodnota sa rovná: 81,31 EUR Továbbértékesítés esetén a jčvedéki termék származásának igazolására nem alkalmas. / ln case of resale the invoice cannot be used for certifying origin of excise goods. A számla a MOL Nyrt-nél alkalmazott számlázási eljárás alapján aláírás nélkul is hiteles. / The invoice is valid without signature in accordance with the invoicing procedure applied at MOL Plc.

3 VTSZ: DIESEL n Kltsh: Kártya: Dátum Idó Kút Helye Bizonylat 1 I 1 MOL Nyrt. Kártyaforgalom - számla melléklet VevO: Számla: Számla kelte: Teljesítés dátuma: Me: L Rendszám: GARAGE4 Menetlevél / Mennyiség Krn-óra állás ÁFA: 27% Bruttó ňsszeg : BERETTYÓÚJFALU - 42.SZ. FKL. Ú , HUF Kártya , HUF Cikk: DIESEL n Bruttó Osszeg 22, HUF 17, HUF 4, HUF VTSZ: EMATRICA D1 HETI Me: DB ÁFA: 27% Kltsh: Kártya: Rendszám: GARAGE4 Dátum Idó Kút Helye Bizonylat Menetlevél / Mennyiség Bruttó čsszeg Km-óra állás : SAJÓSZENTPÉTER - KOSSUTH LAJOS , HUF Kártya , HUF Cikk: EMATRICA D1 HETI 1.00 Bruttó Osszeg 2, HUF 2, HUF HUF KOltséghely: Bruttó Osszeg 25, HUF 20, HUF 5, HUF Számla / Melléklet: Bruttó Ôsszeg 25, HUF 20, HUF 5, HUF

4 Faktúra / Invoice Číslo faktúry /Invoice number: Číslo zoznamu/list number: Číslo zákazníka /Customer code: Číslo zmluvy/contract no: Dátum vystavenia/date of issue: Dátum dodania/date of delivery: Dátum splatnosti /Payment due: null null Dodávateľ/Seller: VIčie hrdlo 1, Bratislava IČO/Registration no: IČ pre DPHNAT registration no: SK Zapisaný v Obchodnom registri Okresného Súdu Bratislava I, Odd.: Sa, Vložka č.: 426/B Registered in the Commercial Register of the District Count Bratislava I, Section: Sa, File No.: 426/B Kupujúci/Customer: Šafariková 29, Rožňava IČO/Registration no: Ič pre DPHNAT registration no: Faktúru vystavil /Billing Location: VIČie hrdlo 1, Bratislava Telefón/Phone contact : , 7549, FAX: Názov banky/bank: VŠEOBECNÁ ÚVEROVÁ BANKA A.S. Číslo bankového účtu/bank account: /0200 IBAN: SK SWIFT: SUBASKBX Produkt Mj Množstvo Jednotková cena Základ dane DPH% Hodnota DPH Suma celkom Product UM Quantity Net unit price Net value VAT% VAT value Gross value TEMPO PLUS DIESEL 50,43 1, ,82 20% 11,37 68,19 Sadzba dane Základ dane Daň Fakturovaná suma Mena VAT rate Taxable amount VAT amount Invoice value Currency 20% 56,82 11,37 68,19 EUR Total/Total 56,82 11,37 68,19 EUR Čiastka faktúry/total Amount: 68,19 EUR SLOVNA FT _ eme VIčit bvslio Bratlelr a IČO: ps. DPlk 11~111~ 13 /

5 Č.tovaru: TEMPO PLUS DIESEL Stredisko: Karta: Dátum Čas ČS Miesto Č.potvrd Manažment kariet - príloha faktúry 'Zákazník: Faktúra: Dátum vystavenia: Dátum splatnosti: Dátum dodania: MJ: L 20% EČV: GARAGE4 KiIometre Množstvo EUR suma bez DPH EUR suma s DPH : ROŽŇAVA - KOŠICKÁ CESTA Karta: Názov výrobku: TEMPO PLUS DIESEL Celková suma Nákladové strediská: Celková suma Faktúra/Príloha: Celková suma 68.19

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