ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice IRN : c2853560f4e9d812e9e1c0108f0fe5305edb6d3da84b943d09bd36ecf22a3268 Customer Name & Address : ID:02-16 Invoice No. : 21/BI/20001324 Date : 18/02/2021 18:57:10 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20012848 Job Card Date: 12/02/2021 NEW DELHI Reg.No. : DL3CCP3894 Mileage : 18231 Pin:110015 SA Name : BALJEET BHATIA SA(M) : 9540332271 State & Code : 07-DELHI Mobile Model : MARUTI DZIRE VXI EW Type : NA Loyalty Card : 33041453193 Fuel Trim : Chassis No.: 350657 Last Service : 16981 (17-12-20) Cust GSTIN/UIN : 07AABCB5730G1ZZ PAN : AABCB5730G Next Service Due : PMS 20 Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: DELHI Surveyor Name : Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 1 35750M56R00 LAMP, UNIT RR COMB LH AD 8512 18% 1.000 1915.25 1915.25 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF9992 DENTING CHARGES 998729 350.00 2 ZF9993 PAINTING CHARGES 998729 7,000.00 Sub Total Amount 1,915.25 0.00 7,350.00 BAJAJ , CLM NO OC-21-1101-1801- CGST @ 9% 172.37 661.50 00009732 , SUR RAJIV SINGLA ( IQBAL SGST @ 9% 172.37 661.50 Tax Collection at Source @ 0.075% 1.69 For ROHAN MOTORS LTD Sub Total Amount 2,261.68 0.00 8,673.00 Deductibles(As per policy T & C) 1,000.00 Authorised Signatory Net Bill Amount (Rounded) 9,935.00 Dealer GSTIN :07AAACR1307G1ZV Rupees Nine Thousand Nine Hundred And Thirty Five Only * I acknowledge that the jobs/repairs/service carried out in my vehicle and the respective cost estimates were explained to me. I have received my vehicle after completion of all repairs being carried out to my satisfaction and I confirm that my vehicle is in good condition. I further authorize this workshop to contact me by call or sms to Customer Signature Mobile No.: inform me with any other information in relation to my vehicle. Gate Pass GP No. : GP20012981 Date : 18-FEB-21 18:57:24 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : New Dzire Petrol JC20012848 BI/20001324 18-FEB-21 9,935.00 Tech. Name :IQBAL AHMED Reg.No.: DL3CCP3894 Customer Signature Accountant Signature JC20012848 ---PAGE END---