ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-31 Invoice No. : 34/BI/20000342 Date : 18/12/2020 19:10:19 Bajaj Allianz General Insurance Co. Ltd, 4th Floor,North East Plaza, Erramanzil Circle, Beside BMW Job Card No.: JC20003878 Job Card Date: 12/12/2020 Showroom, Reg.No. : TS36B5544 Mileage: 55094 HYDERABAD SA Name : BATTI HARISH KUMAR SA(M) : 9581406633 Pin:500082 State & Code :36-TELANGANA Model : MARUTI VITARA BREZZA V EW Type : III Mobile Chassis No.: 305189 Last Service : 54441 (30-11-20) Loyalty Card : 33031517536 Fuel Trim : Next Service Due : PMS 50 Service type: BODY REPAIR Cust GSTIN/UIN : 36AABCB5730G1ZY Place of Supply: TELANGANA Ins.Comp. : BAJAJ 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 09409M07L01 CLIP AB 8708 28% 10.000 3.12 31.20 0.00 2 43130M66L10 VALVE, TIRE (TR414) AB 8481 18% 2.000 22.88 45.76 0.00 3 43210M65M01-09L WHEEL COMP(16X6J) AC 8708 28% 2.000 1210.93 2421.86 0.00 4 43250M82P00-27N WHL CVR SLVR BREZZA AC 3919 28% 1.000 421.87 421.87 0.00 5 72321M82P00 LINING,FRONT FENDER,R AD 8708 28% 1.000 699.21 699.21 0.00 6 72411M64M00 COVER,ENGINE UNDER AC 8708 28% 1.000 718.75 718.75 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZA04L0 WHEEL BALANCING - 4 WHEEL 998729 340.00 2 ZA14L0 TYRE REPLACEMENT 998729 525.00 3 ZA11LO WHEEL ALIGNMENT 998729 440.00 4 AB30R0 ENGINE UNDER COVER (ALL) 998729 91.00 5 NC06R0 FRONT FENDER LINING (ONE SIDE) 998729 182.00 Sub Total Amount 4,338.65 0.00 1,578.00 Bajaj Allianz Insurance (surveyor: CGST @ 14% : 601.01 RAGHAVENDRA)OC-21-1801-1801- SGST @ 14% 601.01 00009028 - Liability rs.10,370/-(customer paid CGST @ 9% 4.12 142.02 full bill amount)liability AMOUNT CREDITED IN C SGST @ 9% 4.12 142.02 For ADARSHA AUTOMOTIVES PVT LTD Tax Collection at Source @ 0.075% : 4.15 Authorised Signatory Sub Total Amount : 5,553.06 0.00 1,862.04 Dealer GSTIN : 36AAFCA6098L1Z5 Net Bill Amount (Rounded) : 7,415.00 Rupees Seven Thousand Four Hundred And Fifteen 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. : GP20003974 Date :18-DEC-20 19:11:22 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : VITARA BREZZA 1.3D JC20003878 BI/20000342 18-DEC-20 7,415.00 Tech. Name :PRASHANTH K Reg.No.: TS36B5544 Customer Signature Accountant Signature JC20003878 ---PAGE END---