KHANDELWAL AUTOCORP PRIVATE LIMITED 112,113,MANPASAND COLONY.. KALANI NAGAR AIRPORT ROAD, INDORE,MADHYA PRADESH, INDORE Pin:452001 Job Card Retail - Tax Invoice Customer Name & Address : ID : 02-04 Invoice No. : 5/BI/20000056 Date : 21/12/2020 17:58:29 Bajaj Allianz General Insurance Co. Ltd, 4th floor, Commerce House, 7 Race Course Road 1Job Card No.: JC20002091 Job Card Date: 21/12/2020 INDORE Reg.No. : MP09UL0770 Mileage: 23651 Pin:452001 23-MADHYA PRADESH SA Name : ABHISHEK JOSHI SA(M) : 9039578023 State & Code Mobile Model : ACCESS-DRUM - UZEHL7 EW Type : NA Loyalty Card NA Chassis No.: MB8DP11ACJ8780352 Last Service : 23650 (01-10-19) Cust GSTIN/UIN : Next Service Due : 10th Paid Service 23AABCB5730G1Z5 Service type: ACCIDENTAL REPAIR Ins.Comp. : BAJAJ Place of Supply: MADHYA PRADESH Surveyor Name : Srl. Part Number Description HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 1 01550-0616A-000 BOLT 73181500 18% 4.000 2.96 11.84 0.00 2 06111-06004-000 BALL,STEERING STEEL UPPER 87141090 28% 50.000 0.39 19.50 0.00 3 09159-06024-000 NUT,HANDLE BALANCER 73181600 18% 2.000 3.81 7.62 0.00 4 09409-06L07-000 CLIP 87141090 28% 6.000 5.07 30.42 0.00 5 35601-08K10-000 LAMP ASSY,FRONT TURNSIGNAL,R 85122010 18% 1.000 394.91 394.91 0.00 6 47211-08K04-YVB COVER, FRAME LH (BLACK) 87141090 28% 1.000 799.21 799.21 0.00 7 48111-08K01-YVB SHIELD, LEG FRONT (BLACK) 87141090 28% 1.000 1178.12 1178.12 0.00 8 48133-08K00-YVB SHIELD, LEG RR SIDE LH (BLACK) 87141090 28% 1.000 292.96 292.96 0.00 9 48221-08K00-YVB SHIELD, LEG FRONT, LH (BLACK) 87141090 28% 1.000 617.18 617.18 0.00 10 CAS CONSUMABLES 214532 5% 1.000 47.61 47.61 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZOS001 Fork, Bracket Under & Upper bend removal 998729 400.00 2 ZOS017 Accidental Repair 998729 600.00 Sub Total Amount 3,399.37 0.00 1,000.00 5992 CGST @ 14% 411.24 SGST @ 14% 411.24 CGST @ 9% 37.30 90.00 SGST @ 9% 37.30 90.00 For KHANDELWAL AUTOCORP PRIVATE LIM CGST @ 2.5% 1.19 SGST @ 2.5% 1.19 Authorised Signatory Dealer GSTIN : 23AACCK7237N1ZA Sub Total Amount 4,298.83 0.00 1,180.00 Net Bill Amount (Rounded) 5,479.00 Rupees Five Thousand Four Hundred And Seventy Nine 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. : GP20002134 Date : 21-DEC-20 17:58:47 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : ACCESS-125(EH) JC20002091 BI/20000056 21-DEC-20 5,479.00 Tech.Name :NAVED KHAN Reg.No.: MP09UL0770 Customer Signature Accountant Signature JC20002091 ---PAGE END---