ce No.             INS107262000059                                                               Invoice Type       Credit
     oice Date            22-12-2020                                                                        Payment Type
  illed To                BAJAJ ALLIANZ G.I.C.LTD.HAZRATGANJ LUCKNOW                  Reference No
 Customer Name       : RAVINDRA PANDEY                                                             Jobcard No.         RJC10726202006293
Insurance GSTIN No: 09AABCB5730G1ZV                                                             Jobcard Date       22-12-2020
Mobi e No.                                                                                                         Whether Tax       No
                                                                                                                        Payable on
 Delivery Address :    1/13/204/2,Civil Lines,Station Road,FAIZABAD (UP),PinNO     reverse Charges
                                 224001d10726@baldealer.comUttar Pradesh [State Code :09]
                                                                                                                        Repair Type         Accidental Repair
                                 Mobile-9235517300,05278-222462
Insurance Address    LUCKNOW                                                                         KM Reading         18367
                                                                                                                        Registration No.U2AY3917
                                       Wazirganj,226001
                                      ,Email                                                                        Chassis No.          MD2A11CY7KRM05533
                                                                                                                        Engine No.           :DHYRKM79951
                                                                                                                        Model Name        Pulsar 150 DTS-i
                                                                                                                        Policy No.


                              DK181082-TUBE
                              ASSEMBLY HANDLEBAR                                                                                 25.8          25.8
    8    INS Part                                           184.38               100:0:0       0           184.38    14            14                                236.00
                              LH /87149990/                                                                                              1               1
                              87149990
                              DJ151041-AXLE/                                                                                       10.0          10.0
    9    INS Part                                            71.88      1     100:0:0       0            71.88    14             14                                  92.00
                              87141090 /87141090                                                                                       6               6
                              52DJ0723-FUEL TANK
                              BSIV ebony black WITH    4646.8                                                                   650.           650.
   10   INS Part                                                                    100:0:0       0          4646.88    14             14                             5,948.00
                              3DDECAL /87141090 /           8                                                                     56             56
                              87141090
                              52DH1324-TANK FLAP
                              RH WH EB BLCK DECL                                                                                  43.9          43.9
   11   INS Part                                           314.06              100:0:0       0           314.06    14            14                                402.00
                              P150UG+BS4/                                                                                               7               7
                              87149990 / 87149990
                              DH191066-ASSEMBLY
                                                                 2471.1                                                                   222.          222.
   12   INS Part        SPEEDOMETER K1UG/                                               0         2471.19      9               9                              2,916.01
                                                                        9                                                                     41             41
                              90292090 /90292090
                              DK181086-TUBE
                              ASSEMBLY HANDLEBAR                                                                                 25.8         25.8
   13   INS Part                                           184.38       1    100:0:0       0           184.38    14             14                                236.00
                              RH /87149990/                                                                                             1               1
                              87149990
                                                                                                     TOTAL       11,261.60          1,38         1,38         0.a014,026.02
                                                                                                                                              2.21          2.21
                                                                                                                Round Off
                                                                                                                                                                                        14,984.76
                                                                                                                Total Amount

AMOUHT IN WORDS  RS FOURTEEN THOUSAND NINE HUNDRED EIGHTY FOUR AND PAISE SEVENTY SIX ONLY.
Tax amrount payable on reverse charges (in Rs.) : NIL
Custorer Advice :

 Terms And Conditions :










                                                          Get your vehicle serviced at regular intervels.
                                                        Next due date for service is        22-03-2021                    SAKET BAJAJ(10726)
   Sign cf Customer Or His Agent                                   Thank You & Happy Riding                             Authorised Signatory

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