ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID : 02-15 Invoice No. : 050/BI/20000049 Date : 05/06/2020 16:26:55 Bajaj Allianz General Insurance Co. Ltd, 402-408, 4th Floor., Turquoise Bldg... Near Panchvati Circle,CG Job Card No.: JC20000414 Job Card Date: 01/06/2020 Road Reg.No. : 114840 Mileage: 94844 AHMEDABAD SA Name : VISHWADEEPAK GIRISHCHANDRRSA(M) : 7574831295 Pin:380006 State & Code :24-GUJARAT Model : MARUTI CIAZ ZDI EW Type : NA Mobile Chassis No.: 114840 Last Service : 93844 (12-03-20) Loyalty Card : NA Fuel Trim : Next Service Due : PMS90 Service type: BODY REPAIR Cust GSTIN/UIN : 24AABCB5730G1Z3 Place of Supply: GUJARAT 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 35500M75J11 FRONT FOG LAMP,YN4 AB 8512 18% 1.000 923.72 923.72 0.00 2 71711M79M00-5PK BUMPER, FRONT (PRIMARY) AB 8708 28% 1.000 2187.50 2187.50 0.00 3 71712M79M00-5PK CAP,FRONT BUMPER AB 8708 28% 1.000 59.37 59.37 0.00 4 71751M79M10-5PK BEZEL,FRONT FOG LAMP,R AC 8708 28% 1.000 97.65 97.65 0.00 5 90900M10176 NC THINNER 38140010 18% 1.000 71.82 71.82 0.00 6 99000M24120-881 MASKING PAPER (L 200M* W90 CM) AB 4804 12% 0.020 1964.28 39.29 0.00 7 99000M24121-136 PAPER FLOOR MAT (20X15) AB 4820 18% 4.000 0.84 3.36 0.00 : 990J0M999H2-060 BODY G3 ADVANCE LIQUID NAX PRO AA 3405 18% 0.030 1461.01 43.83 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZZ07H HYGIENE CHARGE 998729 200.00 2 ZF28P0 REAR BUMPER PAINTING 998729 4,290.00 3 NA01RO FRONT BUMPER 998729 296.00 Sub Total Amount 3,426.54 0.00 4,786.00 bajaj ins co final and ri by mr vishal tanna policy IGST @ 28% 656.46 num-og-20-2218-1801-00002142 claim IGST @ 18% 187.69 861.48 num-oc-21-2203-1801-00000145 non IGST @ 12% 4.71 cashless For KATARIA AUTOMOBILES PVT. LTD. Sub Total Amount 4,275.40 0.00 5,647.48 Net Bill Amount (Rounded) 9,923.00 Authorised Signatory Dealer GSTIN :26AAACK6221C1Z3 Rupees Nine Thousand Nine Hundred And Twenty Three 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. ---PAGE END---