CROWN BIKES PVT.LTD.
                                                                                             SHOP NO. 12-19,FIRST FLOOR,14-19,,
                                                                                      SANKET HEIGTHS,OLD PADRA TO SUN PHARMA ROAD,
                                                                                                                O.P.ROAD,
                                                                                                                 VADODARA
                                                                                                                Pin:390015
                                                                                        Job Card Retail - Tax Invoice
Customer Name & Address :                ID: 02-23                                        Invoice No. : 1/BI/20000034
                                                                                                                                                                                       Date : 27/01/2021 11:42:51
Bajaj Allianz General Insurance Co. Ltd,
401, Atlantis Heritage,, Opp : Swagat Petrol Pump, Sarabhai Main                     1Job Card No.: JC20007901
                                                                                                                                                                           Job Card Date: 27/01/2021
Rd,
                                                                                                                      Reg.No. : UR1234                                  Mileage : 10350
VADODARA
                                                                                                                     SA Name : VISHNU J MALI                           SA(M) : 8511110099
Pin:390007
State & Code               24-GUJARAT                                                                    Model : ACCESS-DRUM - UZEHL7     EW Type : NA
Mobile                                                                                                       Chassis No.: MB8DP11AJJ8044848        Last Service : 10350 (22-04-19)
Loyalty Card                NA                                                                                                                                      Next Service Due : 2nd Paid Service
                                                                                                                  Service type: ACCIDENTAL REPAIR
Cust GSTIN/UIN :         24AABCB5730G1Z3                                                Place of Supply: GUJARAT
Ins.Comp. : BAJAJ
                                                                                                            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      47211-08K04-YBA        COVER, FRAME LH (BLUE)                       87141090             28%   1.000                799.21               799.21                0.00
2     48211-08K00-YBA        SHIELD, LEG FRONT, RH (BLUE)                87141090             28%   1.000                617.18              617.18                0.00
3     53110-02L00-YBA         FENDER, FRONT (BLUE)                         87141090             28%   1.000                825.00               825.00                0.00
4      68141-08K00-000         EMBLEM, FRAME COVER, LH                   87089900             28%   1.000                144.53              144.53                0.00
Labour
Demanded Repairs-Others/Suggested Jobs
 1      RC9999                     OTHER                                              998729                                                                                                                         650.00













                                                                                   Sub Total Amount                                                             2,385.92                   0.00                650.00
na
                                                                                   CGST @ 14%                                                                       334.03
                                                                                   SGST @ 14%                                                                       334.03
                                                                                   CGST @ 9%                                                                                                                               58.50
                                FOR CROWN BIKES PVTLTD.
                                                                                   SGST @ 9%                                                                                                                               58.50
                                                                 M
                                               S
                                                                  P
                                                                0                Sub Total Amount                                                              3,053.98                   0.00                767.00
                                     AUTHORIZEDSIGNATORY       Net Bill Amount (Rounded)                                                                                             3,821.00
 Dealer GSTIN : 24AAFCC3902M1ZR
                                                                                        Rupees Three Thousand Eight Hundred And Twenty One 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.         : GP20007973                                  Date : 27-JAN-21 11:43:27                          Job Card No.     Bill.No.            Bill Date                 Amount
Cust. Name : Bajaj Allianz General Insurance Co. L  Model : ACCESS-125(EH)                              JC20007901          BI/20000034      27-JAN-21                   3,821.00
Tech. Name :SATYNARAYAN RAMA                     Reg.No.: UR1234

  Customer Signature                                                                                                            Accountant Signature

                                                                                                                                                                                                       JC20007901

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