ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-16 Invoice No. : 1/BI/20000383 Date : 21/11/2020 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20002642 Job Card Date : 24/10/2020 NEW DELHI Reg.No. : HR26DU0535 Mileage :330992 Pin:110015 SA Name : SANDEEP KUMAR State & Code : )07-DELHI Model : MARUTI DZIRE VXI EW Contract No. : 188559210 Mobile Chassis No.: 436746 Loyalty Card : 33050474817 Fuel Trim : Service type : BODY REPAIR Ins.Comp. BAJAJ Place of Supply : DELHI Cust GSTIN/UIN : 07AABCB5730G1ZZ Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 1 01550M0616A BOLT AB 7318 18% 20.000 2.54 50.80 2 01550M0825A BOLT AB 7318 18% 5.000 4.23 21.15 3 03141M05203 SCREW FR.FENDER LINING AA 7318 28% 15.000 1.95 29.25 4 08316M1008A NUT AA 7318 18% 8.000 1.69 13.52 5 09409M06322 CLIP(RADIATOR UPPER/RR MUD AA 8708 28% 8.000 1.56 12.48 FLAP) 6 09409M07L01 CLIP AB 8708 28% 30.000 3.12 93.60 7 13780M68P01 ELEMENT, AIR CLEANER AB 8421 18% 1.000 245.76 245.76 8 17100M68P00 FAN ASSY, ENG CLG AB 8501 28% 1.000 2929.68 2929.68 9 17700M68P00 RADIATOR ASSY AB 8708 28% 1.000 2031.25 2031.25 10 17854M68P00 HOSE, RDTR OUTLET AB 4009 18% 1.000 118.64 118.64 11 17861M52R00 BRACKET, RDTR SUPPORT UPPER R AA 8708 28% 1.000 39.84 39.84 12 17861M52R10 BRACKET, RDTR SUPPORT UPPER L AA 8708 28% 1.000 36.71 36.71 13 18213M68P10 SENSOR, OXYGEN RR AB 9031 18% 1.000 1633.05 1633.05 14 35100M55R10 HEADLAMP ASSY,RH AB 8512 18% 1.000 2245.76 2245.76 15 35300M55R10 HEADLAMP ASSY,LH AB 8512 18% 1.000 2245.76 2245.76 16 35500M75J11 FRONT FOG LAMP,YN4 AC 8512 18% 1.000 940.67 940.67 17 38450M56R30 TANK ASSY AD 8708 28% 1.000 160.15 160.15 18 38453M75000 GROMMET AB 4016 28% 1.000 2.34 2.34 19 38480M55R00 NOZZLE COMP,WASHER AB 8708 28% 1.000 29.68 29.68 20 42431M55R00 MOUNT, STABILIZER BAR AC 4016 18% 2.000 48.30 96.60 21 43210M55R00-09L WHEEL COMP(14X5J) AD 8708 28% 1.000 710.93 710.93 22 45201M55R00 ARM ASSY, FRONT SUSPENSION, R AB 8708 28% 1.000 1054.68 1054.68 23 45202M55R00 ARM ASSY, FRONT SUSPENSION, L AB 8708 28% 1.000 1054.68 1054.68 24 45810M68P00 FRAME,FRONT SUSPENSION AB 8708 28% 1.000 4453.12 4453.12 Contd.. 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 (Customer Signature) Mobile No.: to inform me with any other information in relation to my vehicle. Gate Pass GP No. : GP20002886 Date : 21-NOV-20 17:35:35 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance C Model : New Dzire Petrol JC20002642 BI/20000383 21-NOV-20 1,13,623.00 Tech. Name :SHOKEEN KHAN Reg No.: HR26DU0535 JC20002642 BC/20003018 21-NOV-20 0.00 Customer Signature Accountant Signature ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-16 Invoice No. : 1/BI/20000383 Date : 21/11/2020 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20002642 Job Card Date : 24/10/2020 NEW DELHI Reg.No. : HR26DU0535 Mileage : 30992 Pin:110015 SA Name : SANDEEP KUMAR State & Code : 07-DELHI Model : MARUTI DZIRE VXI EW Contract No. : 188559210 Mobile Chassis No.: 436746 Loyalty Card : 33050474817 Fuel Trim : Service type : BODY REPAIR Ins.Comp. BAJAJ Place of Supply : DELHI Cust GSTIN/UIN : 07AABCB5730G1ZZ Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 25 57300M55R10 PANEL COMP,FRONT HOOD AB 8708 28% 1.000 1847.65 1847.65 26 57611M56R10 PANEL,FRONT FENDER,R (ED AC 8708 28% 1.000 914.06 914.06 COATED) 27 57711M56R10 PANEL,FRONT FENDER,L (ED AC 8708 28% 1.000 914.06 914.06 COATED) 28 58618M68P00 ..BRACE, RADIATOR SUPPORT AA 8708 28% 1.000 30.46 30.46 29 58630M68P20 MEMBER,APRON SIDE OUTER RH AA 8708 28% 1.000 107.81 107.81 30 58718M68P00 ..BRACE, RDTR SUPPORT INNER LH AA 8708 28% 1.000 30.46 30.46 31 58730M68P20 MEMBER,APRON SIDE OUTER LH AA 8708 28% 1.000 107.81 107.81 32 63510M56R10 PANEL COMP, FR PILLAR INNER, L AA 8708 28% 1.000 1000.00 1000.00 33 65111M56R00 PANEL, ROOF AB 8708 28% 1.000 2820.31 2820.31 34 65120M56R10 RAIL COMP, ROOF FRONT INNER AA 8708 28% 1.000 222.65 222.65 35 68001M56R00 PANEL ASSY, FRONT DOOR, R AC 8708 28% 1.000 3664.06 3664.06 36 68002M56R00 PANEL ASSY, FRONT DOOR, L AC 8708 28% 1.000 3664.06 3664.06 37 71711M56R00-5PK BUMPER,FRONT (BLACK) AC 8708 28% 1.000 1398.43 1398.43 38 71721M56R00-5PK GRILLE, RADIATOR LOWER AD 8708 28% 1.000 183.59 183.59 39 71731M55R00 HOLDER, FR BUMPER SIDE, R AB 8708 28% 1.000 46.09 46.09 40 71732M55R00 HOLDER, FR BUMPER SIDE, L AB 8708 28% 1.000 46.09 46.09 41 71740M56R00-C48 GRILLE COMP, RADIATOR UPPER AD 8708 28% 1.000 652.34 652.34 42 71751M56R10-5PK BEZEL, FRONT FOG LAMP, R AD 8708 28% 1.000 117.18 117.18 43 71771M56R10-0PG GARNISH, RADIATOR UPPER GRILLE AC 8708 28% 1.000 1941.40 1941.40 44 71781M56R10-0PG GARNISH, FR BUMPER LOWER, R AC 8708 28% 1.000 339.84 339.84 45 71821M56R00 HOLDER, RR BUMPER SIDE, R AB 8708 28% 1.000 69.53 69.53 46 71822M56R00 HOLDER, RR BUMPER SIDE, L AB 8708 28% 1.000 69.53 69.53 47 72312M55R00 HOLDER, FRONT HOOD STAY AA 8708 28% 1.000 3.90 3.90 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-16 Invoice No. : 1/BI/20000383 Date : 21/11/2020 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20002642 Job Card Date : 24/10/2020 NEW DELHI Reg.No. : HR26DU0535 Mileage : 30992 Pin:110015 SA Name : SANDEEP KUMAR State & Code : 07-DELHI Model : MARUTI DZIRE VXI EW Contract No. : 188559210 Mobile Chassis No.: 436746 Loyalty Card : 33050474817 Fuel Trim : Service type : BODY REPAIR Ins.Comp. BAJAJ Place of Supply : DELHI Cust GSTIN/UIN : 07AABCB5730G1ZZ Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 48 72390M68P00 CROSSMEMBER,FRONT LOWER AA 8708 28% 1.000 937.50 937.50 49 72460M55R00 ABSORBER COMP, FR BUMPER AD 8708 28% 1.000 468.75 468.75 LOWER 50 72470M55R00 LINING COMP, FRONT FENDER, R AB 8708 28% 1.000 396.87 396.87 51 72480M55R00 LINING COMP, FRONT FENDER, L AB 8708 28% 1.000 392.18 392.18 52 76291M56R00 TRIM, FRONT DOOR OPENING AC 8708 28% 1.000 394.53 394.53 53 83661M56R00 RUN, FRONT DOOR GLASS, R AC 8708 28% 1.000 492.18 492.18 54 83665M56R00 RUN, FRONT DOOR GLASS, L AC 8708 28% 1.000 492.18 492.18 55 83811M56R00 WEATHERSTRIP, FRONT DOOR OUT, AC 8708 28% 1.000 421.87 421.87 R 56 83821M56R00 WEATHERSTRIP, FRONT DOOR OUT, AC 8708 28% 1.000 421.87 421.87 L 57 83831M56R00 WEATHERSTRIP, REAR DOOR OUT, AC 8708 28% 1.000 164.06 164.06 R 58 83841M56R00 WEATHERSTRIP, REAR DOOR OUT, L AC 8708 28% 1.000 164.06 164.06 59 83923M56R00-0CB TAPE, FRONT DOOR OUTER RR, R AD 3919 18% 1.000 182.20 182.20 60 83924M56R00-0CB TAPE,FRONT DOOR OUTER RR,L AD 3919 18% 1.000 182.20 182.20 61 84511M56R00 GLASS WINDSHIELD AC 7007 18% 1.000 3211.86 3211.86 62 84611M56R00 MOLDING, WINDSHIELD AB 8708 28% 1.000 285.15 285.15 63 84701M56R40-5PK MIRROR ASSY, OUT REAR VIEW, R AC 7009 18% 1.000 2605.93 2605.93 64 84702M56R40-5PK MIRROR ASSY, OUT REAR VIEW, L AC 7009 18% 1.000 2605.93 2605.93 65 95310M55R00 CONDENSER ASSY AC 8415 28% 1.000 3222.65 3222.65 66 95731M55R30 PIPE, LIQUID AC 8415 28% 1.000 1453.12 1453.12 67 99000M24120-460 DG SEALANT SET WITHOUT PRIMER AB 3506 18% 2.000 572.88 1145.76 68 99000M24120-639 COOLANT (GOLDEN YELLOW) AB 3820 18% 1.500 228.81 343.22 69 99000M24121-078 AIR DRYING SEALANT AB 3214 18% 1.000 661.01 661.01 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID: 02-16 Invoice No. : 1/BI/20000383 Date : 21/11/2020 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20002642 Job Card Date : 24/10/2020 NEW DELHI Reg.No. : HR26DU0535 Mileage :30992 Pin:110015 SA Name : SANDEEP KUMAR State & Code : 07-DELHI Model : MARUTI DZIRE VXI EW Contract No. : 188559210 Mobile: Chassis No.: 436746 Loyalty Card : 33050474817 Fuel Trim : Service type : BODY REPAIR Ins.Comp. BAJAJ Place of Supply : DELHI Cust GSTIN/UIN : 07AABCB5730G1ZZ Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 70 99000M24121-136 PAPER FLO0R MAT (20X15) AB 4820 18% 2.000 0.84 1.68 71 990J0M999H4-050 AC CAN GAS (450GM) SRF AB 2903 18% 2.000 394.06 788.12 72 9999EM00W20-IOC ECSTAR PETROL 0W20 - IOCL AA 2710 18% 1.500 339.83 509.75 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF9993 PAINTING CHARGES 998729 30,250.00 Sub Total Amount 62,386.04 30,250.00 Mr Vinay Verma Bajaj cl no- IGST @ 28% 11,910.30 oc2111033187000002080 IGST @ 18% 3,572.91 5,445.00 Tax Collection at Source @ 0.075% 58.37 : For MAITRI SERVICE STATION Sub Total Amount 77,927.62 35,695.00 Net Bill Amount (Rounded) 1,13,623.00 Authorised Signatory Rupees One Lakh Thirteen Thousand Six Hundred And Twenty Three Only ---PAGE END---