DHARMARAJ MOTORS PRIVATE LIMITED
                                                                                GROUND FLOOR,SHOP NO. 17/18/19,HARIKUNJ SOCIETY,
                                                                                            OPP. PANI TANKI,BESIDE CNG PUMP,
                                                                                            VARACHHA MAIN ROAD,SURAT,GUJARAT,
                                                                                                                SURAT
                                                                                                             Pin:395006
                                                                                      Job Card Retail - Tax Invoice
Customer Name & Address :                ID:02-15                                       Invoice No. : 1/BI/20000034
                                                                                                                                                                                  Date : 19/03/2021 15:42:27
Bajaj Allianz General Insurance Co. Ltd,
402-408, 4th Floor, Turquoise BIdg., Near Panchvati Circle,CG
                                                                                                            IJob Card No. : JC20001426                   Job Card Date: 05/03/2021
Road
                                                                                                                    Reg.No. : GJ05SC0371                           Mileage : 37635
AHMEDABAD
Pin:380006                                                                                                   SA Name : BHAVESH VASAVA                       SA(M) : 7069867000
State & Code               24-GUJARAT                                                                  Model : ACCESS-DRUM -UZEHL7     EW Type : NA
Mobile                                                                                                     Chassis No.: MB8DPIIACJ8761943        Last Service : 35476 (18-01-21)
Loyalty Card                NA                                                                         Service type: ACCIDENTAL REPAIR          Next Service Due : Paid Service (O/W)
Cust GSTIN/UIN :         24AABCB5730GIZ3                                                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
:      02112-0416A-000        SCREW                                           73181110             18%   4.000                  3.81                15.24               0.00
2     0354I-0516A-000        SCREW                                           84099110             28%   2.000                  4.68                9.36               0.00
3     09409-06L07-000        CLIP                                               87141090             28%   4.000                  5.07               20.28               0.00
4     35712-08K02-000        .LENS,OUTER                                    85122010             18%   1.000               329.66              329.66               0.00
5     63III-08K00-29I         FENDER, REAR UPPER(BLACK)                87089900             28%   1.000               342.96              342.96               0.00
6     68|4I-08K00-000         EMBLEM, FRAME COVER, LH                   87089900            28%    1.000               144.53              144.53               0.00
Labour
Demanded Repairs-Others/Suggested Jobs
 :      ZOS001                    Fork, Bracket Under & Upper bend removal   998729                                                                                                                       250.00
 2     ZOS009                    Painting Charges                                  998729                                                                                                                    1,250.00
 3     RH9999                    OTHER                                            998729                                                                                                                      250.00










                                                                                  Sub Total Amount                                                              862.03                   0.00             1,750.00
BAJAJ CLAIM NO:- 1427
                                                                                 CGST @ 14%                                                                        72.39
                                                                                 SGST @ 14%                                                          :            72.39
                                                                                 CGST @ 9%                                                                         31.04                                         157.50
                                                                                 SGST @ 9%                                                                         31.04                                         157.50
                                                        SETRAT

                                                                                 Sub Total Amount                                                             I,068.89                   0.00             2,065.00
                                        Authorised Signatory       Net Bill Amount (Rounded)                                                                                            3,134.00
 Dealer GSTIN : 24AAHCD9336NIZ6
                                                                                      Rupees Three Thousand One Hundred And Thirty Four 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.
                                                                                                          GatePass
GP No.        :GP20001672                                 Date : 19-MAR-21 15:43:48                        Job Card No.    Bill.No.           Bill Date                Amount
Cust. Name : Bajaj Allianz General Insurance Co. L Model : ACCESS-125(EH)                            JC20001426          BI/20000034      19-MAR-21                  3, 134.00
Tech.Name:HUSEN SHEKH                              Reg.No.: GJ05SC0371

  Customer Signature                                                                                                         Accountant Signature

                                                                                                                                                                                                   JC20001426

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