ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER
Job Card Retail - Tax Invoice
Customer Name & Address : ID : 02-14
Invoice No. : 001/BI/20000107 Date : 30/06/2020 18:33:04
Bajaj Allianz General Insurance Co. Ltd,
N-A/7,Irrigation Dept., Employees Co-operative, Society,Chitragupt Job Card No.: JC20000372
Job Card Date: 30/06/2020
Nagar Reg.No. : BR01AR6838
Mileage: 35583
PATNA
SA Name : AMRESH KUMAR DWIVEDI SA(M) : 9334656236
Pin:800020
State & Code : 10-BIHAR ModeI : WAGON R LXI BS III (WITH EW Type : NA
Mobile Chassis No.: 862696 Last Service : 7356 (07-10-12)
Loyalty Card : NA Fuel Trim : Next Service Due : PMS 30
Service type: BODY REPAIR
Cust GSTIN/UIN : 10AABCB5730G1ZC Place of Supply: BIHAR
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 35121M67K00 UNIT HEADLAMP RH,WAG R MINOR AB 8512 18% 1.000 2648.30 1324.15 0.00
INSURANCE 50
2 71711M67K00-5PK BUMPER FRONT AB 8708 28% 1.000 1406.25 703.13 0.00
INSURANCE 50
3 71741M67K00 GRILLE FR BUMPER UPP AB 8708 28% 1.000 382.81 191.41 0.00
INSURANCE 50
4 71751M67K00 GRILLE RADIATOR LOWE AC 8708 28% 1.000 214.84 107.42 0.00
INSURANCE 50
Labour
Demanded Repairs-Others/Suggested Jobs
1 ZF16D0 PANEL FRONT FENDER RH DENTING 998729 450.00
2 ZF16P0 PANEL FRONT FENDER RH PAINTING 998729 2,268.00
3 ZF01D0 PANEL, FRONT HOOD DENTING 998729 500.00
4 ZA64L0 OUT SIDE LABOUR 998729 450.00
5 ZF27P0 FRONT BUMPER PAINTING 998729 2,835.00
6 ZF02D0 MEMBER FRONT UPPER DENTING 998729 800.00
7 ZF01P0 PANEL, FRONT HOOD PAINTING 998729 2,917.25
Sub Total Amount 2,326.11 0.00 10,220.25
CGST @ 14% 140.28
SGST @ 14% 140.28
CGST @ 9% 119.17 919.82
SGST @ 9% : 119.17 919.82
For TIRUPATI AUTO
Sub Total Amount 2,845.01 0.00 12,059.89
Authorised Signatory Deductibles(As per policy T & C) 1,000.00
):
Dealer GSTIN : 10AACFT2338Q1Z4 Net Bill Amount (Rounded) 13,905.00
Rupees Thirteen Thousand Nine Hundred And Five 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. : GP20000365 Date : 30-JUN-20 18:33:17 Job Card No. Bill.No. Bill Date Amount
Cust. Name : Bajaj Allianz General Insurance Co. L Model : WAGON R JC20000372 BR/20000110 30-JUN-20 5,197.00
Tech. Name :IRSHAD ALAM Reg.No.: BR01AR6838 JC20000372 BI/20000107 30-JUN-20 13,905.00
Customer Signature
Accountant Signature
JC20000372
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