ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID : 2040412038 Invoice No. : 3/BC/20007709 Date : 25/02/2021 BAJAJ ALLIANZ GENERAL INSURENCE CO .LTD Tin : 37AABCB5730G1ZW Peejay Plaza,3rd Floor, CBM Compound VIP Road, Job Card No.: JC20008211 Job Card Date : 24/02/2021 VISAKHAPATNAM Reg.No. : AP31CY4136 Mileage 89883 VISAKHAPATNAM SA Name : GOLAGANI MAHESH YADAV Pin:530043 Model : GIXXER-150-GSXL4 State & Code : 37-ANDHRA PRADESH Chassis No.: 8133397 Mobile : 9133003888 Service type : ACCIDENTAL REPAIR Loyalty Card : NA Cust GSTIN/UIN : 37AABCB5730G1ZW Place of Supply : ANDHRA PRADESH Srl. Part Number Description HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 1 01550-0616A-000 BOLT 73181500 18% 2.000 2.96 5.92 2 09280-13010-000 O RING (D:1.9,ID:12.6) 40169320 18% 1.000 5.93 5.93 3 35100-34J40-000 HEADLAMP ASSY 85122010 18% 1.000 1178.81 1178.81 4 47221-34J00-YVB COVER, FRAME FRONT LH (BLACK) 87141090 28% 1.000 358.59 358.59 5 51600-28800-000 RACER STEERING KIT 87141090 28% 1.000 281.25 281.25 6 51812-34J00-YVB HOUSING, HEADLAMP LH(BLACK) 87141090 28% 1.000 283.59 283.59 7 51813-34J10-291 HOUSING, HEADLAMP UPPER 87141090 28% 1.000 120.31 120.31 8 51814-34J00-YKV METER , COVER 87141090 28% 1.000 200.00 200.00 9 51831-30H00-000 CUSHION 40169320 18% 4.000 5.93 23.72 10 51850-34J10-000 BRACE, HEADLAMP HSG 87141090 28% 1.000 274.21 274.21 11 51890-34J00-000 PLATE, FRONT LICENSE 87082900 28% 1.000 42.96 42.96 12 53111-34J00-YVB FENDER, FRONT (BLACK) 87141090 28% 1.000 563.28 563.28 13 56111-34J21-000 HANDLEBAR 87141090 28% 1.000 312.50 312.50 14 56216-34J00-000 CAP, GRIP END 87141090 28% 1.000 15.62 15.62 15 56600-34J41-000 MIRROR ASSY, REAR VIEW LH 70091090 18% 1.000 124.57 124.57 16 57621-28G50-000 LEVER, CLUTCH 87141090 28% 1.000 39.06 39.06 17 68171-34J10-FJA EMBLEM,SUZUKI (SILVER/BLACK) 39199090 18% 1.000 11.01 11.01 18 68666-34J00-AYU TAPE, FRAME COVER FRONT LH 39199010 18% 1.000 33.05 33.05 19 S-123 GIXXER FOOTREST 87141090 28% 1.000 156.25 156.25 Labour Demanded Repairs-Others/Suggested Jobs 1 AA9999 OTHER 998729 500.00 2 AA9999 OTHER 998729 1,500.00 Recommendations : Sub Total Amount 4,030.63 2,000.00 CGST @ 14% 370.67 SGST @ 14% 370.67 CGST @ 9% 124.45 180.00 SGST @ 9% : 124.45 180.00 For PADMAJA MOTORS PRIVATE LIMITED : Sub Total Amount : 5,020.87 2,360.00 Authorised Signatory Net Bill Amount (Rounded) 7,381.00 Rupees Seven Thousand Three Hundred And Eighty One Only Dealer GSTIN : 37AAKCP6942M1Z0 * Unapproved fitments affects the performance & safety. Suggested to keep the vehicle in original specifications. 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. : GP20008236 Date : 25-FEB-21 10:39:54 Job Card No. Bill.No. Bill Date Amount Cust. Name : LT. BAJAJ ALLIANZ GENERAL I Model : Gixxer (GSX150) JC20008211 BC/20007709 25-FEB-21 7,381.00 Tech. Name :AKHBAR BASHA Reg No.: AP31CY4136 Customer Signature Accountant Signature ---PAGE END---