ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER
Job Card Retail - Tax Invoice
Customer Name & Address : ID :02-39
Invoice No. : 1/BI/20000038 Date : 06/02/2021 11:02:10
Bajaj Allianz General Insurance Co. Ltd,
4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH
Job Card No.: JC20000737 Job Card Date: 06/02/2021
ESTATE, 11 MG MARG, HAZRATGANJ,
Reg.No. : UP14ED4997 Mileage : 15776
LUCKNOW
SA Name : JAYDEEP KUMAR SA(M) : 9717002770
Pin:226001
State & Code :09-UTTAR PRADESH Model : WAGONR LXI(O) CNG 1.0L EW Type : III
Mobile Chassis No.: 204428 Last Service : 11033 (15-06-20)
Loyalty Card : NA Fuel Trim : Next Service Due : PMS 20
Service type: BODY REPAIR
Cust GSTIN/UIN : 09AABCB5730G1ZV Place of Supply: UTTAR PRADESH
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 71711M69R00-5PK BUMPER,FRONT AD 8708 28% 1.000 1437.50 1437.50 0.00
2 71761M69R10-5PK BEZEL,FRONT FOG LAMP,L AB 8708 28% 1.000 35.15 35.15 0.00
Labour
Demanded Repairs-Others/Suggested Jobs
1 ZF9993 PAINTING CHARGES 998729 2,500.00
Sub Total Amount 1,472.65 0.00 2,500.00
CGST @ 14% 206.17
SGST @ 14% 206.17
CGST @ 9% 225.00
SGST @ 9% 225.00
For AUTO POINT
Sub Total Amount 1,884.99 0.00 2,950.00
Authorised Signatory Net Bill Amount (Rounded) 4,835.00
Dealer GSTIN :09AAKCA6207A1Z1 Rupees Four Thousand Eight Hundred And Thirty 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. : GP20000727 Date : 06-FEB-21 11:02:28 Job Card No. Bill.No. Bill Date Amount
Cust. Name : Bajaj Allianz General Insurance Co. L Model : NEW WAGON R 1L CNG JC20000737 BC/20000735 06-FEB-21 0.00
Tech.Name :KULDEEP VERMA Reg.No.: UP14ED4997 JC20000737 BI/20000038 06-FEB-21 4,835.00
Customer Signature
Accountant Signature
JC20000737
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