C G MOTORS SHOP NO.21/22, SATYAM TOWERS, PLOT NO.18/19, SECTOR 20, KOPERKHAIRANE,NAVI MUMBAI, NAVI MUMBAI Pin:400709 Job Card Retail - Tax Invoice Customer Name & Address : ID :1725735995 Invoice No. : 1/BC/20002939 Date : 17/12/2020 18:38:51 BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED Regd. office,& Head office: , GE Plaza Airport Road, Yerwada, 1Job Card No.: JC20002939 Job Card Date: 17/12/2020 Pune Reg.No. : MH05DR59642 Mileage : 16000 PUNE SA Name : NIKHIL SAKPAL SA(M) : 7506303434 Pin:411006 State & Code 27-MAHARASHTRA Model : GIXXER- REAR DISC - GS EW Type : NA Mobile 9833490051 Chassis No.: MB8NG4BACJ8336884 Last Service : 13000 (14-07-19) Loyalty Card NA Next Service Due : 6th Paid Service Service type: ACCIDENTAL REPAIR Cust GSTIN/UIN : 27AABCB5730G1ZX Place of Supply: MAHARASHTRA Srl. Part Number Description HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 1 25600-34J00-000 LEVER ASSY, GEAR SHIFTING 87141090 28% 1.000 171.87 171.87 0.00 2 35100-34J40-000 HEADLAMP ASSY 85122010 18% 1.000 1178.81 1178.81 0.00 3 35603-34J11-000 LAMP ASSY,RR TURNSIGNAL,R (CLR) 85122010 18% 1.000 204.23 204.23 0.00 4 35710-34J10-000 LAMP ASSY, REAR COMBINATION 85122010 18% 1.000 1124.57 1124.57 0.00 5 35910-16G71-000 LAMP ASSY,LICENSE 85122010 18% 1.000 111.01 111.01 0.00 6 45100-34J20-AW1 SEAT ASSY (BLACK/RED) 94012000 18% 1.000 1264.40 1264.40 0.00 7 46211-34J00-YVB HANDLE, PILLION RIDER LH 87141090 28% 1.000 395.31 395.31 0.00 8 46231-34J00-YVB HANDLE, PILLION RIDER RH 87141090 28% 1.000 360.15 360.15 0.00 9 47221-34J00-YVB COVER, FRAME FRONT LH (BLACK) 87141090 28% 1.000 358.59 358.59 0.00 10 47851-34J10-291 COVER, FRAME CENTER 87149990 28% 1.000 311.71 311.71 0.00 11 51410-34J00-291 BRACKET, UNDER (BLACK) 87141090 28% 1.000 2117.18 2117.18 0.00 12 51811-34J00-YVB HOUSING, HEADLAMP RH(BLACK) 87141090 28% 1.000 283.59 283.59 0.00 13 51812-34J00-YVB HOUSING, HEADLAMP LH(BLACK) 87141090 28% 1.000 283.59 283.59 0.00 14 51813-34J10-291 HOUSING, HEADLAMP UPPER 87141090 28% 1.000 120.31 120.31 0.00 15 51814-34J00-YVB COVER, METER (BLACK) 87141090 28% 1.000 207.03 207.03 0.00 16 51850-34J20-000 BRACE, HEADLAMP HSG 87141090 28% 1.000 269.53 269.53 0.00 17 51890-34J10-000 PLATE, FRONT LICENSE 87141090 28% 1.000 50.78 50.78 0.00 18 53111-34J00-YVB FENDER, FRONT (BLACK) 87141090 28% 1.000 563.28 563.28 0.00 19 56111-34J21-000 HANDLEBAR 87141090 28% 1.000 312.50 312.50 0.00 20 56216-34J00-000 CAP, GRIP END 87141090 28% 1.000 15.62 15.62 0.00 21 56500-34J40-000 MIRROR ASSY, REAR VIEW RH 70091090 18% 1.000 128.81 128.81 0.00 22 56600-34J40-000 MIRROR ASSY, REAR VIEW LH 70091090 18% 1.000 128.81 128.81 0.00 ---PAGE END--- C G MOTORS SHOP NO.21/22, SATYAM TOWERS, PLOT NO.18/19, SECTOR 20, KOPERKHAIRANE,NAVI MUMBAI, NAVI MUMBAI Pin:400709 Job Card Retail - Tax Invoice Customer Name & Address : ID :1725735995 Invoice No. : 1/BC/20002939 Date : 17/12/2020 18:38:51 BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LIMITED Regd. office,& Head office: , GE Plaza Airport Road, Yerwada, 1Job Card No.: JC20002939 Job Card Date: 17/12/2020 Pune Reg.No. : MH05DR59642 Mileage: 16000 PUNE Pin:411006 SA Name : NIKHIL SAKPAL SA(M) : 7506303434 State & Code 27-MAHARASHTRA Model : GIXXER- REAR DISC - GS EW Type : NA Mobile 9833490051 Chassis No.: MB8NG4BACJ8336884 Last Service : 13000 (14-07-19) Loyalty Card NA Next Service Due : 6th Paid Service Service type: ACCIDENTAL REPAIR Cust GSTIN/UIN : 27AABCB5730G1ZX Place of Supply: MAHARASHTRA Srl. Part Number Description HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 24 57621-28G50-000 LEVER, CLUTCH 87141090 28% 1.000 39.06 39.06 0.00 25 59211-34J40-000 DISC,FRONT BRAKE 87141090 28% 1.000 1460.15 1460.15 0.00 26 59600-30H30-000 CYLINDER ASSY, FRONT MASTER 87149400 28% 1.000 1224.21 1224.21 0.00 27 68155-34J00-J7A EMBLEM, ABS (GRAY/BLACK) 39199090 18% 1.000 11.86 11.86 0.00 28 68171-34J10-YMD EMBLEM,SUZUKI 39199010 18% 1.000 11.01 11.01 0.00 29 68211-34J00-BF2 TAPE, HEAD LAMP HOUSING ,RH 39199010 18% 1.000 33.89 33.89 0.00 30 68212-34J00-BF2 TAPE, HEAD LAMP HOUSING ,LH 39199010 18% 1.000 33.89 33.89 0.00 31 68666-34J20-BJR TAPE , FRAME COVER FRONT , LH 39199010 18% 1.000 105.08 105.08 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 AE9999 OTHER 998729 100.00 2 ZOS017 Accidental Repair 998729 4,130.00 3 ZoS010 Other Outside Charges 998729 1,475.00 Recommendations : Sub Total Amount 13,019.89 0.00 5,705.00 CGST @ 14% 1,215.68 SGST @ 14% 1,215.68 CGST @ 9% 390.27 513.45 SGST @ 9% : 390.27 513.45 Sub Total Amount 16,231.79 0.00 6,731.90 Authorised Signatory Net Bill Amount (Rounded) 22,964.00 Dealer GSTIN : 27AADFC9148E1ZG Rupees Twenty Two Thousand Nine Hundred And Sixty Four Only * 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 to Customer Signature Mobile No.: inform me with any other information in relation to my vehicle. Gate Pass GP No. : GP20003001 Date : 17-DEC-20 18:39:09 Job Card No. Bill.No. Bill Date Amount Cust. Name : MS BAJAJ ALLIANZ GENERAL INSU Model : Gixxer (GSX150) JC20002939 BC/20002939 17-DEC-20 22,964.00 Tech. Name :SUJIT KUMAR MANDAL Reg.No.: MH05DR59642 Customer Signature Accountant Signature JC20002939 ---PAGE END---