ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-12 Invoice No. : 1/BI/20000129 Date : 10/01/2021 Bajaj Allianz General Insurance Co. Ltd, HIG 10 1st Shivaji Nagar, Opp Pragati Petrol Pump Job Card No.: JC20001280 Job Card Date : 04/01/2021 BHOPAL Reg.No. : UP94Y7099 Mileage :8076 Pin:462016 SA Name : BRAJESH RAI State & Code :23-MADHYA PRADESH Model : MARUTI S-PRESSO VX EW Contract No. : 2010246035 Mobile Chassis No.: 169420 Loyalty Card : NA Fuel Trim : Service type : BODY REPAIR Ins.Comp. BAJAJ Place of Supply : MADHYA PRADESH Cust GSTIN/UIN : 23AABCB5730G1Z5 Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 1 01550M0612A BOLT FRT HOOD HINGE AB 7318 18% 2.000 2.54 5.08 2 09148M06022 NUT AB 8708 28% 2.000 5.46 10.92 3 09409M07L01 CLIP AB 8708 28% 8.000 3.12 24.96 4 35100M62S00 HEADLAMP ASSY,R AB 8512 18% 1.000 1601.69 1601.69 5 38500M78122 HORN ASSY, HIGH AD 8512 18% 1.000 177.96 177.96 6 57611M62S00 PANEL,FRONT FENDER,RH AC 8708 28% 1.000 1257.81 1257.81 7 71711M62S00-5PK BUMPER, FRONT LOWER (BLACK) AC 8708 28% 1.000 1195.31 1195.31 8 71721M62S00-5PK BUMPER, FRONT UPPER (BLACK) AC 8708 28% 1.000 714.84 714.84 9 77811M54GC0-0PG EMBLEM,MARK(S)(CHROME) AC 8708 28% 1.000 97.65 97.65 Labour Demanded Repairs-Others/Suggested Jobs 1 NA01R0 FRONT BUMPER 998729 150.00 2 ZF27P0 FRONT BUMPER PAINTING 998729 2,735.00 3 ZF09D0 PANEL, LAMP SUPPORT RH DENTING 998729 250.00 4 SA02R0 HEADLAMP UNIT OR HEADLAMP ASSY 998729 120.00 (ONE SIDE) 5 ZF16P0 PANEL FRONT FENDER RH PAINTING 998729 1,684.00 Sub Total Amount 5,086.22 4,939.00 CUSTOMER NAME - JITENDRA KUMAR CGST @ 14% 462.20 PATEL SGST @ 14% 462.20 CGST @ 9% 160.63 444.51 SGST @ 9% 160.63 444.51 For ASHENDRA AUTOMOBILES : Sub Total Amount : 6,331.88 5,828.02 Authorised Signatory Net Bill Amount (Rounded) 12,160.00 Rupees Twelve Thousand One Hundred And Sixty Only Dealer GSTIN : 23ACJPT6310M1ZD 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. : GP20001290 Date : 10-JAN-21 15:15:27 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance C Model : S-PRESSO JC20001280 BI/20000129 10-JAN-21 12,160.00 Tech.Name :FAKARUDDEEN KHAN Reg No.: UP94Y7099 Customer Signature Accountant Signature ---PAGE END---