ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID : 02-26 Invoice No. : 002/BI/20000652 Date : 30/08/2020 11:31:26 Bajaj Allianz General Insurance Co. Ltd, 15/54-B,2ND FLOOR,, VIRENDRA SMRATI COMPLEX,, CIVIL Job Card No.: JC20004632 Job Card Date: 20/08/2020 LINES, Reg.No. : TEMP677751 Mileage: 220 KANPUR Pin:226001 SA Name : PRAMOD VERMA SA(M) : 9455213963 State & Code : 09-UTTAR PRADESH Model : MARUTI DZIRE VXI 1.2L ISSEW Type : III Mobile Chassis No.: 677751 Next Service Due : Loyalty Card : NA Fuel Trim : 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 35100M55R10 HEADLAMP ASSY,RH AB 8512 18% 1.000 2245.76 2245.76 0.00 2 57611M56R10 PANEL,FRONT FENDER,R (ED AC 8708 28% 1.000 914.06 914.06 0.00 COATED) 3 71711M56R00-5PK BUMPER,FRONT (BLACK) AC 8708 28% 1.000 1398.43 1398.43 0.00 4 71731M55R00 HOLDER, FR BUMPER SIDE, R AC 8708 28% 1.000 47.65 47.65 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZA64L0 OUT SIDE LABOUR 998729 600.00 2 ZF27P0 FRONT BUMPER PAINTING 998729 3,965.00 3 ZF16P0 PANEL FRONT FENDER RH PAINTING 998729 2,750.00 4 ZF32D0 PANEL, REAR DOOR RH DENTING 998729 450.00 5 ZF01P0 PANEL, FRONT HOOD PAINTING 998729 1,000.00 6 ZF38D0 PANEL, QUARTER OUTER RH DENTING 998729 300.00 7 ZF38P0 PANEL, QUARTER OUTER RH PAINTING 998729 2,600.00 8 ZF43D0 RUNNING BOARD DENTING 998729 200.00 9 ZF43P0 RUNNING BOARD PAINTING 998729 900.00 10 ZF32P0 PANEL, REAR DOOR RH PAINTING 998729 3,348.00 Sub Total Amount 4,605.90 0.00 16,113.00 MOHD RAFIQUEL HAQ = OC-21-1302- CGST @ 14% 330.42 1825-00000464 = MOHIT SAHU JI SGST @ 14% 330.42 CGST @ 9% 202.12 1,450.17 SGST @ 9% : 202.12 1,450.17 For SURI AUTOMOBILES Sub Total Amount 5,670.98 0.00 19,013.34 Authorised Signatory Net Bill Amount (Rounded) 24,684.00 Dealer GSTIN : 09AARFS6245C1ZW Rupees Twenty Four Thousand Six Hundred And Eighty Four 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. : GP20004714 Date : 30-AUG-20 11:31:33 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : New Dzire Petrol JC20004632 BR/20001824 30-AUG-20 0.00 Tech. Name :IRFAN I KHAN Reg.No.: TEMP677751 JC20004632 BI/20000652 30-AUG-20 24,684.00 Customer Signature Accountant Signature JC20004632 ---PAGE END---