ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice IRN : 663d2489997d239b9b44c97e0b4a24ccbdf93be2010968b6353d7457dbed8275 Customer Name & Address : ID :1725205363 Invoice No. : 8/BR/20506567 Date : 29/01/2021 18:39:46 BAJAJ ALLIANZ GENERAL INSURNACE COMPANY LIMITED GE PIaZa AIR PORT ROAD, OPP GUNJAN THEATRE, YERWADA Job Card No.: JC20510056 Job Card Date: 29/01/2021 PUNE Reg.No. : MH39J8303 Mileage : 127811 PUNE SA Name : SACHIN HIRALAL WAGH SA(M) : 9960590406 Pin:411002 State & Code :27-MAHARASHTRA Model : MARUTI S-CROSS ZETA EW Type : NA Mobile : 7387263141 Chassis No.: 115362 Last Service : 107212 (24-10-19) Loyalty Card : NA Fuel Trim : Next Service Due : PMS120 Service type: BODY REPAIR Cust GSTIN/UIN : 27AABCB5730G1ZX PAN : AABCB5730G Place of Supply: MAHARASHTRA Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Amount Amount Charges Parts Demanded Repairs-Others/Suggested Jobs 1 84055M64M10 GLASS SET AA 7007 18% 1.000 3777.11 3777.11 0.00 2 84611M64M00 MOLDING,WINDSHIELD AD 8708 28% 1.000 414.06 414.06 0.00 3 99000M24120-460 DG SEALANT SET WITHOUT PRIMER AC 3506 18% 2.000 584.74 1169.48 0.00 4 99000M24121-162 INTERIOR PROTECTION COVERS- AA 3920 18% 1.000 25.42 25.42 0.00 ARENA Labour Demanded Repairs-Others/Suggested Jobs 1 ZA67L0 GLASS ETCHING 998729 1,200.00 Recommendations : Sub Total Amount 5,386.07 0.00 1,200.00 VINAYCHANDRA HIRALAL GANDHI CGST @ 14% 57.97 SGST @ 14% 57.97 CGST @ 9% 447.48 108.00 SGST @ 9% 447.48 108.00 For SEVA AUTOMOTIVE PVT. LTD. Tax Collection at Source @ 0.075% : 4.79 Authorised Signatory Sub Total Amount : 6,401.76 0.00 1,416.00 Dealer GSTIN : 27AAACS7220H1ZI Net Bill Amount (Rounded) 7,818.00 Rupees Seven Thousand Eight Hundred And Eighteen Only * Unapproved fitments may affect your and vehicle safety. Kindly do not fit any unapproved fitments in your vehicle. 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. : GP20509557 Date : 29-JAN-21 18:40:56 Job Card No. Bill.No. Bill Date Amount Cust. Name : M/S BAJAJ ALLIANZ GENERAL INS Model : S-CROSS (D13) JC20510056 BR/20506567 29-JAN-21 7,818.00 Tech. Name :VIJAY RAMODE Reg.No.: MH39J8303 Customer Signature Accountant Signature JC20510056 ---PAGE END---