ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER
Job Card Retail - Tax Invoice
Customer Name & Address : ID :02-39 Invoice No. : 001/BI/20000147
Date : 21/07/2020 19:20:11
Bajaj Allianz General Insurance Co. Ltd,
4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH Job Card No.: JC20001459
Job Card Date: 14/07/2020
ESTATE, 11 MG MARG, HAZRATGANJ,
Reg.No. : UP32HA1523 Mileage: 57165
LUCKNOW
Pin:226001 SA Name : AKHILESH KUMAR SA(M) : 7705803279
State & Code :09-UTTAR PRADESH Model : MARUTI SWIFT DZIRE VDI EW Type : NA
Mobile Chassis No.: 922492 Last Service : 11491 (22-12-16)
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 01550M0616A BOLT AB 7318 18% 5.000 2.54 12.70 0.00
2 03241M0516A SCREW AA 7318 18% 5.000 0.84 4.20 0.00
3 09409M07L01 CLIP AB 3926 28% 15.000 3.12 46.80 0.00
4 09409M08006 CLIP AB 8708 28% 9.000 3.12 28.08 0.00
5 13620M60M50 COOLER, INTER AB 8708 28% 1.000 3945.31 3945.31 0.00
6 35100M75L00 HEAD LAMP ASSY RH AA 8512 18% 1.000 2377.11 2377.11 0.00
7 35300M75L00 HEAD LAMP ASSY LH AB 8512 18% 1.000 2406.77 2406.77 0.00
8 35500M75J11 FRONT FOG LAMP,YN4 AB 8512 18% 1.000 923.72 923.72 0.00
9 39461M73M00 NUT,RR COMB LAMP AB 7318 28% 5.000 2.34 11.70 0.00
10 57300M74L00 PANEL, FRONT HOOD AB 8708 28% 1.000 3058.59 3058.59 0.00
11 57410M74L00 HINGE, FRONT HOOD RH AB 8708 28% 1.000 156.25 156.25 0.00
12 57420M74L00 HINGE, FRONT HOOD LH AA 8708 28% 1.000 133.59 133.59 0.00
13 58230M74L00 MEMBER, HOOD LOCK AB 8708 28% 1.000 632.81 632.81 0.00
14 71711M84P00-5PK BUMPER, FRONT (BLACK) AC 8708 28% 1.000 1437.50 1437.50 0.00
15 71721M84P00-5PK GRILLE, RADIATOR LOWER (BLACK) AB 8708 28% 1.000 207.03 207.03 0.00
16 71740M84P00-C48 GRILLE, RADIATOR UPPER AC 8708 28% 1.000 1328.12 1328.12 0.00
17 71760M82R10-BMB BEZEL, FRONT FOG LAMP, L AB 8708 28% 1.000 445.31 445.31 0.00
18 72321M74L00 LINING, FRONT FENDER RH AB 8708 28% 1.000 289.06 289.06 0.00
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ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER
Job Card Retail - Tax Invoice
Customer Name & Address : ID :02-39 Invoice No. : 001/BI/20000147
Date : 21/07/2020 19:20:11
Bajaj Allianz General Insurance Co. Ltd,
4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH Job Card No.: JC20001459
Job Card Date: 14/07/2020
ESTATE, 11 MG MARG, HAZRATGANJ,
Reg.No. : UP32HA1523 Mileage: 57165
LUCKNOW
SA Name : AKHILESH KUMAR SA(M) : 7705803279
Pin:226001
State & Code :09-UTTAR PRADESH Model : MARUTI SWIFT DZIRE VDI EW Type : NA
Mobile Chassis No.: 922492 Last Service : 11491 (22-12-16)
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
20 72460M68P00 COVER,FR BUMPER LOWER AB 8708 28% 1.000 210.15 210.15 0.00
21 990J0M999H2-970 WAX TOP KIT 100ML AA 3405 18% 0.500 295.76 147.88 0.00
Labour
Demanded Repairs-Others/Suggested Jobs
1 ZF9993 PAINTING CHARGES 998729 6,000.00
2 ZF9992 DENTING CHARGES 998729 900.00
Sub Total Amount 18,091.74 0.00 6,900.00
BILLING DUE TO NON M.I. POL.NO. OG-21-
CGST @ 14% 1,710.70
1301-1801-00001014 ( BAJAJ) MR. G.P.
SGST @ 14% 1,710.70
TIWARI
CGST @ 9% 528.51 621.00
SGST @ 9% : 528.51 621.00
For SMARTWHEELS PVT LTD
Sub Total Amount 22,570.16 0.00 8,142.00
Authorised Signatory Deductibles(As per policy T & C) : 1,000.00
Dealer GSTIN :09AACCR1862L1Z2 Net Bill Amount (Rounded) 29,712.00
Rupees Twenty Nine Thousand Seven Hundred And Twelve 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. : GP20001585 Date : 21-JUL-20 19:20:31 Job Card No. Bill.No. Bill Date Amount
Cust. Name : Bajaj Allianz General Insurance Co. L Model : SWIFT NEW/ DZIRE NEW DIESEL JC20001459 BI/20000147 21-JUL-20 29,712.00
Tech.Name :KULDEEP YADAV Reg.No.: UP32HA1523
Customer Signature Accountant Signature
JC20001459
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