ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice IRN : f4e509152cfb3a5718f4effe3a9ebcc24afe36bda2e579bae63fe1a5233d2669 Customer Name & Address : ID :02-15 Invoice No. : 27/BI/20001049 Date : 26/11/2020 16:01:27 Bajaj Allianz General Insurance Co. Ltd, 402-408, 4th Floor,, Turquoise Bldg., Near Panchvati Circle,CG Job Card No.: JC20010284 Job Card Date: 19/11/2020 Road Reg.No. : GJ09BH1395 Mileage: 1413 AHMEDABAD SA Name : PARTH SURESHKUMAR PANCHA SA(M) : 7624000261 Pin:380006 State & Code :24-GUJARAT Model : MARUTI ALTO LXI EW Type : NA Mobile : Chassis No.: G00274 Last Service : 341 (06-09-20) Loyalty Card : NA Fuel Trim : Next Service Due : 2ND FREE SERVICE Service type: BODY REPAIR Cust GSTIN/UIN : 24AABCB5730G1Z3 PAN : AABCB5730G Place of Supply: GUJARAT 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 68003M53M00 PANEL ASSY,REAR DOOR,R AC 8708 28% 1.000 6183.59 6183.59 0.00 2 99000M24120-879 MASKING TAPE (24 MM*30 MTRS) AC 3919 18% 1.000 46.61 46.61 0.00 3 99000M24120-883 AIR DRYING SEALER (PU 92) AC 3506 18% 0.330 673.72 222.33 0.00 4 990J0M999GH-020 PRF SPRAY OCEAN DR MARCUS AA 3307 18% 1.000 168.64 168.64 0.00 5 990J0M999H2-250 SCREEN WASH 50ML AB 3402 18% 4.000 14.40 57.60 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 PC07R0 REAR DOOR PANEL ASSY (ONE SIDE) 998729 623.00 2 ZF9993 PAINTING CHARGES 998729 8,288.00 3 ZF9992 DENTING CHARGES 998729 1,800.00 Sub Total Amount 6,678.77 0.00 10,711.00 BAJAJ SUR BY RAKESH BHAI CLAIM NO- CGST @ 14% 865.70 OC-21-2202-1825-00001172 SGST @ 14% 865.70 CGST @ 9% 44.56 963.99 SGST @ 9% 44.56 963.99 For KIRAN MOTORS LTD Tax Collection at Source @ 0.075% : 6.38 Authorised Signatory Sub Total Amount 8,505.67 0.00 12,638.98 Dealer GSTIN : 24AAACK3828R1Z5 Net Bill Amount (Rounded) 21,145.00 Rupees Twenty One Thousand One Hundred And Forty Five 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. : GP20010619 Date : 26-NOV-20 16:02:37 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : ALT0 800 JC20010284 BR/20004402 26-NOV-20 0.00 Tech.Name :MABOOD MAKSOOD KHAN Reg.No.: GJ09BH1395 JC20010284 BI/20001049 26-NOV-20 21,145.00 Customer Signature Accountant Signature JC20010284 ---PAGE END---