ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-39 Invoice No. : 007/BI/20000358 Date : 15/09/2020 17:56:33 Bajaj Allianz General Insurance Co. Ltd, 4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH Job Card No.: JC20001927 Job Card Date: 13/09/2020 ESTATE, 11 MG MARG, HAZRATGANJ, Reg.No. : UP32HK8958 Mileage: 60511 LUCKNOW Pin:226001 SA Name : GAURAV GAURAV SA(M) : 8569822811 State & Code :09-UTTAR PRADESH Model : MARUTI SWIFT DZIRE VDI EW Type : NA Mobile Chassis No.: 999489 Last Service : 51615 (23-01-19) Loyalty Card : NA Fuel Trim : Next Service Due : PMS 50 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 09409M06314 CLIP,FRONT DOOR TRIM AA 8708 28% 10.000 3.51 35.10 0.00 2 09409M07L01 CLIP AA 8708 28% 30.000 2.34 70.20 0.00 3 09471M12211 .BULB (12V,35W H8) AB 8539 18% 1.000 322.03 322.03 0.00 4 35121M74L01 UNIT, HEADLAMP RH AB 8512 18% 1.000 2042.37 2042.37 0.00 5 38450M74L00 TANK ASSY, WASHER AB 8479 28% 1.000 132.81 132.81 0.00 6 42420M55K02 JOINT COMP,FR STABILIZER BAR AA 8708 28% 1.000 355.46 355.46 0.00 7 43110M75J80 165/80R14 DURAPLUS (GY) AD 4011 28% 1.000 2805.46 2805.46 0.00 8 43210M74L02-09L WHEEL COMP(14X5J) AD 8708 28% 1.000 796.87 796.87 0.00 9 44101M55R81 SHAFT ASSY,FRONT DRIVE,RH AB 8708 28% 1.000 4914.06 4914.06 0.00 10 45201M74L20 ARM ASSY,FRONT SUSPENSION,R AB 8708 28% 1.000 1757.81 1757.81 0.00 11 57410M82P00 HINGE COMP,FRONT HOOD,R AB 8708 28% 1.000 154.68 154.68 0.00 12 57611M71P10 PANEL,FRONT FENDER,R AB 8708 28% 1.000 1015.62 1015.62 0.00 13 71711M84P00-5PK BUMPER, FRONT (BLACK) AB 8708 28% 1.000 1406.25 1406.25 0.00 14 71721M84P00-5PK GRILLE, RADIATOR LOWER (BLACK) AB 8708 28% 1.000 207.03 207.03 0.00 15 71731M74L00 HOLDER, FR BUMPER SIDE RH AB 8708 28% 1.000 74.21 74.21 0.00 16 71732M74L00 HOLDER, FR BUMPER SIDE LH AB 8708 28% 1.000 74.21 74.21 0.00 17 71750M84P10-C48 BEZEL, FRONT FOG LAMP RH AB 8708 28% 1.000 439.06 439.06 0.00 18 72321M74L10 LINING, FRONT FENDER RH AB 8708 28% 1.000 378.90 378.90 0.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID: 02-39 Invoice No. : 007/BI/20000358 Date : 15/09/2020 17:56:33 Bajaj Allianz General Insurance Co. Ltd, 4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH Job Card No.: JC20001927 Job Card Date: 13/09/2020 ESTATE, 11 MG MARG, HAZRATGANJ, Reg.No. : UP32HK8958 Mileage: 60511 LUCKNOW SA Name : GAURAV GAURAV SA(M) : 8569822811 Pin:226001 State & Code :09-UTTAR PRADESH Model : MARUTI SWIFT DZIRE VDI EW Type : NA Mobile Chassis No.: 999489 Last Service : 51615 (23-01-19) Loyalty Card : NA Fuel Trim : Next Service Due : PMS 50 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 77862M86G00-0PG EMBLEM(DDIS) AB 8708 28% 1.000 39.06 39.06 0.00 21 83714M62B00 CLIP DOOR TRIM AB 8708 28% 10.000 3.12 31.20 0.00 22 84701M74LG0-5PK MIRROR ASSY,OUT REAR VIEW,R AB 7009 18% 1.000 5118.64 5118.64 0.00 23 99000M99095-001 DASH BOARD SHINER(225 AB 3402 18% 1.000 132.20 132.20 0.00 24 990J0M999CV-MS1 FACE MASK 3PLY (PAIR) AA 9018 12% 1.000 8.92 8.92 0.00 25 990J0M999GR-430 PRF LEMON AB 3307 18% 1.000 67.79 67.79 0.00 26 990J0M999H2-260 SCREEN WASH 50 AB 3402 18% 4.000 14.40 57.60 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZZ07H HYGIENE CHARGE 998729 175.00 2 ZF9992 DENTING CHARGES 998729 1,800.00 3 ZF9993 PAINTING CHARGES 998729 11,573.00 Sub Total Amount 22,491.44 0.00 13,548.00 Er. Sanjay singh CGST @ 14% 2,063.87 SGST @ 14% 2,063.87 CGST @ 9% 696.65 1,219.32 SGST @ 9% 696.65 1,219.32 For BRIGHT 4 WHEEL SALES PVT. LTD. CGST @ 6% 0.54 SGST @ 6% : 0.54 Authorised Signatory Dealer GSTIN : 09AACCB8810E1ZV Sub Total Amount 28,013.56 0.00 15,986.64 Net Bill Amount (Rounded) 44,000.00 Rupees Forty Four Thousand 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. : GP20001884 Date : 15-SEP-20 18:03:59 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : SWIFT NEW/ DZIRE NEW DIESEL JC20001927 BR/20000978 15-SEP-20 0.00 Tech. Name :SUNIL KUMAR VERMA Reg.No.: UP32HK8958 JC20001927 BI/20000358 15-SEP-20 44,000.00 Customer Signature Accountant Signature JC20001927 ---PAGE END---