ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-39 Invoice No. : 4/BI/20000301 Date : 10/11/2020 12:26:20 Bajaj Allianz General Insurance Co. Ltd, 4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH Job Card No.: JC20002002 Job Card Date: 20/10/2020 ESTATE, 11 MG MARG, HAZRATGANJ, Reg.No. : UP43AD8419 Mileage: 92667 LUCKNOW SA Name : RAVI PRAKASH PANDEY SA(M) : 8383816537 Pin:226001 State & Code : 09-UTTAR PRADESH Model : VITARA BREZZA ZDI EW Type : NA Mobile Chassis No.: 199186 Last Service : 82932 (02-07-20) Loyalty Card : NA Fuel Trim : Next Service Due : PMS80 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 71711M82P00-5PK BUMPER,FRONT UPPER AB 8708 28% 1.000 2187.50 2187.50 0.00 2 72322M82P00 LINING,FRONT FENDER,L AC 8708 28% 1.000 685.93 685.93 0.00 3 84055M82P00 GLASS COMP,WINDSHIELD AC 7007 18% 1.000 3677.96 3677.96 0.00 4 84611M82P00 MOLDING,WINDSHIELD AC 8708 28% 1.000 300.78 300.78 0.00 5 84701M82P10-5PK MIRROR ASSY,OUT REAR VIEW,R AC 7009 18% 1.000 1677.96 1677.96 0.00 6 99000M24120-460 DG SEALANT SET WITHOUT PRIMER AC 3506 18% 1.000 584.74 584.74 0.00 7 99000M24120-879 MASKING TAPE ( 24 MM*30 MTRS) AC 3919 18% 2.000 46.61 93.22 0.00 8 99000M24120-883 AIR DRYING SEALER (PU 92) AC 3506 18% 0.300 673.72 202.12 0.00 9 99000M24120-978 MGP RUST SMASH AC 2710 18% 1.000 80.50 80.50 0.00 10 99000M24121-112 MASKING PAPER (L 200M*W 45CM) AC 4804 12% 0.100 1080.35 108.04 0.00 11 99000M24121-136 PAPER FLOOR MAT (20X15) AB 4820 18% 10.000 0.84 8.40 0.00 12 990J0M99921-020 BATTERY - CR 2032 ACC REMOTE AB 8506 18% 1.000 79.66 79.66 0.00 13 990J0M999CV-GM2 GERM TERMINATOR - PLASTIC AA 3402 18% 0.600 487.28 292.37 0.00 CLEANER 14 990J0M999H1-013 ANTIRUST COATING REG AB 2715 18% 0.500 296.61 148.31 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF9992 DENTING CHARGES 998729 2,140.00 2 ZF9993 PAINTING CHARGES 998729 16,274.00 Sub Total Amount 10,127.49 0.00 18,414.00 NON EMI CLAIM NO.0C-21-130-11801- CGST @ 14% 444.39 00001558 vinay kumar srivastava SGST @ 14% : 444.39 CGST @ 9% 616.09 1,657.26 SGST @ 9% 616.09 1,657.26 For ANAND MOTORS AGENCIES LTD CGST @ 6% : 6.48 SGST @ 6% : 6.48 Authorised Signatory Tax Collection at Source @ 0.075% 9.21 Dealer GSTIN : 09AACCA0843N1ZK Sub Total Amount 12,270.62 0.00 21,728.52 Net Bill Amount (Rounded) : 33,999.00 Rupees Thirty Three Thousand Nine Hundred And Ninety Nine 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. : GP20002225 Date:10-NOV-20 12:26:38 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : VITARA BREZZA 1.3D JC20002002 BI/20000301 10-NOV-20 33,999.00 Tech.Name :RIZWAN KHAN Reg.No.: UP43AD8419 Customer Signature Accountant Signature JC20002002 ---PAGE END---