ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice ID:02-13 Invoice No.:1/BI/21000044 Date : 28/04/2021 11:50:19 Customer Name & Address : Bajaj Allianz General Insurance Co. Ltd, Job Card No.: JC21000450 Job Card Date:25/04/2021 6th Floor,Mani Square,No 164, Manicktala Main Rd,Mani Square, Reg.No.:WB40AH4900 Mileage:8191 Premises No 41,Canal Circle Rd SA(M):8158063020 KOLKATA SA Name :ASHIS RUIDAS EW Type:NA Pin:700156 Model : MARUTI SWIFT VXI BS IV Last Service : 3532 (23-09-18) State&Code19-WEST BENGAL Chassis No.: D50173 Next Service Due:PMS 20 Mobile Fuel Trim: Service type: BODY REPAIR Loyalty Card NA Place of Supply: WEST BENGAL Cust GSTIN/UIN:19AABCB5730G1ZU Surveyor Name : Ins.Comp.: BAJAJ Qty. Rate Taxable Tax Paid Labour Srl.Part Number Description Batch HSN/SAC Tax Amount Amount Charges Parts 0.00 Demanded Repairs-Others/Suggested Jobs AC 85122010 18% 1.000 2080.50 2080.50 1 35121M74L01 UNIT,HEADLAMP RH 18% 1.000 2080.50 2080.50 0.00 2 35321M74L01 UNIT,HEADLAMP LH AC 85122010 940.67 940.67 0.00 FRONT FOG LAMP,YN4 AC 87089900 18% 1.000 0.00 3 35500M75J11 AC 87089900 28% 1.000 160.15 160.15 4 57410M74L00 HINGE,FRONT HOOD RH AC 87089900 28% 1.000 148.43 148.43 0.00 5 57420M74L00 HINGE,FRONT HOOD LH AC 87089900 28% 1.000 1437.50 1437.50 0.00 6 71711M83P00-5PK BUMPER, FRONT (BLACK) AC 87089900 28% 1.000 75.78 75.78 0.00 7 71731M74L00 HOLDER,FR BUMPER SIDE RH AC 87089900 28% 1.000 75.78 75.78 0.00 8 71732M74L00 HOLDER, FR BUMPER SIDE LH 28% 1.000 250.00 250.00 0.00 71741M83P00-5PK GRILLE, RADIATOR UPPER (BLACK) AC 87089900 77.34 0.00 9 BEZEL,FRONT FOG LAMP RH AB 87089900 28% 1.000 77.34 0.00 10 71751M83P00-5PK AC 87089900 28% 1.000 50.78 50.78 11 71752M83P00-5PK GARNISH, FOG LAMP BEZEL RH Labour 750.00 Demanded Repairs-Others/Suggested JobsBOLT REMOVING CUTTING 998729 7,800.00 1 ZA70LO 998729 400.00 2 ZF9993 PAINTING CHARGES 998729 3 ZF9992 DENTING CHARGES 7,377.43 0.00 8,950.00 Sub Total Amount CGST @14% 318.61 SGST @ 14% 318.61 459.16 805.50 CGST @ 9% 459.16 805.50 SGST @ 9% FOr THE QUICKEST 8,932.97 0.00 10,561.00 Sub Total Amount 19,494.00 Authorised Signatory Net Bill Amount (Rounded) Rupees Nineteen Thousand Four Hundred And Ninety Four Only Dealer GSTIN:19AEUPB0339R1ZU PUR I acknowledge that the jobs/repairs/service carried out in my vehicle and the respective cost estimates were Customer Signature Mobile No.: explained to me. I have received my vehicle after completion of all repairs being carried out to my satisfaction andI confirm that my vehicle is in good condition. I further authorize this workshop to contact me by call or sms to inform me with any other information in relation to my vehicle. Gate Pass Amount Job Card No. Bill.No. Bill Date GP No. GP21000401 Date28-APR-21 11:50:29 JC21000450 BR/21000057 28-APR-21 0.00 Cust. NameBajaj Allianz General Insurance Co.LModel: SWIFT NEW /DZIRE NEW PETROL JC21000450 BI/21000044 28-APR-21 19,494.00 Tech.Name:EKLAKH SEKH Reg.No.:WB40AH4900 Customer Signature Accountant Signature. JC21000450 --------------PAGE END-----------------------