ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID : 02-20 Invoice No. : 061/BI/20000064 Date : 21/07/2020 15:17:56 Bajaj Allianz General Insurance Co. Ltd, 1st Floor,Tower1,Commerce Zone, Samrat Ashok Path,Yerwad Job Card No.: JC20000636 Job Card Date: 16/07/2020 PUNE Reg.No. : MH10CA1124 Mileage: 95708 Pin:411006 SA Name : SUMIT MAHESH PATIL SA(M) : 9423550679 State & Code :27-MAHARASHTRA Mobile : Model : MARUTI ALTO 800 LXI BS EW Type : NA Loyalty Card : NA Fuel Trim : Chassis No.: 699400 Last Service : 90071 (05-02-20) Cust GSTIN/UIN : 27AABCB5730G1ZX Next Service Due : PMS90 Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: MAHARASHTRA 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 64511M53M01-P41 PANEL, SIDE SILL LH AB 8708 28% 1.000 2736.71 2736.71 0.00 2 68002M53M20 PANEL ASSY,FRONT DOOR,L AB 8708 28% 1.000 4316.40 4316.40 0.00 3 84651M53M00 WEATHERSTRIP,FRONT DOOR AD 4016 28% 1.000 378.90 378.90 0.00 OPNG,L Labour Demanded Repairs-Others/Suggested Jobs 1 ZF14L0 STRIPING TAPES (ONE SIDE) 998729 500.00 2 ZF9993 PAINTING CHARGES 998729 4,270.00 3 ZF9992 DENTING CHARGES 998729 1,400.00 Sub Total Amount 7,432.01 0.00 6,170.00 INSURANCE CLAIM BAJAJ ZERO CGST @ 14% 1,040.49 MR.HEMANT SGST @ 14% 1,040.49 CGST @ 9% 555.30 SGST @ 9% : 555.30 For CHOWGULE INDUSTRIES PVT. LTD. Sub Total Amount 9,512.99 0.00 7,280.60 Authorised Signatory Deductibles(As per policy T & C) : 1,000.00 Dealer GSTIN : 27AACCC9272H1ZG Net Bill Amount (Rounded) 15,794.00 Rupees Fifteen Thousand Seven Hundred And Ninety Four 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. : GP20000666 Date : 21-JUL-20 15:18:35 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : ALT0 800 JC20000636 BI/20000064 21-JUL-20 15,794.00 Tech. Name : SUDHIR SHASHIKANT MANE Reg.No.: MH10CA1124 JC20000636 BR/20000310 21-JUL-20 1,735.00 Customer Signature Accountant Signature JC20000636 ---PAGE END---