ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice IRN : c54f24ace599559e4d46876ed3bad8b9882aa017fd9eb48fb0148b2e94dce814 Customer Name & Address : ID :02-31 Invoice No. : 7/BI/22000789 Date : 30/01/2023 19:26:34 Bajaj Allianz General Insurance Co. Ltd, 4th Floor,North East Plaza, Erramanzil Circle, Beside BMW Job Card No.: JC22006244 Job Card Date: 27/01/2023 Showroom, Reg.No. : TS07FV4614 Mileage : 1290 HYDERABAD SA Name : BEDARAKOTA RAVINDAR SA(M) : 6309888379 Pin:500082 State & Code :36-TELANGANA Model : MARUTI DZIRE VDI EW Type : NA Mobile : Chassis No.: 201053 Last Service : 108593 (24-12-22) Loyalty Card : 33036450709 Fuel Trim : Next Service Due : PMS110 Service type: BODY REPAIR Cust GSTIN/UIN : 36AABCB5730G1ZY PAN : AABCB5730G Place of Supply: TELANGANA 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 43110M55R00 165/80R14 ECOPIA EP150 (BS) AJ 40111010 28% 1.000 3686.71 3686.71 0.00 2 43210M55R01-09L WHEEL COMP AA 87087000 28% 1.000 1289.06 1289.06 0.00 3 71711M56R00-5PK BUMPER,FRONT (BLACK) AE 87081090 28% 1.000 1460.93 1460.93 0.00 4 71781M56R10-0PG GARNISH, FR BUMPER LOWER, R AE 87089900 28% 1.000 363.28 363.28 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF27P0 FRONT BUMPER PAINTING 998729 5,384.00 2 ZF16D0 PANEL FRONT FENDER RH DENTING 998729 300.00 3 ZA64L0 OUT SIDE LABOUR 998729 400.00 4 ZA11LO WHEEL ALIGNMENT 998729 515.00 5 ZA14L0 TYRE REPLACEMENT 998729 250.00 6 ZF16P0 PANEL FRONT FENDER RH PAINTING 998729 2,991.00 Sub Total Amount 6,799.98 0.00 9,840.00 CGST @ 14% 952.00 SGST @ 14% 952.00 CGST @ 9% 885.60 SGST @ 9% 885.60 For THE MITHRA AGENCIES Tax Collection at Source : 8.71 Authorised Signatory Sub Total Amount 8,712.69 0.00 11,611.20 Dealer GSTIN : 36AABFT2607H1ZE Deductibles(As per policy T & C) 1,000.00 Net Bill Amount (Rounded) 19,324.00 Rupees Nineteen Thousand Three Hundred And Twenty Four Only ** This is a system generated soft copy of invoice for insurance company records. 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. : GP22005963 Date : 30-JAN-23 19:26:51 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : New Dzire Diesel JC22006244 BI/22000789 30-JAN-23 19,324.00 Tech. Name :NUKAPANGU RAMU Reg.No.: TS07FV4614 JC22006244 BR/22001346 30-JAN-23 1,915.00 Customer Signature ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice JC22006244 ---PAGE END---