ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIERORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax InvoiceJob Card Retail - Tax Invoice Customer Name & Address : ID : 02-04 Invoice No. : 18/BR/20004374 IRN : 94b6362dc2db5bbbfecf9eeb095adc18a3503184d4e6c2104cee7e887e6f2596 Date : 12/03/2021 18:54:02 Bajaj Allianz General Insurance Co. Ltd, 4th floor, Commerce House, 7 Race Course Road Job Card No.: JC20004713 Job Card Date: 10/03/2021 INDORE Reg.No. : MP09WB9769 Mileage: 82675 Pin:452001 State & Code :23-MADHYA PRADESH SA Name : JITENDRA LODWAL SA(M) : 7869806353 Mobile Model : MARUTI DZIRE VDI EW Type : III Loyalty Card : NA Fuel Trim : Chassis No.: 502934 Last Service : 5266 (31-07-19) Cust GSTIN/UIN : 23AABCB5730G1Z5 PAN : AABCB5730G Service type: BODY REPAIR Next Service Due : 3RD FREE SERVICE Place of Supply: MADHYA PRADESH Customer Name & Address : ID: 02-04 Invoice No. : 18/BR/20004374 Srl. Part Number Description Qty. Rate Taxable Date : 12/03/2021 18:54:02Tax Paid Labour Bajaj Allianz General Insurance Co. Ltd, Batch HSN/SAC Tax 4th floor, Commerce House, 7 Race Course Road Amount Amount Charges Job Card No.: JC20004713 Job Card Date: 10/03/2021 INDOREParts Reg.No. : MP09WB9769 Mileage: 82675 Pin:452001Demanded Repairs-Others/Suggested Jobs State & Code :23-MADHYA PRADESH SA Name : JITENDRA LODWAL SA(M) : 7869806353 16 72351M56R00 COVER, FRONT FENDER, R AB 8708 Model : MARUTI DZIRE VDI28%1.000 67.96 EW Type : III67.96 0.00 Mobile : 17Loyalty Card : NA72352M56R00 COVER, FRONT FENDER, L Fuel Trim : AB 8708 Chassis No.: 50293428% 1.000 67.96 Last Service : 5266 (31-07-19)67.96 0.00 18Cust GSTIN/UIN : 23AABCB5730G1Z572371M56R00-5PK GARNISH, COWL TOP SIDE, R PAN : AABCB5730G AB 8708 Service type: BODY REPAIR28%1.000 32.03 Next Service Due : 3RD FREE SERVICE32.03 0.00 19 72372M56R00-5PK GARNISH, COWL TOP SIDE, L AB 8708 Place of Supply: MADHYA PRADESH28%1.000 32.03 32.03 0.00 20 72480M55R00 LINING COMP, FRONT FENDER, L AD 8708 28% 1.000 437.50 437.50 0.00 21 77862M86G00-0PG EMBLEM(DDIS) AC 8708 28% 1.000 39.84 39.84 0.00 Srl. Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable Tax Paid Labour Labour Demanded Repairs-Others/Suggested Jobs Amount Amount Charges Parts1 ZF27P0 FRONT BUMPER PAINTING 998729 4,472.00 Demanded Repairs-Others/Suggested Jobs2ZF16P0 PANEL FRONT FENDER RH PAINTING 998729 3,104.00 13 ZF30P001550M0616A BOLTPANEL, FRONT DOOR RH PAINTING AB 7318998729 18% 10.000 2.54 25.40 0.00 4,236.00 24 03241M0516AZF9996 SCREWBODY ALIGNMENT AB 7318998729 18% 10.000 1.69 16.90 0.00 1,000.00 35 ZF999209409M07L01 CLIPDENTING CHARGES AB 8708998729 28% 20.000 3.12 62.40 0.00 600.00 46 09409M08006ZA64L0 CLIPOUT SIDE LABOUR AB 8708998729 28% 10.000 3.12 31.20 0.00 1,000.00 75 35300M55R10ZF17P0 PANEL FRONT FENDER LH PAINTINGHEADLAMP ASSY,LH AB 8512998729 18% 1.000 2245.76 2245.76 0.00 2,050.00 6 35500M75J11 FRONT FOG LAMP,YN4 AC 8512 18% 1.000 940.67 940.67 0.00 7Recommendations :57611M56R10 PANEL,FRONT FENDER,R (ED Sub Total AmountAC 8708 28% 1.000 914.06 7,455.85 914.06 0.000.00 16,462.00 COATED) 8NON MI (SACHIN JI) (BAJAJ ) CM-0000058771711M56R00-5PKBUMPER,FRONT (BLACK) AC 8708 28% 1.000 1398.43 1398.43 0.00 9 CGST @ 14% AD 591.79 0.00 NJP IMRAN, MR.MONIKA YADAV71721M56R00-5PK GRILLE, RADIATOR LOWER 8708 28% 1.000 183.59 183.59 71731M55R00 SGST @ 14% 591.79 0.00 10 HOLDER, FR BUMPER SIDE, R CGST @ 9% AC 8708 28% 1.000 47.65 290.59 47.65 11 71732M55R00 AC 47.65 47.65 0.00 1,481.58 HOLDER, FR BUMPER SIDE, L SGST @ 9% 8708 28% 1.000 290.59 1,481.58 12 AC 67.96: 67.96 0.00 71734M55R00For PATEL MOTORS (INDORE) PVT LTDHOLDER, FR BUMPER FRONT, L 8708 28% 1.000 13 71761M56R10-5PK BEZEL, FRONT FOG LAMP, L AD 8708 28% 1.000 117.18 117.18 0.00 Sub Total Amount : 9,220.61 0.00 19,425.16 14 71781M56R10-0PG GARNISH, FR BUMPER LOWER, RAuthorised Signatory AC 8708 28% 1.000 339.84 339.84 0.00 Net Bill Amount (Rounded) 28,646.00 15 71782M56R10-0PG GARNISH, FR BUMPER LOWER, L AC 8708 28% 1.000 339.84 339.84 0.00 Dealer GSTIN :23AABCP1892R1ZX Rupees Twenty Eight Thousand Six Hundred And Forty Six Only * Unapproved fitments may affect your and vehicle safety. Kindly do not fit any unapproved fitments in your vehicle. 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. : GP20006181 Date : 12-MAR-21 18:54:31 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : New Dzire Diesel JC20004713 BR/20004374 12-MAR-21 28,646.00 Tech. Name :KISHORE PRAJAPATI Reg.No.: MP09WB9769 Customer Signature Accountant Signature JC20004713