ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER
                                                                                                                                   Job Card Retail - Tax Invoice
           Customer Name & Address :                                                   ID :02-39                                                                     Invoice No. : 011/BI/20000072                                                                Date : 17/07/2020 18:53:49
           Bajaj Allianz General Insurance Co. Ltd,
           4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH                                                                                                            Job Card No.: JC20000329                                                        Job Card Date: 16/07/2020
           ESTATE, 11 MG MARG, HAZRATGANJ,                                                                                                                                 Reg.No. : UP32JC9777                                                             Mileage: 32385
           LUCKNOW
           Pin:226001                                                                                                                                                    SA Name : SANJAY SAINI                                                                   SA(M) : 6307995486
           State & Code :09-UTTAR PRADESH                                                                                                                                     Model : MARUTI VITARA BREZZA V E                                       EW Type : NA
          Mobile :                                                                                                                                                   Chassis No.: 252055                                                             Last Service : 28742 (10-02-20)
           Loyalty Card : NA                                                                  Fuel Trim :                                                            Service type: BODY REPAIR                                                        Next Service Due : PMS 30
           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
           Labour
           Demanded Repairs-Others/Suggested Jobs
           1          ZF9992                                     DENTING CHARGES                                                                   998729                                                                                                                                                                 1,000.00
            2         ZF9993                                     PAINTING CHARGES                                                                  998729                                                                                                                                                                12,736.00
                                                                                                                           Sub Total Amount                                                                                                                                                                            13,736.00
           BAJAJ MI P_0G-20-9910-1801-00079147                                                                              Less Discount                                                                                                                                                                                        0.00
                                                                                                                            CGST @ 9%                                                                                                                                                                                   1,236.24
           CL_ OC-21-1301-1801-00000609 MR.                                                                                SGST @ 9%
           PRAKHAR                                                                                                                                                                                                                                                                                                       1,236.24
                                                                                                                            Sub Total Amount                                                                                                                                                 0.00                      16,208.48
                                   For ANAND MOTORS AGENCIES LTD                                                            Deductibles(As per policy T & C) :                                                                                                                                                        1,000.00
                                                                                                                            Net Bill Amount (Rounded)                                                                                                                                                               15,208.00
                                                                  Authorised Signatory
                                                                                                                                   Rupees Fifteen Thousand Two Hundred And Eight Only
            Dealer GSTIN :09AACCA0843N1ZK                                                                                  *
            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.                   : GP20000345                                                              Date : 17-JUL-20 18:53:55                                                                   Job Card No.                        Bill.No.                        Bill Date                                 Amount
          Cust. Name : Bajaj Allianz General Insurance Co. L Model : VITARA BREZZA 1.3D                                                                                                                   JC20000329                          BR/20000239                     17-JUL-20                                    1,755.00
           Tech. Name :MOD. SALEEM                                                                            Reg.No.: UP32JC9777                                                                         JC20000329                          BI/20000072                     17-JUL-20                                  15,208.00
             Customer Signature
                                                                                                                                                                                                            Accountant Signature
                                                                                                                                                                                                                                                                                         JC20000329
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