ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice IRN : ffe08ae055212b0c703424a034027573ab93c72c5df83c1d521c2946dfe09078 Customer Name & Address : ID : 02-16 Invoice No. : 34/BI/20001226 Date : 17/02/2021 15:30:41 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20001803 Job Card Date: 23/12/2020 NEW DELHI Reg.No. : TEPP2700 Mileage: 82582 Pin:110015 SA Name : KAPIL SA(M) : 8685005551 State & Code : 07-DELHI Mobile Model : MARUTI ALTO 800 GREEN EW Type : NA : Loyalty Card : NA Fuel Trim : Chassis No.: 975036 Last Service : 10375 (30-07-17) Cust GSTIN/UIN : 07AABCB5730G1ZZ PAN : AABCB5730G Next Service Due : PMS 20 Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: DELHI 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 01550M0616A BOLT AA 7318 18% 10.000 1.69 16.90 0.00 2 01550M0825A BOLT AA 7318 18% 4.000 3.38 13.52 0.00 3 08314M4012A NUT AA 7318 18% 2.000 6.77 13.54 0.00 4 08331M41629 CIRCLIP AA 7318 18% 1.000 9.32 9.32 0.00 5 09100-10169 BOLT AC 8708 28% 1.000 61.71 61.71 0.00 6 09117M10025 BOLT, CTRL ARM AA 7318 18% 1.000 15.25 15.25 0.00 7 09148M06022 NUT AA 8708 28% 2.000 4.68 9.36 0.00 8 09164M12017 WASHER AA 7318 18% 1.000 8.47 8.47 0.00 9 09209M09L02 LINKAGE AA 8708 28% 1.000 4.68 4.68 0.00 10 09409M07L01 CLIP AA 8708 28% 15.000 2.34 35.10 0.00 11 09471M12076 BULB AA 8512 18% 2.000 29.66 59.32 0.00 12 09471M12090 BULB 12V(SX4 MINOR 2009) AA 8539 18% 2.000 71.18 142.36 0.00 13 11610M53M00 MOUNTING COMP,ENG RH AC 8708 28% 1.000 390.62 390.62 0.00 14 17878M75J00 MOUNTING RDTR SUPPORT LOWER AA 8708 28% 1.000 10.15 10.15 0.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-16 Invoice No. : 34/BI/20001226 Date : 17/02/2021 15:30:41 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20001803 Job Card Date: 23/12/2020 NEW DELHI Reg.No. : TEPP2700 Mileage : 82582 Pin:110015 SA Name : KAPIL SA(M) : 8685005551 State & Code : 07-DELHI Mobile : Model : MARUTI ALTO 800 GREEN EW Type : NA Fuel Trim : Chassis No.: 975036 Last Service : 10375 (30-07-17) Loyalty Card : NA Next Service Due : PMS 20 Cust GSTIN/UIN : 07AABCB5730G1ZZ PAN : AABCB5730G Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: DELHI 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 16 35121M53MA0 UNIT HEAD LAMP, RH AC 8512 18% 1.000 1733.05 1733.05 0.00 17 36410M75F30 LAMP ASSY,SIDE TURN SIGNAL AA 8512 18% 1.000 55.08 55.08 0.00 18 38402M53M00 INLET SET,WASHER WITH CAP AB 8708 28% 1.000 44.53 44.53 0.00 19 38410M66161 MOTOR & PUMP ASSY, WINDSHIELD AC 8708 28% 1.000 195.31 195.31 0.00 20 38450M53M00 .TANK ASSY, WASHER AC 8708 28% 1.000 97.65 97.65 0.00 21 38452M65L00 CAP AA 8708 28% 1.000 7.81 7.81 0.00 22 38453M75000 GROMMET AB 4016 28% 1.000 2.34 2.34 0.00 23 38459M53M00 .HOSE AB 8708 28% 1.000 9.37 9.37 0.00 24 38500M79FA0 HORN ASSY AA 8512 18% 1.000 203.38 203.38 0.00 25 41069M53M21 STRUT SETFR SUSP RH AC 8708 28% 1.000 2386.71 2386.71 0.00 26 43130M66L00 VALVE (TR413) AD 8481 18% 1.000 23.72 23.72 0.00 27 43210M53M00-09L WHEEL COMP AC 8708 28% 1.000 722.65 722.65 0.00 28 43440M79F00 BEARING FRONT WHEEL AC 8482 18% 1.000 631.35 631.35 0.00 29 44101M53M00 SHAFT ASSY,FRONT DRIVE,R AC 8708 28% 1.000 3492.18 3492.18 0.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-16 Invoice No. : 34/BI/20001226 Date : 17/02/2021 15:30:41 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20001803 Job Card Date: 23/12/2020 NEW DELHI Reg.No. : TEPP2700 Mileage: 82582 Pin:110015 SA Name : KAPIL SA(M) : 8685005551 State & Code : 07-DELHI Mobile : Model : MARUTI ALTO 800 GREEN EW Type : NA Fuel Trim : Chassis No.: 975036 Last Service : 10375 (30-07-17) Loyalty Card : NA Next Service Due : PMS 20 Cust GSTIN/UIN : 07AABCB5730G1ZZ PAN : AABCB5730G Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: DELHI 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 31 45200M79F11 ARM ASSY FRONT SUSPENSION AC 8708 28% 1.000 417.96 417.96 0.00 32 48810M84030 END COMP,STEERING TIE ROD AD 8708 28% 1.000 191.40 191.40 0.00 33 57300M53M00 PANEL COMP,FRONT HOOD AA 8708 28% 1.000 2018.75 2018.75 0.00 34 57410M79G00 HINGE COMP FRT HOOD,RH AA 8708 28% 1.000 67.18 67.18 0.00 35 57420M79G00 HINGE COMP FRT HOOD, LH AA 8708 28% 1.000 67.18 67.18 0.00 36 57611M53M02 PANELFR FENDERR AA 8708 28% 1.000 742.18 742.18 0.00 37 58111M53M00 BRACE,LAMP SUPPORT,R AA 8708 28% 1.000 167.18 167.18 0.00 38 58210M53MB0 CROSSMEMBER COMP,FRONT AB 8708 28% 1.000 1375.00 1375.00 0.00 LOWER 39 58230M53M00 MEMBER COMP,HOOD LOCK AA 8708 28% 1.000 252.34 252.34 0.00 40 58251M53M00 MEMBER,LAMP SUPPORT,R AA 8708 28% 1.000 256.25 256.25 0.00 41 58310M53M00 PANEL COMP,FENDER APRON,R AA 8708 28% 1.000 1379.68 1379.68 0.00 42 58313M53M00 EXTENSION,APRON FR REINF,R AA 8708 28% 1.000 58.59 58.59 0.00 43 58318M53M00 BRACKET,FR FENDER LWR,R AA 8708 28% 1.000 28.90 28.90 0.00 44 58330M53M00 EXTENSION COMP,APRON,R AA 8708 28% 1.000 186.71 186.71 0.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-16 Invoice No. : 34/BI/20001226 Date : 17/02/2021 15:30:41 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20001803 Job Card Date: 23/12/2020 NEW DELHI Reg.No. : TEPP2700 Mileage: 82582 Pin:110015 SA Name : KAPIL SA(M) : 8685005551 State & Code : 07-DELHI Mobile : Model : MARUTI ALTO 800 GREEN EW Type : NA Fuel Trim : Chassis No.: 975036 Last Service : 10375 (30-07-17) Loyalty Card : NA Next Service Due : PMS 20 Cust GSTIN/UIN : 07AABCB5730G1ZZ PAN : AABCB5730G Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: DELHI 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 46 63145M75J00 RETAINER,DOOR HINGE AA 8708 28% 2.000 13.28 26.56 0.00 47 64111M53M01-P11 PANEL, A-PILLAR RH AA 8708 28% 1.000 2703.12 2703.12 0.00 48 68001M53M00 PANEL ASSY,FRONT DOOR,R AC 8708 28% 1.000 4210.93 4210.93 0.00 49 69310M63J00 HINGE COMP,FRONT DOOR NO.1 AA 8708 28% 1.000 97.65 97.65 0.00 50 69330M58J00 HINGE COMP,FRONT DOOR LOWER,R AA 8708 28% 1.000 111.71 111.71 0.00 51 71711M53MA0-5PK BUMPER, FRONT AC 8708 28% 1.000 1039.06 1039.06 0.00 52 71731M53M00 HOLDER,FR BUMPER SIDE,R AA 8708 28% 1.000 42.18 42.18 0.00 53 71732M53M00 HOLDER,FR BUMPER SIDE,L AA 8708 28% 1.000 42.18 42.18 0.00 54 71741M53MA0-5PK NET, FRONT BUMPER AD 8708 28% 1.000 875.00 875.00 0.00 55 72321M53M00 LINING,FRONT FENDER,R AA 8708 28% 1.000 175.78 175.78 0.00 56 72350M79F01 BRACKET COMP,STABILIZER,R AA 8708 28% 1.000 175.78 175.78 0.00 57 72380M53M01-5PK GARNISH COMP,COWL TOP SID AA 8708 28% 1.000 50.00 50.00 0.00 58 73811M53M00-U3J COVER,STRG COLUMN HOLE AA 8708 28% 1.000 78.12 78.12 0.00 59 77811M63J00-0PG EMBLEM,MARK(S) AA 8708 28% 2.000 61.71 123.42 0.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-16 Invoice No. : 34/BI/20001226 Date : 17/02/2021 15:30:41 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20001803 Job Card Date: 23/12/2020 NEW DELHI Reg.No. : TEPP2700 Mileage: 82582 Pin:110015 SA Name : KAPIL SA(M) : 8685005551 State & Code : 07-DELHI Mobile : Model : MARUTI ALTO 800 GREEN EW Type : NA Loyalty Card : NA Fuel Trim : Chassis No.: 975036 Last Service : 10375 (30-07-17) Cust GSTIN/UIN : 07AABCB5730G1ZZ PAN : AABCB5730G Next Service Due : PMS 20 Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: DELHI 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 61 83401M68K12 REGULATOR ASSY,FRONT WINDOW,R AA 8708 28% 1.000 462.50 462.50 0.00 62 83811M53M00 WEATHERSTRIP,FRONT DOOR OUT,R AA 8708 28% 1.000 137.50 137.50 0.00 63 84511M53M00 GLASS,WINDSHIELD AA 7007 18% 1.000 2272.03 2272.03 0.00 64 84611M53M00 MOLDING,WINDSHIELD AA 8708 28% 1.000 229.68 229.68 0.00 65 84617M55R00 SPACER,WINDSHIELD GLASS AA 4016 18% 2.000 38.13 76.26 0.00 66 84641M53M00 WEATHERSTRIP,FRONT DOOR AA 8708 28% 1.000 363.28 363.28 0.00 OPNG,R 67 84701M53M10-5PK MIRROR ASSY,OUT REAR VIEW,R AA 7009 18% 1.000 937.28 937.28 0.00 68 90900M10164 DISTILLED WATER 8708 28% 2.000 19.53 39.06 0.00 69 99000M24120-290 SEALENT SET AA 3214 18% 1.000 553.38 553.38 0.00 70 99000M24120-290 SEALENT SET AC 3214 18% 1.000 605.93 605.93 0.00 71 99000M24120-389 COMPRESSOR OIL(250ML)DENSO AA 3403 18% 0.200 606.77 121.35 0.00 8(R134A) 72 99000M24120-551 COOLANT (SG) NON AMINE AA 3820 18% 1.300 222.88 289.74 0.00 73 99000M24120-883 AIR DRYING SEALER ( PU 92) AC 3506 18% 1.000 673.72 673.72 0.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-16 Invoice No. : 34/BI/20001226 Date : 17/02/2021 15:30:41 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC20001803 Job Card Date: 23/12/2020 NEW DELHI Reg.No. : TEPP2700 Mileage: 82582 Pin:110015 SA Name : KAPIL SA(M) : 8685005551 State & Code : 07-DELHI Mobile Model : MARUTI ALTO 800 GREEN EW Type : NA Fuel Trim : Chassis No.: 975036 Last Service : 10375 (30-07-17) Loyalty Card : NA Cust GSTIN/UIN : 07AABCB5730G1ZZ PAN : AABCB5730G Next Service Due : PMS 20 Service type: BODY REPAIR Ins.Comp. : BAJAJ Place of Supply: DELHI 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 75 990J0M999H4-050 AC CAN GAS (450GM) SRF AA 2903 18% 2.000 377.11 754.22 0.00 76 99999M75W90-TTL MGGO(75W90)-TOTAL AB 2710 18% 2.300 338.13 777.70 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF9993 PAINTING CHARGES 998729 15,100.00 2 PB09R0 WINDSHIELD GLASS (ADHERED TYPE) 998729 1,112.50 3 ZF9992 DENTING CHARGES 998729 10,400.00 Sub Total Amount 37,874.75 0.00 26,612.50 reg no=HR12AG1912 IGST @ 28% 7,783.71 IGST @ 18% 1,813.66 4,790.25 Tax Collection at Source @ 0.075% : 35.59 For JAGMOHAN MOTORS PVT LTD Sub Total Amount 47,507.71 0.00 31,402.75 Net Bill Amount (Rounded) 78,910.00 Authorised Signatory Rupees Seventy Eight Thousand Nine Hundred And Ten Only Dealer GSTIN : 06AAACJ7090E1ZP * 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. : GP20002159 Date : 17-FEB-21 15:30:54 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : ALT0 800 CNG JC20001803 BI/20001226 17-FEB-21 78,910.00 Tech.Name :RAJESH KUMAR Reg.No.: TEPP2700 Customer Signature Accountant Signature JC20001803 ---PAGE END---