ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER
                                                                                                                                   Job Card Retail - Tax Invoice
           Customer Name & Address :                                                    ID :1725633779                                                              Invoice No. : 001/BR/20000203                                                                 Date : 15/06/2020 11:20:44
           BAJAJ ALLIANZ GENERAL INSURANCE COMPANY LTD
                3rd FLOOR,JMD REGENT, PLAZA SIKANDERPUR,MAHRAULI,                                                                                                Job Card No.: JC20000188                                                          Job Card Date: 12/06/2020
           ROAD                                                                                                                                                           Reg.No. : DL3CAH3278
           GURGAON                                                                                                                                                                                                                                            Mileage : 55000
           State & Code : 06-HARYANA                                                                                                                                    SA Name : PRASHANT GUPTA                                                                  SA(M) :8860772381
          Mobile       :                 7290080541                                                                                                                           Model : MARUTI WAGON R VXI BS EW Type : NA
           Loyalty Card : NA                                                                  Fuel Trim :                                                            Chassis No. : 829818                                                            Last Service : 10031 (06-01-16)
           Cust GSTIN/UIN : 06AABCB5730G1Z1                                                                                                                          Service type: BODY REPAIR                                                        Next Service Due : PMS 20
                                                                                                                                                               Place of Supply: HARYANA
           Srl. Part Number                                      Description                                                       Batch HSN/SAC Tax                                        Qty.                             Rate                   Taxable                       Tax Paid                            Labour
                                                                                                                                                                                                                                                     Amount                         Amount                         Charges
           Parts
           Demanded Repairs-Others/Suggested Jobs
           1           01550M0825A                               BOLT                                                                              7318                        18%             5.000                             3.38                           16.90                           0.00
           2           09409M08L01                               CLIP                                                                              8708                        28%             5.000                             2.34                           11.70                           0.00
           3          33920M67LD2                                CONTROLLER ASSY, EPI-AT-A/C                                                       9032                        28%             1.000                       8891.40                         8891.40                              0.00
           4          58440M84000                                BRACKET, BATTERY                                                                  8708                        28%             1.000                           72.65                           72.65                            0.00
           Labour
           Demanded Repairs-Others/Suggested Jobs
            1         ZF9993                                     PAINTING CHARGES                                                                  998729                                                                                                                                                                 4,000.00
           Recommendations :                                                                                               Sub Total Amount                                                                                                      8,992.65                                    0.00                        4,000.00
                                                                                                                           CGST @ 14%                                                                                                             1,256.61
                                                                                                                           SGST @ 14%                                                                                                             1,256.61
                                                                                                                            CGST @ 9%                                                                                                                     1.52                                                              360.00
                                                                                                                           SGST @ 9%                                                                                                                     1.52                                                               360.00
                                                For SOMESH AUTOMOBILES
                                                                                                                            Sub Total Amount                                                                                                   11,508.91                                     0.00                        4,720.00
                                                                  Authorised Signatory                                      Net Bill Amount (Rounded)                                                                                                                                                              16,229.00
                                                                                                                                                                                                               :
             Dealer GSTIN : 06ADPFS6040L1ZM
                                                                                                                                   Rupees Sixteen Thousand Two Hundred And Twenty Nine 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.                    :GP20000193                                                              Date : 15-JUN-20 11:22:55                                                                   Job Card No.                        Bill.No.                        Bill Date                                Amount
           Cust.Name :M/S BAJAJ ALLIANZ GENERAL INS Model : WAGON-R NEW                                                                                                                                   JC20000188                          BR/20000203                     15-JUN-20                                  16,229.00
           Tech. Name :OM PRAKASH                                                                             Reg.No.: DL3CAH3278
             Customer Signature                                                                                                                                                                             Accountant Signature
                                                                                                                                                                                                                                                                                         JC20000188
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