ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID : 02-26 Invoice No. : 1/BI/20001127 Date : 20/01/2021 18:33:05 Bajaj Allianz General Insurance Co. Ltd, 15/54-B,2ND FLOOR,, VIRENDRA SMRATI COMPLEX,, CIVIL Job Card No.: JC20004839 Job Card Date: 14/01/2021 LINES, Reg.No. : C29175 Mileage: 24338 KANPUR SA Name : ARUN KUMAR SHUKLA SA(M) : 9889035065 Pin:226001 State & Code :09-UTTAR PRADESH ModeI : MARUTI WAGON R VXI EW Type : II Mobile Chassis No.: C29175 Last Service : 19199 (03-08-20) Loyalty Card : NA Fuel Trim : Next Service Due : PMS 30 Service type: BODY REPAIR 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 Parts Demanded Repairs-Others/Suggested Jobs 1 35650M67L00 LAMP UNIT, RR COMBINATION RH AC 8512 18% 1.000 800.84 800.84 0.00 2 71711M67LA0-5PK BUMPER FRONT AC 8708 28% 1.000 1085.93 1085.93 0.00 3 71731M67L00 HOLDER, FR BUMPER SIDE RH AC 8708 28% 1.000 60.15 60.15 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF9992 DENTING CHARGES 998729 1,800.00 2 ZA54L0 AMC/SERVICE 998729 75.00 3 ZF9993 PAINTING CHARGES 998729 9,000.00 Sub Total Amount 1,946.92 0.00 10,875.00 CGST @ 14% 160.45 SGST @ 14% 160.45 CGST @ 9% 72.08 978.75 SGST @ 9% : 72.08 978.75 For CLASSIC MOTORS Sub Total Amount 2,411.98 0.00 12,832.50 Authorised Signatory Net Bill Amount (Rounded) 15,244.00 Dealer GSTIN : 09AFTPA6824L1ZX Rupees Fifteen Thousand Two Hundred And Forty Four Only * 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. : GP20004688 Date : 20-JAN-21 18:37:37 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : WAGON-R NEW JC20005037 BR/20001092 20-JAN-21 300.00 Tech. Name : IRSHAD . Reg.No.: C29175 JC20004839 BI/20001127 20-JAN-21 15,244.00 Customer Signature Accountant Signature JC20004839 ---PAGE END---