ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID:02-39 Invoice No. : 001/BI/20000030 Date : 02/09/2020 16:34:12 Bajaj Allianz General Insurance Co. Ltd, 4TH FLOOR, HALWASIYA COMM, HOUSE, HABIBULLAH Job Card No.: JC20000590 Job Card Date: 02/09/2020 ESTATE, 11 MG MARG, HAZRATGANJ, Reg.No. : UP13BN0062 Mileage: 4895 LUCKNOW SA Name : SAHIB SINGH SA(M) : 9897606696 Pin:226001 State & Code :09-UTTAR PRADESH ModeI : MARUTI WAGON R VXI 1L EW Type : III Mobile Chassis No.: 255323 Last Service : 4088 (30-07-20) Loyalty Card : NA Fuel Trim : Next Service Due : 3RD FREE SERVICE 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 09409M07L01 CLIP AB 8708 28% 20.000 3.12 62.40 0.00 2 17100M69R00 FAN ASSY,COOLING AC 8708 28% 1.000 2421.87 2421.87 0.00 3 17700M69R00 RADIATOR ASSY AC 8708 28% 1.000 2363.28 2363.28 0.00 4 71711M69R00-5PK BUMPER,FRONT AD 8708 28% 1.000 1437.50 1437.50 0.00 5 71740M69R00-C48 GRILLE COMP,RADIATOR UPPER AC 8708 28% 1.000 875.00 875.00 0.00 6 71771M69R00-5PK GUIDE,GRILLE AIR AD 8708 28% 1.000 558.59 558.59 0.00 7 84702M69RA0-5PK MIRROR ASSY,OUT REAR VIEW,L AC 7009 18% 1.000 2038.13 2038.13 0.00 8 95310M69R00 CONDENSER ASSY AC 8415 28% 1.000 3070.31 3070.31 0.00 9 99000M24120-551 COOLANT (SG) NON AMINE AB 3820 18% 1.000 228.81 228.81 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF9993 PAINTING CHARGES 998729 4,500.00 2 ZF9992 DENTING CHARGES 998729 1,250.00 Sub Total Amount 13,055.89 0.00 5,750.00 CGST @ 14% 1,510.45 SGST @ 14% 1,510.45 CGST @ 9% 204.02 517.50 SGST @ 9% : 204.02 517.50 For GURUNANAK AUTOMOBILES Sub Total Amount 16,484.83 0.00 6,785.00 Authorised Signatory Net Bill Amount (Rounded) 23,270.00 Dealer GSTIN : 09AAUFG3984H1ZN Rupees Twenty Three Thousand Two Hundred And Seventy 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. : GP20000571 Date : 02-SEP-20 16:34:40 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : NEW WAGON R 1L PETROL JC20000590 BI/20000030 02-SEP-20 23,270.00 Tech. Name :ARSH MALIK Reg.No.: UP13BN0062 Customer Signature Accountant Signature JC20000590 ---PAGE END---