ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-14 Invoice No. : 9/BI/21001715 Date : 27/02/2022 16:19:56 Bajaj Allianz General Insurance Co. Ltd, N-A/7,Irrigation Dept.., Employees Co-operative, Society,Chitragupt Job Card No.: JC21010105 Job Card Date: 08/02/2022 Nagar Reg.No. : BR24T3499 Mileage : 31922 PATNA Pin:800020 SA Name : AMIT KUMAR PANDEY SA(M) : 7360034662 State & Code : 10-BIHAR Model : ALTO K10 VXI AMT EW Type : NA Mobile : Chassis No.: 307571 Last Service : 30381 (31-10-21) Loyalty Card : NA Fuel Trim : Next Service Due : PMS 50 Service type: BODY REPAIR Cust GSTIN/UIN : 10AABCB5730G1ZC Place of Supply: BIHAR 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 35121M67P00 HEADLAMP ASSY RH AD 85122010 18% 1.000 1686.44 1686.44 0.00 2 35650M67P00 LAMP UNIT RR COMB RH AD 85122010 18% 1.000 974.57 974.57 0.00 3 69100M67P00 PANEL ASSY BACK DOOR AD 87089900 28% 1.000 3925.78 3925.78 0.00 4 71811M67P02-5PK BUMPER,REAR AD 87081090 28% 1.000 2253.90 2253.90 0.00 5 71821M53M00 HOLDER,RR BUMPER SIDE,R AD 87081090 28% 1.000 53.90 53.90 0.00 6 71822M53M00 HOLDER,RR BUMPER SIDE,L AD 87081090 28% 1.000 53.90 53.90 0.00 7 77811M58J10-0PG EMBLEM,REAR AD 87089900 28% 1.000 57.81 57.81 0.00 8 77832M67P00-0PG EMBLEM,REAR(ALTO K10) AE 87089900 28% 1.000 105.46 105.46 0.00 9 77841M75J10-0PG EMBLEM,VXI(CHROME) AD 87089900 28% 1.000 28.90 28.90 0.00 10 90900M10029 HORN THIMBLE 87089900 28% 2.000 2.34 4.68 0.00 11 99000M24120-460 DG SEALANT SET WITHOUT PRIMER AD 35069999 18% 1.000 614.40 614.40 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF63D0 Bumper repairing (FR) 998729 200.00 2 ZF27P0 FRONT BUMPER PAINTING 998729 3,146.00 3 NA02R0 REAR BUMPER 998729 133.50 4 ZF28P0 REAR BUMPER PAINTING 998729 2,992.00 5 ZF38P0 PANEL, QUARTER OUTER RH PAINTING 998729 2,384.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-14 Invoice No. : 9/BI/21001715 Date : 27/02/2022 16:19:56 Bajaj Allianz General Insurance Co. Ltd, N-A/7,Irrigation Dept., Employees Co-operative, Society,Chitragupt Job Card No.: JC21010105 Job Card Date: 08/02/2022 Nagar Reg.No. : BR24T3499 Mileage: 31922 PATNA SA Name : AMIT KUMAR PANDEY SA(M) : 7360034662 Pin:800020 State & Code : 10-BIHAR Model : ALTO K10 VXI AMT EW Type : NA Mobile : Chassis No.: 307571 Last Service : 30381 (31-10-21) Loyalty Card : NA Fuel Trim : Next Service Due : PMS 50 Service type: BODY REPAIR Cust GSTIN/UIN : 10AABCB5730G1ZC Place of Supply: BIHAR 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 7 ZF29P0 PANEL, BACKDOOR PAINTING 998729 3,146.00 8 ZF38D0 PANEL, QUARTER OUTER RH DENTING 998729 400.00 9 ZA50LO ALL ELECTRICALS CHECK-UP 998729 100.00 Sub Total Amount 9,759.74 0.00 14,059.00 CUSTOMER NAME-MR.MANEESH CGST @ 14% 907.82 TIWARI,SURVEYOR NAME-MR.SUJEET KR. SGST @ 14% 907.82 PANDEY,C.NO.-OC-22-2416-1801- CGST @ 9% 294.79 1,265.32 00004146,P.NO.-OG-22-9910-1801-0017417 SGST @ 9% : 294.79 1,265.32 For PEARL CARS(A UNIT OF VINDHYAVASIN Tax Collection at Source 12.18 Authorised Signatory Sub Total Amount : 12,177.14 0.00 16,589.64 Dealer GSTIN :10AADCV5253G1Z0 Net Bill Amount (Rounded) : 28,767.00 Rupees Twenty Eight Thousand Seven Hundred And Sixty Seven Only * This is a system generated soft copy of invoice for insurance company records. 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. : GP21010173 Date : 27-FEB-22 16:20:06 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : ALTO K10 JC21010105 BC/21008850 27-FEB-22 605.00 Tech. Name :RIYAJ AHMAD Reg.No.: BR24T3499 JC21010105 BI/21001715 27-FEB-22 28,767.00 Customer Signature Accountant Signature JC21010105 ---PAGE END---