ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID : 02-16 Invoice No. : 008/BI/20000008 Date : 21/05/2020 16:33:16 Bajaj Allianz General Insurance Co. Ltd, Block No. 04, 7th Floor, DLF Tower 15, Shivaji Marg Job Card No.: JC19017187 Job Card Date: 17/03/2020 NEW DELHI Reg.No. : HR38AA1983 Mileage : 17719 Pin:110015 SA Name : AMRIT PAL SINGH SA(M) : 9999145894 State & Code : 07-DELHI Mobile Model : MARUTI TOUR M CNG 1.5L EW Type : NA Loyalty Card : 33058763120 Fuel Trim : Chassis No.: 193720 Last Service : 1150 (18-11-19) Cust GSTIN/UIN : 07AABCB5730G1ZZ Next Service Due : 2ND FREE SERVICE 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 03141M05203 SCREW FR.FENDER LINING AA 7318 28% 8.000 1.95 15.60 0.00 2 09409M07L01 CLIP AA 3926 28% 8.000 2.34 18.72 0.00 3 35321M72R00 HEADLAMP ASSY,L AB 8512 18% 1.000 4720.33 4720.33 0.00 4 57711M73R10 PANEL,FRONT FENDER,L AB 8708 28% 1.000 1278.12 1278.12 0.00 5 71711M72R00-5PK BUMPER,FRONT AB 8708 28% 1.000 1921.87 1921.87 0.00 6 71731M73R00 HOLDER,FR BUMPER SIDE,R AB 8708 28% 1.000 47.65 47.65 0.00 7 71762M73R00-5PK COVER,FRONT FOG LAMP BEZEL,L AB 8708 28% 1.000 55.46 55.46 0.00 Labour Demanded Repairs-Others/Suggested Jobs 1 ZF9993 PAINTING CHARGES 998729 14,695.00 2 ZF9992 DENTING CHARGES 998729 700.00 Sub Total Amount 8,057.75 0.00 15,395.00 BAJAJ & HARINDER & CLAIM NO :- OC-20- CGST @ 14% 467.23 1101-1803-0004099 SGST @ 14% 467.23 CGST @ 9% 424.83 1,385.55 SGST @ 9% : 424.83 1,385.55 For T R SAWHNEY AUTOMOBILES PVT LTD Sub Total Amount 9,841.87 0.00 18,166.10 Authorised Signatory Deductibles(As per policy T & C) 500.00 Dealer GSTIN : 07AADCT9476H1ZU Net Bill Amount (Rounded) 27,508.00 Rupees Twenty Seven Thousand Five Hundred And Eight 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. : GP20000045 Date : 21-MAY-20 16:34:14 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : Next-Gen ERTIGA CNG JC19017187 BI/20000008 21-MAY-20 27,508.00 Tech. Name :SAHADAT Reg.No.: HR38AA1983 JC19017187 BC/20000045 21-MAY-20 500.00 Customer Signature Accountant Signature JC19017187 ---PAGE END---