ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail - Tax Invoice Customer Name & Address : ID :02-13 Invoice No. : 001/BI/20000294 Date : 23/08/2020 14:35:11 Bajaj Allianz General Insurance Co. Ltd, 6th Floor,Mani Square,No 164, Manicktala Main Rd,Mani Square, Job Card No.: JC20001639 Job Card Date: 22/08/2020 Premises No 41,Canal Circle Rd Reg.No. : WB10A8422 Mileage : 11060 KOLKATA Pin:700156 SA Name : SURAJIT KHATAI SA(M) : 9874793201 State & Code :19-WEST BENGAL Model : MARUTI CELERIO X ZXI EW Type : III Mobile : Chassis No.: 661694 Last Service : 10530 (19-08-20) Loyalty Card : NA Fuel Trim : Next Service Due : PMS 20 Service type: BODY REPAIR Cust GSTIN/UIN : 19AABCB5730G1ZU Place of Supply: WEST BENGAL 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 1 ZF9993 PAINTING CHARGES 998729 3,200.00 2 ZF9992 DENTING CHARGES 998729 350.00 Sub Total Amount 3,550.00 Less Discount 0.00 BAJAJ CLAIM NO- OC-21-2401-1825- CGST @ 9% 319.50 00000655, RH RR D0OR D/P SGST @ 9% 319.50 Sub Total Amount 0.00 4,189.00 For ONE AUTO PVT. LTD. Deductibles(As per policy T & C) : 1,000.00 Net Bill Amount (Rounded) 3,189.00 Authorised Signatory Rupees Three Thousand One Hundred And Eighty Nine Only Dealer GSTIN :19AABCO5642E1ZI * 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. : GP20001580 Date : 23-AUG-20 14:35:23 Job Card No. Bill.No. Bill Date Amount Cust. Name : Bajaj Allianz General Insurance Co. L Model : CELERIO JC20001639 BR/20001595 23-AUG-20 2,180.00 Tech.Name :ASHOK CHOWDHURY Reg.No.: WB10A8422 JC20001639 BI/20000294 23-AUG-20 3,189.00 Customer Signature Accountant Signature JC20001639 ---PAGE END---