ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

                                                                                       Job Card Retail - Tax Invoice
Customer Name & Address :                 ID:02-04
                                                                                                                 Invoice No. : 007/BI/20000204     Date :    24/08/2020
Bajaj Allianz General Insurance Co. Ltd,
4th floor, Commerce House, 7 Race Course Road                                            Job Card No.: JC20001382
                                                                                                                                                                 Job Card Date : 18/08/2020
INDORE
                                                                                                                     Reg.No. : MP12CA6499          Mileage      : 20467
Pin:452001
                                                                                                                   SA Name : AALOK SHARMA
State & Code :23-MADHYA PRADESH
                                                                                                                       Model : MARUTI DZIRE VDI            EW Contract No. : 198971717
Mobile
                                                                                                                Chassis No.: 517138                           MCP No. : AMC1900548046
Loyalty Card : NA                                        Fuel Trim :
                                                                                                               Service type : BODY REPAIR                  MCP Exp Date : 12/04/2021
Ins.Comp.    BAJAJ
                                                                                                           Place of Supply : MADHYA PRADESH
Cust GSTIN/UIN : 23AABCB5730G1Z5

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%   10.000                  3.12                31.20
2      43110M55R00           165/80R14 ECOPIA EP150 (BS)               AC          4011     28%    1.000              3034.37             3034.37
3      43130M66L10            VALVE, TIRE (TR414)                            AB          8481     18%    1.000                 22.88                22.88
4      43210M74L02-09L      WHEEL COMP(14X5J)                          AD          8708     28%    1.000               796.87               796.87
5      90900M10154            ADHESIVE : INSTANT FIX                                     8708     28%    3.000                  3.90                11.70
Labour
Demanded Repairs-Others/Suggested Jobs
1      ZF9992                    DENTING CHARGES                                         998729                                                                                                            450.00
2      ZF9993                    PAINTING CHARGES                                       998729                                                                                                          6,964.00













                                                                                    Sub Total Amount                                                               3,897.02                                   7,414.00
Bill paybeI by BAJAJ ALLIANZ GENERAL
                                                                                    CGST @ 14%                                                                         542.38
INSURANCE COMPANY LTD (BRAJLAL S/O
                                                                                   SGST @ 14%                                                                         542.38
GOPAL PATEL )
                                                                                    CGST @ 9%                                                                              2.06                                     667.26
                                                                                   SGST @ 9%                                                                              2.06                                     667.26
                              For NIMAR MOTORS PVT LTD                                                                                   :
                                                                                    Sub Total Amount                                                     :         4,985.90                                    8,748.52
                                        Authorised Signatory         Net Bill Amount (Rounded)                                                                                         13,734.00
                                                                                       Rupees Thirteen Thousand Seven Hundred And Thirty Four Only
 Dealer GSTIN : 23AACCN9368D1ZG

 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       (Customer Signature)                 Mobile No.:
to inform me with any other information in relation to my vehicle.
                                                                                                           Gate Pass
GP No.        : GP20001441                              Date : 24-AUG-20 18:30:51                       Job Card No.       Bill.No.                Bill Date                 Amount
Cust. Name : Bajaj Allianz General Insurance C  Model : New Dzire Diesel                            JC20001382         BI/20000204           24-AUG-20                    13,734.00
Tech. Name :YOGESH HIRODKAR                   Reg No.: MP12CA6499                                JC20001382         BR/20000546           24-AUG-20                           0.00

Customer Signature                                                                                                          Accountant Signature

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