ustoiner Na aAlian( 40-4084th ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Read ANMEDABAI P80006 Job Card Retail-Tax Invoice State Cod IRN: Oa530149184b67f2943be70f229fda83c8ba64b90f9b057a6399018b179712ed Mobile GSTIN/UIN Srl. D Par Customer Name & Address ID:02-15 Date : 25/06/2024 15.34:14 Invoice No.:3/Bl/24000254 Bajaj Allianz General insurance Co.Ltd 402408,4 th FloorTurquoise Bldg.Near Panchvati CircleCG Job Card Date 17/06/2024 Job Card No.:JC24002396 Road Mileage:21386 AHMEDABAD Reg.No.:GJ08CR8489 Pin:380006 SA Name : HARSHKUMAR JAYANTILAL PANC SA(M):7383475538 State &Code: 24-GUJARAT Model :MARUTI WAGON R VXI 1L EW Type:NA Last Service 8181(05-02-24) Mobile Chassis No.:691802 Next Service Due PMS 20 Loyalty CardNA Fuel Trim Service type: BODY REPAIR Cust GSTIN/UIN24AABCB5730G1Z3 PAN:AABCB5730G Ins.Comp. Place of SupplyGUJARAT BAJAJ Surveyor Name: Srl. Part Number Rate Taxable Tax Paid Labour Description Batch HSN/SAC Tax Qty. Amount Amount Charges orts 3landed Repairs-Others/Suggested Jobs 09148 M06022 NUT 28% 2.000 7.03 14.06 0.00 AD 87089900 2 09409 M07L01 6.25 62.50 0.00 CLIP AE 87082900 29% 10.000 3 37736 M69R00 BRACKET,PARK SNSR 67.96 135.92 0.00 AA 87089900 28% 2.000 63481 M69R00 332.03 332.03 0.00 4 PANELWHEEL HOUSE OUTERR M 87082900 28% 1.000 5 64111 M69R00-P31 2339.84 2339.84 0.00 PANL QUARTER RH AF 87089900 28% 1.000 71811 M69R00-SPK 4773.43 4773.43 0.00 6 BUMPERREAR AF 87081090 29% 1.000 28% 1.000 74.21 74.21 0.00 71821 M69R00 HOLDERRR BUMPER SIDER AD 87089900 71822 MG9R00 29% 74.21 74.21 0.00 8 HOLDERRR BUMPER SIDEL AD 87089900 1,000 3.90 15.60 0.00 9 8741 BM84020 DOOR GUARD AC 87089900 28% 4.000 7.81 7.81 0.00 10 90900 M10184 CLEANING CLOTH 87089900 28%, 1.000 1182.20 118.22 0.00 77 99000 M24120-958 BODY FILLER(3KG LIGHTWEIGHT AF 32141000 10% 0.100 49.15 49.15 0.00 12 99000 M24121-059 MASKING TAPE (24 MM*30 MTRS) AF 48114100 18% 1.000 AF 18% 1.000 720.33 720.33 0.00 13 99000 M24121-078 AIR DRYING SEALANT 32141000 AA 18% 1.000 71.18 71.18 0.00 14 990 JOM999GR-370 AROMA PPERFUME ROSE 33074900 Xtreme Exterior Microfibre Cloth AC 5% 1.000 180.95 180.95 0.00 ---PAGE END--- ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER Job Card Retail-Tax Invoice Customer Name&Address: ID 02-15 Involce No.:3/Bl/24000254 Date :25/06/2024 15:34:14 Bajaj Allianz GeneralInsurance Co. Ltd 402 -408, 4th Floor,Turquoise Bldg. Near Panchvati CircleCG Job Card No.JC24002396 Job Card Date: 17/06/2024 Road AHMEDABAD Reg.No.:GJ08CR8489 Mileage:21386 SA Name : HARSHKUMAR JAYANTILAL PANC SA(M):7383475538 Pin:380006 State&Code:24-GUJARAT Model:MARUTI WAGON R VXI 1L EW Type:NA Mobile Chassis No.:691802 Last Service :8181 05-02-24) Fuel Trim: Next Service Due:PMS 20 Loyalty CardNA Service typeBODY REPAIR Cust GSTIN/UIN:24AABCB5730G1Z3 PAN:AABCB5730G Place of SupplyGUJARAT Addre: Ins.Comp. BAJAJ alInsul Surveyor Name : Turqur Sri.Part Number Description Batch HSN/SAC Tax Qty. Rate Taxable TaxPaid Labour Amount Amount Charges Labour GUJAI Demanded Repairs-Others/Suggested Jobs NA02RO REAR BUMPER 998729 336.00 2 ZF38P0 PANEL, QUARTER OUTER RH PAINTING 998729 2,976.00 IAABI REAR BUMPER PAINTING 998729 3 ZF28P0 4,121.00 ZF38D0 PANEL QUARTER OUTER RH DENTING 998729 2,000.00 s/Si Sub Total Amount 8,969.44 0.00 9,433.00 CGST @ 14% 1,096.14 SGST @ 14% 1,096.14 CGST @ 9% 86.30 848.97 SGST @9% 86.30 848.97 FOr TANU MOTORSPVETD. CGST @ 2.5% 4.52 SGST @ 2.5% 4.52 Authorjsed Signatory Tax Collection at Source 11.33 Dealer GSTIN:24AACCT60239]ZY Sub Total Armount 11,354.69 0.00 11,130.94 Net Bill Amount (Rounded) 22,486.00 Rupees Twenty Two Thousand Four Hundred And Eighty Six Only ** This is a system generated soft copy of invoice for insurance company records. I acknowledge that the jobs/repalrs/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 dition.I further authorize this workshop to contact me by call or sms to inform me with any other informatlon In relation tomy Customer Signature Mobile No.: de. Gate Pass Job Card No. Bill.No. Bill Date Amount GP No. GP24002536 Date25-JUN-24 15:34:23 JC24002396 BI/24000254 25-JUN-24 22,486.00 Cust Name Bajaj Allianz General Insurance Co.L Model : NEW WAGON R TL PETROL 0.00 JC24002396 BR/24002526 25-JUN-24 Tech.Name :MOHANMADFAIZ INAYATBHAI Reg.No.:GJ08CR8489 Customer Signature Accountant Signature JC24002396 ---PAGE END---