ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail-Tax Invoice

IRN
Of52eaf2a073062304f137146771571c6ac6c80e3bf673615e558b6d4db1b245

Customer Name & Address ID 02-21 InvoiceNo. 2/B1/22000134

Bajaj Allianz General Insurance Co. Ltd, Date 30/04/2022 1449 21
SCO 156-159,2nd floor,
CHANDIGARH
Sector 9-C Job Card No.; JC21016236 Job Card Date: 22/03/2022
Pin:160009 Reg.No. HR920318 Mileage 45285
State & Code 04-CHANDIGARH SA Name: NAVJOT SINGH SA(M) : 9812423332
Mobile Model MARUTI SWIFT VXI EW Type: NA
Loyalty Card NA Fuel Trim: Chassis No.: 325125 Last Service: 44278 (13-02-22)
Cust GSTIN/UIN 04AABCB573062Z4 PAN: AABCB5730G Service type: BODY REPAIR Next Service Due: PMS 40
Ins.Comp. BAJAJ
Place of Supply: CHANDIGARH

Surveyor Name:
Srl. Part Number Description Batch HSN/SAC Tax Taxable
Qty. Rate Tax Paid Labour
Amount Amount Charges
Parts
Demanded Repairs-0thers/Suggested Jobs
0155OM0616A BOLT AA 73181500 28% 10.000 1.56 15.60 0.00
01550M0616A BOLT AA 73181500 L87% 8.000 1.56 12.48 0.00
03141 MO5165 SCREW AA 73181500 18% 10.000 1.69 6. 90 0.00
09409M07LO1 CLIP AA 87082900 28% 0.000 2.34 163.2 30 0.00
09409M08006 CLIP AA 87089900 28% 10.000 2.34 23. 0.00
11910M55ROO ROD COMP, ENG RR TRQ AD 87088000 28% 1.000 667.96 667.996 0.00
11941 M68PO0 BRACKET, ENG RR TRQ ROD AA 87089900 28% 1.000 7.96 417.96 O.00
1411OM68P00 MANIFOLD, EXH AF 87089200 28% 1.000 14152.34 14152.34 0.00
14271 M73KO00 STIFFENER, EXH MANF AC 87089900 28% 1.000 78.12 78.1 2 o 00
14272M73KAO STIFFENER, EXH MANF NO.2 AC 87089900 28% 1.000 82.03 82.03 0.00
17100M68PO0 FAN ASSY, ENG CLG AD 87089100 28% 1.000 3175.78 3175.78 000
17700M68PO0 RADIATOR ASSY AE 87089100 28% 1.000 2207.03 2207.0 0.00
3 17854M68POO HOSE, RDTR OUTLET AD 40093100 18% 000 4.57 124.57 0.00
14 17931 M68PO0 TANK, WATER RESERVE AD 87089900 28% 1.000 191. 40 191.40
18213M68P00 SENSOR, OXYGEN AD 90318000 28% 1.000 1816.4 1816.40 000
 ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail- Tax Invoice

Customer Name & Address ID 02-21 InvoiceNo. 2/BI/22000134 Date 30/04/2022 144921
Bajaj Allianz General Insurance Co. Ltd,
sCO 156-159,2nd floor., Sector 9-C, Job Card No. JC21016236 Job Card Date 22/03/2022
CHANDIGARH Reg.No. HR920318
Pin:160009
Mileage 45285
SA Name: NAVJOT SINGH SA(M) 9812423332
State & Code 04-CHANDIGARH
Model MARUTI SWIFT VXI EW Type NA
Mobile
Chassis No. 325125 Last Service 44278 (13-02-22)
Loyalty Card: NA FuelTrim: Next Service Due PMS 40
Cust GSTIN/UIN 04AABCB5730G2Z4 PAN AABCB5730G Service type. BODY REPAIR
Ins.Comp. BAJAJ
Place of Supply: CHANDIGARH
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
16 18213M68P80 SENSOROXYGEN RR AB 90318000 28% 1.000 1632.81 1632.81 0 00

17 34112M56RAO GLASS, FRONT AC 87089900 28% 1.000 343.75 5

18 3510OM55R10 HEADLAMP ASSY,RH AD 85122010 18% 1.000 2330.50 2330 50

19 35300MSSR10 HEADLAMP ASSY,LH AD 85122010 18% I.000 2330.50 2330 50

CABLE ASsY.CONTACT COIL AE 85443000 18% I.000 898.30 898.30
20 37480M68P10
177.96 177.96 0.00
21 3758 5M66R00 SWITCH ASsSY, ESP OFF AB 85365090 18% I.000
swITCH ASSY,JD STOP OFF AB 85365090 28% 1.000 156.25 156.25 0.00
22 3778OM66ROO
TANK ASSY AF 87089900 28% 1.000 187.5 187.50 0.00
38450M56R30
HOSE AE 87089900 28% 1.000 43 23.43 0.00
38491M79020
2449.21 2449 21 0.00
3891OM54T30 cONTROLLER ASSY,A/B8 AC 87089900 28% 1.000
AE 28% 1.000 644.53 4.53 0.00
26 38930M55ROO SENSOR ASsy, FORWARD RIGHT 87089900
STRUT ASSY,FRONT SPNSN,R AE 87088000 28% 1.000 1316.40 1316.40
27 41601 M55ROO
41602M55R00 STRUT ASSY.FRONT SPNSN,L AE 87088000 28% 1.000 1316.40 1316.40

41710M55RO0 SUPPORT cOMP, FRONT STRUT AF 87088000 28% 2.000 289.06 578.12

MOUNT, STABILIZER BAR AE 40169990 18% 1.000 50.8 50.84

42431 M55RO0
 ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail - Tax Invoice

Custome Name & Address ID 02-21
Baa Allianz General lnsurance Co. Ltd.
InvolceNo. 2/B1/22000134 Date 30/04/2022 144921
SCO 156-159.2nd floor. Sector 9-C.
CHANDIGARH Job Card No. JC21016236 Job Card Date: 22/03/2022
Pin 160009 Reg.No.: HR920318 Mileage: 45285
State & Code 04-CHANDIGARH SA Name: NAVJOTSINGH SA(M) :9812423332
Mobile Model MARUTI
Loyalty Card NA Chassis No.: 325125
SWIFT VXI EW Type NA
Fuel Trim Last Service: 44278 (13-02-22)
Cust GSTIN/UIN 04AABCB5730G274 PAN AABCB5730G Service type' BODY REPAIR Next Service Due: PMS 40
Ins Comp BAJAJ
Place of Supply: CHANDIGARH
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
31 4321OM55RO0-09L WHEEL COMP(14X5J) AF 87087000 28% 1.000 753.9 753.90 0.00
32 44102Mb8PAO SHAFT ASSY, FRONT DRIVE LH AD 5750.00 0.00
87085000 28% 1.000 5750.00
33 45201M55ROO ARM ASSY, FRONT SUSPENSION, R AE 87089900 28% 1.000 1093.75 1093.75 0.00
34 45202M55ROO ARM ASSY, FRONT SUSPENSION, L AE 87089900 28% 000 1093.75 1093.75 0.00
35 4581OM68PO0 FRAME FRONT SUSPENSION AD 87089900 28% 1.000 4816.40 4816.40 0.00
36 481 50M55R20-BJC MODULE ASSY, AIRBAG AE 87089500 28% 1.000 3046.87 3046.87 0.00
37 56220M68PO1 SENSOR, FR WHEEL LH AF 87089900 28% 1.000 488.28 488.2 0.00
38 57711M55R10 PANELFRONT FENDERL AE 87089900 28% 1 000 1156.25 1156.25 0.00
39 58270M55ROO MEMBER COMP.FRONT BUMPER AE 87081090 28% 1.000 1304.68 1304.68 0.00
0 71711M55RO0-5PK BUMPER FRONT AE 87089900 28% 1.000 1714.84 1714.84 0.00
1 71721M52R00-5PK GRILLERADIATOR LOWER AF 87089900 28% 1.000 121I.09 1211.09 0.00
42 71731M55R00 HOLDER, FR 8UMPER SIDE, R AE 87089900 28% 1.000 50.78 50.78 0.00
43 71732M5SROO HOLDER, FR BUMPER SIDE, L AE 87089900 28% 1.000 50.78 50.78 0.00
44 71734M55RO0 HOLDER FR BUMPER FRONT, L AE 87089900 28% 1.000 71.87 71.87 0.00
45 71740M55RO0-C48 GRILLE COMP.RADIATOR UPPER AE 87081090 28% 1.000 882.81 882.81 0.00
 il

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 ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER
Job Card Retail- Tax Invoice
Customer Name & Address ID 02-21
Bajaj Allianz General Insurance Co. Ltd Invoice No. 2/BI/22000134 Date 30/04/2022 14:49:21
SCO 156 159.2nd floor, Sector 9-C,
CHANDIGARH Job Card No.; JC21016236
Job Card Date: 22/03/2022
Pin 160009 Reg.No. HR920318
State &Code: Mileage: 45285
04-CHANDIGARH SA Name : NAVJOT SINGH
Mobile SA(M):9812423332
Model MARUTI
Loyalty Card NA SWIFT VXI EW Type : NA
Fuel Trim Chassis No. 325125 Last Service: 44278 (13-02-22)
Cust GSTIN/UIN 04AABCB5730G2Z4 PAN AABC85730G Next Service Due:
Ins.Comnp. BAJAJ Service type BODY REPAIR PMS 40
Place of Supply: CHANDIGARH
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
60 77190M60M00-5PK GARNISH, FR PILLAR OUTER LH AB 87089900 28% 1.000 30.4 30.46 0.00
61 84901 M56R31-BHE BELT ASSY,FR,R AC 87082100 28% 1.000 3039.06 3039.06 0.00
62 84902M56R32-BHE BELT ASSY FR LH AB 87082100 28% 1.000 3183.59 3183.59 0.00
63 95310MS5ROO CONDENSER ASSY AE 84159000 28% 1.000 3417.96 3417.96 0.00
99000M24120-639 CoOLANT (GOLDEN YELLOW) AC 38200000 18% 1.000 233.05 233.05 0.00
b5 990 JOM999H4-050 AC CAN GAS (450GM) SRF AB 29034500 18% 1.000 394.06 394.06 0.00
Labour
Demanded Repairs-Others/Suggested Jobs
ZA64LO OUT SIDE LABOUR 998729
22.453.00

Sub Total Amount 79,974.87 0.00 22,453.00

HR920318 BAJAJ INDER DEV
IGST@ 28% 20,557.11
IGST@ 18% 1,180.19
Tax Collection at Source
4,041.54
101.70

For PANDIT AUTOMOBILES PVT. LTD. Sub Total Amount 1,01.813.87 0.00 26,494.54
Net Bill Amount (Rounded)
Authorised Signatory One Lakh Twenty Eight Thousand Three Hundred And
1,28,308.00
Rupees Eight Only
Dealer GSTIN 06AACCP2076Q1Z0 *This is a system generated soft copy of invoice for insurance company records.

Iacknowledge that the jobs/epairs/service carried out in my vehicle and the respective cost estimates were