ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail - Tax Invoice

IRN : 638dcfd86e6089c59c87082ea21f863c4ad0b3fa8feab7619d0ced21a48ebc19

Customer Name & Address : ID : 01-222 Invoice No. : 4/BI/23000189 Date : 10/06/2023 14:06:46
NATIONAL INSURANCE COMPANY LIMITED
1-B, GOVINDPURI Job Card No. : JC23001265 Job Card Date: 06/06/2023
HARIDWAR
Reg.No. : UK15D0152 Mileage : 906
Pin:249403
State & Code : 05-UTTARAKHAND SA Name : VIPIN KUMAR SA(M) : 9760889249
Mobile : Model :MARUTI ALTO K10 VXI+ 1L EW Type : III
Loyalty Card : NA Fuel Trim : Chassis No. :
138925 Last Service : 408 (22-03-23)
Next Service Due : 2ND FREE SERVICE
Cust GSTIN/UIN : 05AAACN9967E1Z9 PAN : AAACN9967E Service type: BODY REPAIR
Ins.Comp. : NIC
Place of Supply: UTTARAKHAND
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 01550M0616A BOLT AD 73181500 28% 2.000 3.90 7.80 0.00
2 03141M05165 .SCREW AC 73181500 18% 4.000 3.38 13.52 0.00
3 09148M06022 NUT AC 87089900 28% 2.000 6.25 12.50 0.00
4 09160M06027 WASHER (6.5X20X1.2) AA 73182200 18% 4.000 1.69 6.76 0.00
5 09409M08006 CLIP AC 87089900 28% 8.000 3.90 31.20 0.00
6 57611M53T00 PANEL,FRONT FENDER,R AA 87089900 28% 1.000 1179.68 1179.68 0.00
7 71711M53T00-5PK BUMPER,FRONT AA 87089900 28% 1.000 921.87 921.87 0.00
8 71731M53T00 HOLDER,FR BUMPER SIDE,R AA 87089900 28% 1.000 46.87 46.87 0.00
9 77811M58J10 EMBLEM (S) MARKS,E3 AD 87089900 28% 1.000 50.78 50.78 0.00
10 99000M24121-136 PAPER FLOOR MAT (20X15) AD 48209090 18% 2.000 1.69 3.38 0.00
11 990J0M999H7-060 DOUBLE SIDE ADHESIVE TAPE AA 39199090 18% 0.500 135.59 67.80 0.00
Labour
Demanded Repairs-Others/Suggested Jobs
1 NC01R0 FRONT FENDER PANEL (ONE SIDE) 998729 311.50
2 NA01R0 FRONT BUMPER 998729 311.50
 ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail - Tax Invoice

Customer Name & Address : ID : 01-222 Invoice No. : 4/BI/23000189 Date : 10/06/2023 14:06:46
NATIONAL INSURANCE COMPANY LIMITED
1-B, GOVINDPURI Job Card No. : JC23001265 Job Card Date: 06/06/2023
HARIDWAR
Reg.No. : UK15D0152 Mileage : 906
Pin:249403
State & Code : 05-UTTARAKHAND SA Name : VIPIN KUMAR SA(M) : 9760889249
Mobile : Model : MARUTI ALTO K10 VXI+ 1L EW Type : III
Loyalty Card : NA Fuel Trim : Chassis No. : 138925 Last Service : 408 (22-03-23)
Next Service Due : 2ND FREE SERVICE
Cust GSTIN/UIN : 05AAACN9967E1Z9 PAN : AAACN9967E Service type: BODY REPAIR
Ins.Comp. : NIC
Place of Supply: UTTARAKHAND
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
3 ZF16P0 PANEL FRONT FENDER RH PAINTING 998729 2,800.00
4 ZF27P0 FRONT BUMPER PAINTING 998729 3,700.00

Sub Total Amount : 2,342.16 0.00 7,123.00

NIC @MR.SACHIN JI @ CL.NO-
CGST @ 14% : 315.10
46220031231194346680
SGST @ 14% : 315.10
CGST @ 9% : 8.23 641.08
SGST @ 9% : 8.23 641.08
For SHAKUMBARI AUTOMOBILES PVT LTD
Sub Total Amount : 2,988.82 0.00 8,405.16
Authorised Signatory Net Bill Amount (Rounded) : 11,394.00
Dealer GSTIN : 05AAGCS2020M1ZJ Rupees Eleven Thousand Three Hundred And Ninety Four Only
** This is a system generated soft copy of invoice for insurance company records.

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
inform me with any other information in relation to my vehicle.
Mobile No.:

Gate Pass
GP No. : GP23001285 Date : 10-JUN-23 14:07:11 Job Card No. Bill.No. Bill Date Amount
Cust. Name : NATIONAL INSURANCE COMPANY Model : ALTO K10C JC23001265 BI/23000189 10-JUN-23 11,394.00
Tech. Name : TAUSEEF MAU Reg.No. : UK15D0152

Customer Signature Accountant Signature

Created By: ANUJ KUMAR GARG