ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail - Tax Invoice

IRN : 5727dcad603a94d1395a2d2894cfe78f8e44776b094452b69088c05789b128b9

Customer Name & Address : ID : 01-01 Invoice No. : 50/BI/24000362 Date : 11/10/2024 12:44:09
NATIONAL INSURANCE COMPANY LIMITED
Maruti Divisional Office - 10,, Tower C,Konnectus Building, Opp Job Card No. : JC24003566 Job Card Date: 06/10/2024
New Delhi Railway Stn
Reg.No. : UP16ED1732 Mileage : 15717
DELHI
Pin:110002 SA Name : VIVEK KUMAR SA(M) : 8882156046
State & Code : 07-DELHI Model : MARUTI BALENO SIGMA 1 EW Type : NA
Mobile : Chassis No. : 659920 Last Service : 9931 (30-06-24)
Next Service Due : PMS 20
Loyalty Card : NA Fuel Trim : Service type: BODY REPAIR
Cust GSTIN/UIN : 07AAACN9967E1Z5 PAN : AAACN9967E Place of Supply: DELHI
Ins.Comp. : NIC
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 AE 87089900 28% 10.000 4.68 46.80 0.00
2 03141M0516A SCREW AB 87089900 28% 10.000 1.56 15.60 0.00
3 09148M06022 NUT AE 87089900 28% 4.000 7.81 31.24 0.00
4 09409M08006 CLIP AD 87089900 28% 10.000 4.68 46.80 0.00
5 35100M55T02 HEADLAMP ASSY RH AB 85122010 18% 1.000 6042.37 6042.37 0.00
6 71711M55T00-5PK BUMPER,FRONT AD 87089900 28% 1.000 2269.53 2269.53 0.00
7 71712M55T00 CAP,FRONT BUMPER AA 87082900 28% 1.000 11.71 11.71 0.00
8 71731M55T00 HOLDER,FR BUMPR SIDE,RH AA 87089900 28% 1.000 46.87 46.87 0.00
9 71732M55T00 HOLDER,FR BUMPR SIDE,LH AA 87089900 28% 1.000 46.87 46.87 0.00
10 71811M55T00-5PK BUMPER,REAR AB 87089900 28% 1.000 3339.84 3339.84 0.00
11 71821M55T00 HOLDER,RR BUMPER SIDE,RH AA 87089900 28% 1.000 50.78 50.78 0.00
12 71822M55T00 HOLDER,RR BUMPER SIDE,LH AA 87089900 28% 1.000 50.78 50.78 0.00
13 990J0M999H7-060 DOUBLE SIDE ADHESIVE TAPE AA 39199090 18% 0.500 135.59 67.80 0.00
Labour
Demanded Repairs-Others/Suggested Jobs
 ORIGINAL FOR RECIPIENT/DUPLICATE FOR TRANSPORTER/TRIPLICATE FOR SUPPLIER

Job Card Retail - Tax Invoice

Customer Name & Address : ID : 01-01 Invoice No. : 50/BI/24000362 Date : 11/10/2024 12:44:09
NATIONAL INSURANCE COMPANY LIMITED
Maruti Divisional Office - 10,, Tower C,Konnectus Building, Opp Job Card No. : JC24003566 Job Card Date: 06/10/2024
New Delhi Railway Stn
Reg.No. : UP16ED1732 Mileage : 15717
DELHI
Pin:110002 SA Name : VIVEK KUMAR SA(M) : 8882156046
State & Code : 07-DELHI Model : MARUTI BALENO SIGMA 1 EW Type : NA
Mobile : Chassis No. : 659920 Last Service : 9931 (30-06-24)
Next Service Due : PMS 20
Loyalty Card : NA Fuel Trim : Service type: BODY REPAIR
Cust GSTIN/UIN : 07AAACN9967E1Z5 PAN : AAACN9967E Place of Supply: DELHI
Ins.Comp. : NIC
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 ZF9992 DENTING CHARGES 998729 800.00
2 ZF9993 PAINTING CHARGES 998729 24,385.00

Sub Total Amount : 12,066.99 0.00 25,185.00

claim no 39030031241194755593 sa NITESH
IGST @ 28% : 1,667.91
THAKURSARVRY N L SHARMA
IGST @ 18% : 1,099.83 4,533.30

Sub Total Amount : 14,834.73 0.00 29,718.30

For RANA MOTORS PVT LTD. Net Bill Amount (Rounded) : 44,553.00
Rupees Forty Four Thousand Five Hundred And Fifty Three Only
Authorised Signatory ** This is a system generated soft copy of invoice for insurance company records.
Dealer GSTIN : 09AABCR7691C1Z7
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 inform me with any other information in relation to my
vehicle. Customer Signature Mobile No.:

Gate Pass
GP No. : GP24003515 Date : 11-OCT-24 12:44:29 Job Card No. Bill.No. Bill Date Amount
Cust. Name : NATIONAL INSURANCE COMPANY Model : NEW BALENO JC24003566 BI/24000362 11-OCT-24 44,553.00

Tech. Name : KARAMVEER SINGH Reg.No. : UP16ED1732

Customer Signature Accountant Signature

Created By : SAURAV KAUSHIK