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LSCC Final Bill CC Form

Uploaded by V Venkata Narayana on Oct 20, 2013
Lumpsum Contract Final Bill CC Form.Full description
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DatedDate of actual
completion of work or
suppliesi)ii)iii)iv)v)1)
2)
L.S.C.C.Rs
II.
CERTIFICAT
ES AND
SIGNATURE
S.
P
Serial numbe
r of this Bill
No. and date
of his previo
us bill for th
i s w o r k Total Lu
mp sum amount as ent
ered in the Contractor'
s agreement … … ….
 … … … …Valueof
additionalworkdon
eup-to-
dateas"authorizede
xtras",thedetailsof
whicharegiveninthe
attached statement
in form P.W.D. VI-
74 ( Inner )… … … ..
.………………
Total
Valueofitemsactua
llymeasuredunderc
lause62(a)and(b)of
thepreliminaryspec
ificationof M.D.S.
S.formingpartofthe
contract,Thedetails
ofwhicharegivenint
heattachedstatemen
tinform P.W.D. VI-
74 ( Inner ) … … …
…………………
………………
Add :-Deduct :-
Reference to
Agreement
I. ACCOUNT
OF WORK E
XECUTED.
Total Value of work
done :-
Thedetailedmeasur
ementsofauthorize
dadditionsandalter
ationsmentionedab
oveandoftheitemso
fworks p e c i f i e d i n i
temIofAccountIo
flastbillarerecor
dedatpage…...…
ofM.B.No………
… . … a n d I a m satisfi
ed that they are
correct.D a t e d S i g n
a t u r e o f t h e Officer
preparing the
BillRankSignature of
Contractor
AEE, (R&B) Section
Icertifythatthewor
khasbeencomplete
dinaccordancewith
theprescribedspeci
ficationsandafterta
kingintoaccountallt
heauthorizedadditi
onsandalterationsa
ndthevalueofworkd
onedate,conformab
lywiththeitemof the
contractor's
agreement Rs. ___
___ ___ ___ ___ ___
___ ___ .
Dy. Exe Engineer
(R&B)[PTO
Name of The Work
FINAL BILL
( See Chapter X
Paragraph 303,
Andhra Pradesh P.W.
Account Code )( To
be used for Final
Payments to
contractors on Lump
sum Contract
)ValueasperLumps
umcontractitemsof
workcoveredbyact
ualmeasurements
vide item (iii) above.
Rs
No. PWA XXII
Date of
commencement of
workSchedule Docket
No.Cash Book
Voucher No.
LUMP SUM
CONTRACT
Name of The
Contractor
P.
Valueofitemsomitte
dtotheexecutedas"
AuthorizedOmissio
ns",thedetailsofwh
icharegiveninthefo
rmattachedstateme
ntintheform P.W.D.
VI-74 ( Inner ) …
vvn]

1i)ii)
3
(a)(b)
H
(c)))STAMP*#2
Deduct :-
RsP
III.
MEMORAND
UM OF
PAYMENTS.
RsP
DatedSignature
o f t h e O f f i c e r auth
orizing paymentBy
recovery of amounts
creditable to this work
……
GBy Cheque … …
………………
…………
Byrecoveryofamou
ntscreditabletoothe
rworksorheadsof ac
count … … … … …
……………
IV.
ACQUAINTA
NCE.
RupeesRankFull
Signature of
Contractor Paid by m
e Cash/ Cheque No….
…………………
dated… … … … …
… …*RupeesReceive
d (RsThe payee's
acknowledgement
should be for the
gross amount as per
item 3 (a+b+c)
Account III, both in
words and
figures.Dated#
WitnessPay (Rs
V.
REMARKS.
Total value of work
done up to date as per
" F " of Account I of
this
Bill.A m o u n t t o b e
withheldat……
……percentona
mountinitemIab
o v e a n d credited to
the head public works
Deposits.Uptodatein
termediatepayment
alreadymadeaccord
ingtoentry"K"ofAc
countIprevious Bill n
o…. … …
… Dated … … …
………
Payments now to be
made :
as above in full
settlement of all
demands on account
of the
contract.D a t e d i n i t i
alsofpersonactua
l l y making the
payment.Payment
should be attested by
some known person
when the payee's
acknowledgement is
given by mark, seal or
thumb impression.
vvn]
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