Govt.of Karnataka From P.W.G.

33(revised) Final Bill (See Para 215)

Final payment most invariable be made on forms printed on yellow paper which should not be used for intermediate Payments. For contractors : This form provides for (1) Advance payments and (2) payments for measured works the Form of account of secured advance which has been printed separately. Should be attached where be necessary.

T.S.No Division

Sub-Division

EE. KBJNL MBC Divn. CHIGARHALLI

Asst.Executive Engineer KBJNL.MBC. Sub-Divn.No.4 Chigarahalli

Cash book Vr.No.. Date

Name of work: Repairs to damaged lining of sl-1 of lat-1 and raising of embankment of BD-3of D-26 mbc Name of Agency: Serial No.of this bill Sri. Golayya.C.Hiremath, Contractor :- RA BILL FIRST & PART
No TWA No. 42/2012-13 Dt ; 22-05-2012 Rs. 912804.00 24-05-2012

No & Date of his previous bill for this work :Reference to agreement Agreement cost Supplimentary agreement No & Date :::-

Date of written order to commence work:Date of actual completion of work Date of Recording ::-

ACCOUNT OF WORKS EXECUTED Item of work (Ground under Sub-Heads and Sub-works of estimate 1 Quantity executed up to-date as per measurement Book 4 ----SEPARATE Total value of work done to date (A) Deduct value of work shown on previous Bill Net Value of work since previous bill (p) Figure (F) in words Rupees. : : : Payment of the basis Actual measurement Up-to date since Previous bill 5 SHEET ENCLOSED---

Unit 2

Rate 3

Remarks 6

When there are two or more entries in column a relating to each Sub-Head, of estimate they should in the case of works Accounts of which are kept by Sub-Heads, be totaled and the total recorded in column For posting the works abstract.

-2II CERTIFICATE AND SIGNATURE The measurements on which are based the entries in columns 1 to 6 Account. I were made by Sri. Shivanand on and re-recorded in Measurement Book No. Page No to Certified that in addition to and quite a part from quantities of works actually executed as shown in column 4 of account. I some work has actually been in connection with several items and the value of such work (after deducting there from the proportionate amount of secured advance if any ultimately recoverable on account of the quantities or materials used therein) is in no case less than the advance payments as per items of the memorandum if payments made as proposed to be made for the convenience of the contractor in anticipation of and subject to the results of the detailed measurement which will be made soon as possible. Date signature of Officer Preparing the Bill Date Signature of ___________Contractor This certificate must be signed by Sub-Division or Divisional Officer This Signature is necessary only when the Officer who prepares the bill is not the officer who authorized the payment in such a case the two Signatures are essentials. III. MEMORANDUM OF PAYMENTS Total Value of work actually measured asper account 1 to Column 5 Entry A Total up-to-date advance payment for work not yet measured as per details Given below Rs.___________Ps.__________(B) a) Total as per previous bill_______________ b) Since previous bill__________as per page ________of M.B.No. Total Up-to-date secured advances security of materials, as per Annexure (Form 26-A) Columns 8 Entry Total (Item 1 x 2 x 3)__________ Deduct amount withheld: a) Form previous bill as per last Running Account bill___________ Figure for works abstract b) From this bill__________________ _______________________ Rs.____________Ps.______ Balance I,e., Up-to-date payments________(Items 5) (K) Total amount of paymentsalready made as per entry (K) of last Running A/c. Bill No._______of ________forwarded with_________Account for________200 100% check measured by me

-3Payment now to be made as detailed below:a) By recovery of amounts creditable to this works Rs._____________Ps.______ b) Rs.______________Ps._________ ____________________________ ____________________________ Total 5 (b) x 8 (a)_______________________(G) b) c) By recovery of amounts creditable to the works On heads of accounts: By Cheque____________________ (b) 8 Total 8 (b) (c)

Pay Rs.________________(______________________Chequed)

Dated initials Disbursing Officer Received ( ) As above memorandum On account of this work

Dated_____________ Witness

(Amount in Varnacular) Stamp Full Signature of Contractors

Paid by me vide Cheque No._______________Dated____________200 Dated initials of persons actually making the payment. This figure should be tested to see that agrees with total of items 7 & 8.If the net amount to be paid is less them Rs. 10 and it cannot to included in cheque the payment should be made in cash. This entry being already suitable and the alteration attested by dated initials. Here specify the net amount payable vide item 8 This payees acknowledgement should be for the gross amount paid as per item 8 (i.e., a x b x c) Payments should be attested by some known person when the payees acknowledgement is given by a marks seal or thumb impression.

-4-

This space is reserved for any remarks which the disbursing officer or the Divisional Officer may wish to record in respect of the execution of the work, check of measurement or the state or Contractors accounts. Entries relating to each description of materials should be posted in the columns. First enter the difference between quantities in column 1 and 2 then show below this entry the quantities if any brought to site against which further advance has been authorized this entry being prefixed by the plussing family strik the total of two entries which will represent the total quantity on standing. Entries columns 8 show the money value of total quantities outstanding as per columns 3. Certified 1) That the plus quantities of materials shown in column 3 of the account above have actually been brought by the contractor to the work and the contractor has not previously received and advance on their security 2) That their materials or of on imserishable nature and are all equired by the contractor for use are the agreements in from 31 signed and executed by the contractor in accordance with paragraph 288 (a) of the Central public Works, Accounts Code is recorded in the Divisional Office. Dated Signature of the Officer preparing the Bill________________________________ Rank_______________________________ Dated Signature of Officer, authorized Payment____________________________ Rank_______________________________ These certificates must signed by the Sub-Divisional or Divisional Officer. This Signature is necessary only when the Office who prepares the bill is not the Officer who authorize the payment is such a case the two signature are essential.

(COPY)