IPE Global Private Limited

28A, Patliputra Colony, Patna-800013, India

Phone: (+91 612) 3211861,
Website: www.ipeglobal.com
Service Certificate for Professional Fee & Other Fixed allowances Claim
Date of Submission

253

Consultant ID No.

Submitted To:
Team Leader,
IPE-Global, Patna
Name of the Consultant
(As per Bank Account):
Phone/Mobile No.:
Email ID :
Pan No.:
Agreement No.:
Name of Programme:
Designation:
Reporting Period From:
Duty Station or Place of Operation:
Block:
District:
Divisional / Sub Region:
Local Address:

S.No.
1
2

1
2

Type of days

No. of
Days

Total No. of days worked

Off days
Claims Professional fee & other fixed monthly allowances
Professional Fee:
Fixed Allowances:
Communication
Contingency
TOTAL
List of Activities Performed as per approved plan:

1
2
3
4
5
Signature of the Consultant:
Name of the Consultant:
Approved /Certified by Supervisor
Signature of the Supervisor:
Name of the Supervisor:

Dates