APPENDIXFOR CONTRACTORS BILL FOR CIVIL ENGINEERING WORK.

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UNIT.
ORIGINAL/DUPLICATE.
1.
2.
3.
4.
5.
6.
7.
8.

On A/c. or final
:
Name of Work
:
Estimate No. of work
:
Agreement/Work Order No. & Date
:
Name of Contractor
:
Date of Commencement of the Work
:
Date of completion of the work as per Agreement/Work Order :
Extension of time granted, if any, with reference to the order :
i)
ii)
9. Actual Date of completion of the work :
10. Claims for work done from...to
QUANTITIES OF WORK
AMOUNTS
Description Paid for
Rate &
Paid as
Since
Upto
Since
of Work
Unit
as per
per last
last bill
date
last bill
last bill
bill
1
2
3
4
5
6
7

Remarks
Total
upto
date
8

Total
1
Brought
Forward

4
Deduct amount of
previous bill

5
Total

Gross amount of the

bill

Dated Signature of Contractor

Certified that the foregoing claims are correct and have been ascertained by actual measurement
by Sri.. on .. And recorded at page. If Measurement
Book No..and that no contractors measurement has been accepted and that the work
has been satisfactorily performed.

MEASUREMENT ACCEPTED

Signature of
Contractor

Signature of
Site Supervisor

Signature of
Project Engineer

Signature of
Project Manager
taking measurement

Received the sum of Rupees.. As per foregoing details

Rs.

Witness

STAMP

Contractor
Certified that there are no claims outstanding against the Contractor for this work of ..
on a/c. of materials supply, House Rent, Water Charges, Electric Energy supply etc.

Site Supervisor

Project Engineer

Project Manager

Certified that I have no claims outstanding against the Department for this work and the claim
preferred through this bill is in full and final settlement of my claim (*to be filled in case of final
bills)
Contractor.