Schedule XLV- Form No. 16 C.P.W.A.

26/(1)
Running Account Bill
(C.P.W.A. CODE, Paragraph 10-2-10, 10-2-12, and 10-2-13)

Final Payments must invariable be made on forms printed on yellow paper which should not be used for intermediate
payment.
For Contractors-- This form provides for [1] Advance Payments, and [2] Payments for measured works. The form of
Account of Secured Advances, which has been printed separately should be attached where necessary.
Division --- Kalahandi Sub-Division ---Bhawanipatna
Cash Voucher No. --- Name of Contractor --- S.J.Singh
Bhambra Name of Work--- Construction of 40KL capacity OHT for
pws to village Gurjung under Bhawanipatna

Serial No. of
Bill--- 4th Running Account & Final Bill, No. and Date of his
Previous Bill for this work-- 3rd Running Account Bill Reference to
Agreement no. --- 66 of 2010/2011 , Date of written order to
commence the work---4.8.10 Date of actual completion of work--
2.10.10
1. Account of work Executed
Quantity
Item of work [grouped under executed up Payment on the basis of actual measurement

Remarks
"Sub-Heads" "Sub-Works" of unit Rate to date as per
estimate]
measurement up-to-date Since previous bill
book
1 2 3 4 5
Rs. p. Rs. p. Rs. p
1).Supplying all labour and
T&P for earth work excavation
in hard soil within 50 M initial
lead and 1.5 M initial lift
including rough dressing and
leveling etc., in foundation and
plinth as per direction of
Engineer –in-charge.

a)-1st depth of 1.50 mtrs 100cum 5800.00 33.22 1926.76 nill

b)-2nd depth of 1.50 mtrs 100cum 7500.00 22.15 1661.25 nill
2)-Supplying all materials,
labour and T&P for filling
foundation with sand watering
and ramming inside in the
plinth etc., all complete as per
direction of Engineer-in-charge

1cum 200.00 44.49 8938.00 nill

3)-Supplying all materials,
labour, T&P for providing
cement concrete (1:3:6) with
4cm size crusher broken HBG
metal with cost, conveyance,
royalty of materials including
watering, curing ramming etc.,
complete.

1 cum 3100.00 3.32 11288.00 nill

4)-Supplying all materials,
labour, T&P for providing
cement concrete M-20 for RCC
work with 12mm crusher
broken HBG chips and washed
and screened sand for RCC
works with cost, conveyance,
royalty of materials and
including watering curing etc.,
but excluding cost of MS rods
complete and as per direction
of Engineer-in-charge.

a)-Ground floor 1 cum 4200.00 17.38 72996.00 nill

b)-1stLift 1 cum 4500.00 3.59 16155.00 nill
c)-2 nd lift 1 cum 4800.00 3.13 15024.00 nill
d)-3rd Lift 1 cum 5000.00 25.26 126300.00 nill
5)-Labour for rigid and
smooth centering and
shuttering for RCC works
and dismantling them after
casting including cost of all
materials T&P etc.,
complete as per direction
of Engineer-in-charge

a)-Ground floor Sqm 320.00 80.30 25696.00 nill

b)-1stLift Sqm 380.00 35.09 11288.00 nill
c)-2 nd lift Sqm 380.00 19.22 7303.00 nill
d)-3rd Lift Sqm 450.00 210.02 94509.00 nill
6)-Supplying all materials
labour and T&P for cutting,
bending binding the
reinforcement and tying the
grills and placing in proper
position including cost of
binding wire of 18 to 20 gauge
all complete including cost of
MS tor rods of HYSD Fe415
grade and as per direction of
Engineer-in-charge.

Qntl. 5800.00 54.88 318304.00 nill

7)-Supplying all materials,
labour, T&P for providing
20mm thick cement plaster in
CM (1:3) brick masonary work
including cost, carriage and
taxes of all materials, watering
and curing etc complete as per
direction of Engineer-in-
charge.

Sqm 100.00 95.08 9508.00 9508.00

8)-Supplying all materials,
labour and T&P for providing
cement punning over
plastered surface including
cost and carriage of materials
and cost of labour etc., all
complete and as per direction
of Engineer-in-charge.

Sqm 15.00 43.98 653.70 653.70

9)-Supplying all materials,
labour and T&P for cement
washing two coats including
cost, carriage, taxes all
materials and cost of all
labour and T&P etc. all
complete as per direction of
Engineer-in- charge.

a)-Ground floor Sqm 10.00 80.30 803.00 803.00

b)-1stLift Sqm 10.00 35.09 350.90 350.90
c)-2 nd lift Sqm 10.00 19.22 1922.00 1922.00
d)-3rd Lift Sqm 10.00 210.02 2100.00 2100.00
10)-Supplying all materials,
labour and T&P for finishing
walls with water proofing
cement paint of approved
shade on new works two coats
including cost of paints and
labour etc., complete

a)-Ground floor Sqm 18.00 80.30 1445.40 1445.40

b)-1stLift Sqm 18.00 35.09 631.62 631.62
c)-2 nd lift Sqm 18.00 19.22 345.96 345.96
d)-3rd Lift Sqm 18.00 210.02 3780.36 3780.36

Pipe line
1)-Supplying all labour and
T&P for earth work excavation
in asll kind of soil and plinth as
per direction of Engineer –in-
charge.

100 cum 5800.00 1730.80 100386.40 nill

2)-laying in trenches
unplastisited PVC pipe
specials-

a)-110mm Mtrs 30.00 1280.00 38400.00 nill

b)-90mm Mtrs 24.00 2200.00 52800.00 nill
3)-Refilling the trenches with
excavated earth
100 cum 3500.00 1730.80 60578.00 nill

985094.35 21540.94

Total value of work done to date [A]-- Rs. 985094.35

Deduct value work shown on previous bill-- 963495.00
Net Value of work done since previous bill [f]- 21540.94

When there are two or more entries in column 6 relating to each sub-head of estimate they should in the case
of work the accounts of which are kept by sub-head be totaled and total record in column 7 for posting the
works Abstract.
When there are two or more entries in column 6 relating to each sub-head of estimate they should in the case
of work the accounts of which are kept by sub-head be totaled and total record in column 7 for posting the
works Abstract.

[3]

II- Certificate and Signature

1.- The measurement on which are based the entries in columns 1 to 6 of account where
made____________________ on_________________ and are recorded at page _________________ of
Measurement Book No._________ .
% 2. Certified that in addition to and quit a part from quantities of work actually executed as shown in column
4 of Account, some work has actually been done in connection with several item and the value of such work
after deducting there from the proportionate amount of secured advances, if any, ultimately recoverable
on account of the quantities of materials used there in ( in no case, less than advance Payments as per item 2
of memorandum of payment made or proposed to be made for the convenience of the Contractor, in
anticipation of and subject to the result of detailed measurement, which will be more) as soon as possible .

Date_____________
Signature of Officer___________
Preparing the Bill (Rank)___________

#Signature of ___________
Signature of Contractor_________ Officer Authorizing(Rank)______________
date_______ Payment_____________________
date_________
% This Certificate must be signed by the sub-division of Divisional Officer
# This signature is necessary only when the Officer who prepares the bill is not the Officer who
authorize the payment in such a case two signatures are essential.

III. Memorandum of Payments

1.- Total value of work actually measure as per Act, I Col. 5 Entry (A)
Rs. P.
2.- Total "up-to-date" Advance payment for work not yet measured .
(B)Rs. P.
as per details below:
(a) total as per previous bill -
(b)- Since previous bill ____________________ as per page ______of M.B. No._____________
3.- "Total up-to-date" secured Advance on security of materials,

as per Annexure [Form 26-A] Col 8 Entry [C].

4.- Total --[items 1+2+3__________________________
5.- Deduct amount withheld:--
 Figures for work Abstract [a] From previous bill as per last Running Account Bill

Rs. P. [b]- From this bill__________

6.-
7.- Balance , i:e: "up-to-date
Total amount of payment "already
payment _____________________
made [item 4,6]
as per Entry [K] of last Running Account Bill [K]*
No._____________ of ___________ forwarded with account for _____ 2009
 [4]
8.- payment
(a) Bynow to be of
recovery made as detailed
amounts below:---
creditable to this
work . Rs. p. Rs. p.

}
___________________________________ } (a)

Total 4 (b+8 (a)_________(G)_____________

(b) By recovery of amounts creditable to Other works or
heads of accounts :--- }
( c ) By cheque **
total 8 (b) + ( c) ________________ (H) } [b]

_____________________________________________________________________________________
Pay (_______________________) __________ * by cheque
Date_________ Initials of Disbursing Officer
Received (___________) as per above memorandum, on account of this work

Date ________
[amount in vernacular]

! Witness______________
Stamp

Full Signature of Contractor

Paid by me vide cheque No. _____________ dated_______________ 2009

date_____________________ initials of person actually making the payment

***should
if the net amount to be paid is less than Rs.10 and it can not be included in a cheque the payment
This figure should
be made in be tested
cash, this to seebeing
entry that italtered
agreedsuitable
with theand
total
theofalteration
item 7 and 8
attested by the dated
initials.

* here specify the net amount payable vide item 8 (c )

* The payee's acknowledgement should before the gross amount paid as per item 8 ( i.e., a+b+c )
! The payment should be attested by some known person when the payee's acknowledgement is
given by a mark thumb impression.

IV. Remarks
(This space reserved for any remarks which the Disbursing Officer or the Divisional Officer may with in
respect of the execution of the work check of measurement on the state of contractor's account.)
 Material Statement 4th R/A & Final Bill
Name of Contractor --- S.J.Singh Bhambra
Name of Work--- Construction of 40KL capacity OHT for pws to village Gurjung
under Bhawanipatna
Qnty. balance
Qnty. Issued Used in Returned by with
Sl no. name of material HR no/date to work work Contractor contractor Remarks
1 cement nill 13.14 13.14 nill nill All
materials
2 sand nill 1.99 1.99 nill nill are
3 water proofing nill 86kg 86kg nill nill supplied
by the
cement paint contarctor

Material Statement 4th R/A & Final Bill

Name of Contractor --- S.J.Singh Bhambra
Name of Work--- Construction of 40KL capacity OHT for pws to village Gurjung
under Bhawanipatna

Qnty. balance
Qnty. Issued Used in Returned by with
Sl no. name of material HR no/date to work work Contractor contractor Remarks
1 cement nill 13.14 13.14 nill nill All
materials
2 sand nill 1.99 1.99 nill nill are
3 water proofing nill 86kg 86kg nill nill supplied
by the
cement paint contarctor
mb no, 4th final bill
measureme 5218
5342
abstract 4523
5264
Serial No. of B
Serial No. of Bill--- 4th Running Account & Final Bill, No. and Date of his Previous Bill for thi
e of his Previous Bill for this work-- 3rd Running Account Bill Reference to Agreement no. --- 66 of 2010/2011 ,
no. --- 66 of 2010/2011 ,
 FINANCIAL RULE FORM NO. 12
( See Financial Rule - 205) Date of comencement:-- 24.12.11
FIRST & FINAL BILL Date of completion:-
20.01.12
(for Contractor's and Suppliers) Actual date of Completion:- 23.01.12
For use in Divisional Office For use in Accounttant General's Office
checked Completed
Checked with Schedule or Classification Reviewed
Accounts Divisional accountant rates/checked with the Checked

Ag No.:-- F2-255, 2011/2012 Auditor Reviewed

W/O No.:-- 3132/23-12-2011 Gazetted
Auditor Superintendent Officer
Name of Work:--Construction of stand post & valve chamber RPWS to Gurjung -Ph- II

Payee's
Item of work or supplies grouped under sub- Ref.to
Sl.no. Quantity Rate Unit Amount Acknowle
heads and sub-work of estimate record dgement

1 2 3 4 5 6 7 8
1 Supplying all materials labour T&P
for construction of single mouth RCC
pillar type stand post, platformof size
1.2m dia using RCC ring & 1.2 m
long drain including earth work in
excavation in hard soil using 4cm size
metal cement concrete 1;2;4, 12 cm
CBHG chiups & 6 mm thick cement
plaster and punning including cost &
conveyance Taxes all complete as per
the direction-of-Engineer-in-charge

MB
4911,
pg-199 3 3400.00 each 10200.00
2 Supplying all materials labour T&P
for construction of 1.2 m dia RCC
ring masonary SV/NRV/AV chanmber
surinder jeet singh bhambra

including earth work in excavation in

hard soil with foundation concrete
1;3;6 with 4 cm size metal and RCC
1:2:4 cover slab using 12 cm CHBG
chips including cost & conveyance
Taxes all complete as per the
direction-of-Engineer-in-charge

pg-200 3 3900.00 each 11700.00

 3 Refilling the trenches with
excavated earth with in initial lead
and lift as per the dorection
appproved by department 100
pg-201 39.92 3900 cum 15518.88
37418.88

Date Signature Officer Preparing the Bill

Sub-Divisional Officer
Sub-Divisional rank

Pay Rs.( ) incash

and Rs. ( ) by cheque

Payment Signature Officer Authorizing

Divisional Officer
Divisional rank
Date________

Note:--- In the Case of Payment to suppliers a red ink entry should be made across the page above the
entries relating to in out the following forms, applicable to the case (1) stock (2) purchase of Stock (3)
purchases for direct issue to work__________
24.12.11
20.01.12
23.01.12

Due to wrong entry in 3 rd item (39.93

insteadof 393.**)and with remaining
payment, this bill was later titled as 1st
running bill and a 2nd final bill was
prepared

pass
order for
this on
mb no.
5416
 FINANCIAL RULE FORM NO. 12
( See Financial Rule - 205) Date of comencement:-- 24.12.11
FIRST & FINAL BILL Date of completion:-
20.01.12
(for Contractor's and Suppliers) Actual date of Completion:- 23.01.12
For use in Divisional Office For use in Accounttant General's Office
checked Completed
Checked with Schedule or Classification Reviewed
Accounts Divisional accountant rates/checked with the Checked

Ag No.:-- F2-256, 2011-2012 Auditor Reviewed

W/O No.:-- 3134, 23-12-2011 Gazetted
Auditor Superintendent Officer
Name of Work:--Dismantling cement concrete to laying pipe line for RPWS to Gurjung PH-1

Payee's
Sl.no. Item of workand
or supplies grouped under sub-heads Ref.to
records Quantity Rate Unit Amount Acknowledg
sub-work of estimate
ement

1 2 3 4 5 6 7 8
1 Providing Flanged joints to flanged C I/P
V C pipes & fittings of the following dia
incl.testing of joints(excl.cost of N& MB
B,Rubber insertion no.
5013
a)-63/80mm p-198 2 15.00 each 30.00
b)-100mm 6 22.00 each 132.00
c)-150mm nill 25.00 each
2 Fitting & fixing of CISV/NRV(labour
only)

surindederjeet singh Bhambra

a)-63/80mm p199 1 23.00 each 23.00
b)-100mm 3 34.00 each 102.00
c)-150mm nill 53.00 each
3 Fixing metal or P V C febricated saddle
pieces withsuitable O rings,bolts,nuts to
P V C pipes
p-199 15 110.00 each 1650.00
4 Fixing of Push cock / Stop Cock p-199 nill 10.00 each
5 cement concrete 1:3:6 with 4 cm size
HGM including cost conveyance royality
p-199 12.62 2800.00 cum 35336.00
6 Dismantling and removing CC including
stacking the useful materials for reuse
and removing the debries within 50 m
lead
p-199 12.62 190.00 cum 2397.80
39670.80

Date Signature Officer Preparing the Bill

 Sub-Divisional Officer
Sub-Divisional rank

Pay Rs.( ) incash

and Rs. ( ) by cheque

Payment Signature Officer Authorizing

Divisional Officer
Divisional rank
Date________

Note:--- In the Case of Payment to suppliers a red ink entry should be made across the page above the
entries relating to in out the following forms, applicable to the case (1) stock (2) purchase of Stock (3)
purchases for direct issue to work__________
 Material Statement 1st & Final Bill
Name of Contractor --- S.J.Singh Bhambra
Name of Work--- Construction of stand post & valve chamber
RPWS to Gurjung -Ph- II

Returned
Qnty. Qnty. by balance
HR Issued to Used in Contracto with
Sl no. name of material no/date work work r contractor Remarks
1 cement All
materials
2 sand are
3 chip supplied
by the
contarctor

Material Statement 1st & Final Bill

Name of Contractor --- S.J.Singh Bhambra
Name of Work--- Construction of stand post & valve chamber
RPWS to Gurjung -Ph- II

Returned
Qnty. Qnty. by balance
HR Issued to Used in Contracto with
Sl no. name of material no/date work work r contractor Remarks
1 cement nill 9.23cum 9.23cum nill nill All
materials
2 sand nill 3.86cum 3.86cum nill nill are
3 chip nill 6.72cum 6.72cum nill nill supplied
by the
contarctor
Seri

Seri
Serial No. of Bill--- 4th Running Account & Final Bill, No. and Date of his Previous

Serial No. of Bill--- 4th Running Account & Final Bill, No. and Date of his Previous
o. and Date of his Previous Bill for this work-- 3rd Running Account Bill Reference to Agreement no. --- 66 of 20

o. and Date of his Previous Bill for this work-- 3rd Running Account Bill Reference to Agreement no. --- 66 of 20
reement no. --- 66 of 2010/2011 ,

reement no. --- 66 of 2010/2011 ,

 Material Statement 1st & Final Bill
Name of Contractor --- S.J.Singh Bhambra
Name of Work--- Dismantling cement concrete to laying pipe line for
RPWS to Gurjung PH-1

Returned
Qnty. Qnty. by balance
name of HR Issued to Used in Contracto with
Sl no. material no/date work work r contractor Remarks
1 cement 28.89cum 28.89cum nill nill All
materials
2 sand 6.05cum 6.05cum nill nill are
3 4cm metal 12.10cum 12.10cum nill nill supplied
by the
contarctor
4 90mm pvc T/P 4 nos. 4 nos. nill nill
5 90m flange 4 nos. 4 nos. nill nill
6 110mm pvc T/P 6 nos. 6 nos. nill nill
7 110mm pvc flange 6 nos. 6 nos. nill nill
8 80mm S.V 2 nos. 2 nos. nill nill
9 100mm S.V. 2 nos. 2 nos. nill nill
10 100mm NRV 1 nos. 1 nos. nill nill
11 90mm pvc saddle 5 nos. 5 nos. nill nill
12 63mm pvc saddle 8 nos. 8 nos. nill nill
13 110mm pvc saddle 2 nos. 2 nos. nill nill
 Material Statement 1st & Final Bill
Name of Contractor --- S.J.Singh Bhambra
Name of Work--- Dismantling cement concrete to laying pipe line for
RPWS to Gurjung PH-1

Returned
Qnty. Qnty. by balance
name of HR Issued to Used in Contracto with
Sl no. material no/date work work r contractor Remarks
1 cement 28.89cum 28.89cum nill nill All materials
are supplied
2 sand 6.05cum 6.05cum nill nill by the
3 4cm metal 12.10cum 12.10cum nill nill contarctor

4 90mm pvc T/P 4 nos. 4 nos. nill nill

5 90m flange 4 nos. 4 nos. nill nill
6 110mm pvc T/P 6 nos. 6 nos. nill nill
7 110mm pvc flange 6 nos. 6 nos. nill nill
8 80mm S.V 2 nos. 2 nos. nill nill
9 100mm S.V. 2 nos. 2 nos. nill nill
10 100mm NRV 1 nos. 1 nos. nill nill
11 90mm pvc saddle 5 nos. 5 nos. nill nill
12 63mm pvc saddle 8 nos. 8 nos. nill nill
13 110mm pvc saddle 2 nos. 2 nos. nill nill
Serial No. of Bill--- 4th Ru
Serial No. of Bill--- 4th Ru
Serial No. of Bill--- 4th Running Account & Final Bill, No. and Date of his Previous Bill for this work-- 3r
Serial No. of Bill--- 4th Running Account & Final Bill, No. and Date of his Previous Bill for this work-- 3r
vious Bill for this work-- 3rd Running Account Bill Reference to Agreement no. --- 66 of 2010/2011 ,
vious Bill for this work-- 3rd Running Account Bill Reference to Agreement no. --- 66 of 2010/2011 ,
f 2010/2011 ,
f 2010/2011 ,
 9 Cement concrete (1:3:6)with 4cm size hard
granite metal per 1cum
a. Materials
Hand broken gr 0.96
Sand (screene 0.48
Cement 2.29

21 20mm thick cement plaster (1:4) over

Stone masonry including all cost,
conveyance, taxes complete.
Sand (screene 0.021
Cement 0.057

34 Cement punning per Sqm.

a) Materials

Cement 0.0114

Stand post
1 sand filling found 22
2 cc 136 0.35
3 cc124 0.31
4 20cp 1;4 6.08
5 c punning 6.08
6
 Schedule XLV- Form No. 16 C.P.W.A. 26/(1)
2nd Running & final Account Bill
(C.P.W.A. CODE, Paragraph 10-2-10, 10-2-12, and 10-2-13)
Final Payments must invariable be made on forms printed on yellow paper which should not be used for
intermediate payment.
Division --- Kalahandi
For Contractors-- This formSub-Division ---Bhawanipatna
provides for [1] Cash
Advance Payments, and [2] Voucher
Payments forNo. ---
measured works. The form of
NameofofSecured
Account Contractor --- S.J.Singh
Advances, Bhambra
which has Name of should
been printed separately Work---beConstruction of necessary.
attached where stand post & valve
chamber RPWS to Gurjung -Ph- II , Serial No. of Bill--- 2nd Running Account & Final Bill,

No. and Date of his Previous Bill

for this work---1stRunning Account Bill Reference to Agreement no. ---
F2-255of 2011/2012 , Date of written order to commence the work--- no.3132, dt-23-12-11
Date of actual completion of work-- 23-01-12
1. Account of work Executed
Quantity
executed
Item of work [grouped under "Sub- up to date Payment on the basis of actual measurement
unit Rate as per
Heads" "Sub-Works" of estimate]
measureme up-to-date Since previous bill
nt book
1 2 3 4 5
Rs. p. Rs. p. Rs. p
1 Supplying all materials labour T&P
for construction of single mouth RCC
pillar type stand post, platformof size
1.2m dia using RCC ring & 1.2 m
long drain including earth work in
excavation in hard soil using 4cm
size metal cement concrete 1;2;4, 12
cm CBHG chiups & 6 mm thick
cement plaster and punning including
cost & conveyance Taxes all
complete as per the direction-of-
Engineer-in-charge

each 3400.00 3nos. 10200.00 nill

2 Supplying all materials labour T&P
for construction of 1.2 m dia RCC
ring masonary SV/NRV/AV
chanmber including earth work in
excavation in hard soil with
foundation concrete 1;3;6 with 4 cm
size metal and RCC 1:2:4 cover slab
using 12 cm CHBG chips including
cost & conveyance Taxes all
complete as per the direction-of-
Engineer-in-charge
each 3900.00 3 nos. 11700.00 nill
3 Refilling the trenches with
excavated earth with in initial lead
and lift as per the diection 100cu
appproved by department m 3400.00 397.92 13529.28 12172
35429.28 12172
Total value of work done to date [A]-- Rs. 35429.28
Deduct value work shown on previous bill-- Rs- 23257.00
Net Value of work done since previous bill [f]- Rs-12172.00

When there are two or more entries in column 6 relating to each sub-head of estimate they should in the
case of work the accounts of which are kept by sub-head be totaled and total record in column 7 for
posting the works Abstract.
When there are two or more entries in column 6 relating to each sub-head of estimate they should in the
case of work the accounts of which are kept by sub-head be totaled and total record in column 7 for
posting the works Abstract.

[3]
II- Certificate and Signature

1.- The measurement on which are based the entries in columns 1 to 6 of account where
made____________________ on_________________ and are recorded at page _________________ of
Measurement Book No._________ .
% 2. Certified that in addition to and quit a part from quantities of work actually executed as shown in
column 4 of Account, some work has actually been done in connection with several item and the value
of such work after deducting there from the proportionate amount of secured advances, if any,
ultimately recoverable on account of the quantities of materials used there in ( in no case, less than
advance Payments as per item 2 of memorandum of payment made or proposed to be made for the
convenience of the Contractor, in anticipation of and subject to the result of detailed measurement,
which will be more) as soon as possible .

Date_____________ Signature of Officer___________

Preparing the Bill (Rank)___________

#Signature of ___________
Signature of Contractor_________ Officer Authorizing(Rank)______________
date_______ Payment_____________________
date_________
% This Certificate must be signed by the sub-division of Divisional Officer

# This signature is necessary only when the Officer who prepares the bill is not the Officer who
authorize the payment in such a case two signatures are essential.

III. Memorandum of Payments

1.- Total value of work actually measure as per Act, I Col. 5 Entry (A)
Rs. P.
2.- Total "up-to-date" Advance payment for work not yet measured .
(B)Rs. P.
as per details below:
(a) total as per previous bill -
(b)- Since previous bill ____________________ as per page ______of M.B. No._____________

3.- "Total up-to-date" secured Advance on security of materials,

as per Annexure [Form 26-A] Col 8 Entry [C].

4.- Total --[items 1+2+3__________________________
5.- Deduct amount withheld:-- [a] From previous bill as per last Running
Figures for work Abstract Account Bill
Rs. P. [b]- From this bill__________

6.- Balance , i:e: "up-to-date " payment _____________________ [item 4,6] [K]*
7.- Total amount of payment already made as per Entry [K] of last Running Account Bill
No._____________ of ___________ forwarded with account for _____ 2009

[4]
8.- payment now toof
(a) By recovery beamounts
made ascreditable
detailed below:---
to this
work . Rs. p.
} Rs. p.

___________________________________ } (a)

Total 4 (b+8 (a)_________(G)_____________

(b) By recovery of amounts creditable to Other works or
heads of accounts :--- }
( c ) By cheque **
total 8 (b) + ( c) ________________ (H) } [b]

_____________________________________________________________________________________
Pay (_______________________) __________ * by cheque
Date_________ Initials of Disbursing Officer
Received (___________) as per above memorandum, on account of this work
Date ________
[amount in vernacular]

! Witness______________
Stamp

Full Signature of Contractor

Paid by me vide cheque No. _____________ dated_______________ 2009

date_____________________ initials of person actually making the payment

*payment
This figure should
should be tested
be made to see
in cash, this that
entryit being
agreedaltered
with the total of
suitable anditem
the7alteration
and 8 attested by the
dated initials.
* here specify the net amount payable vide item 8 (c )
*! The
The payee's
paymentacknowledgement
should be attestedshould before
by some the person
known gross amount paid
when the as peracknowledgement
payee's item 8 ( i.e., a+b+c is
)
given by a mark thumb impression.

IV. Remarks

(This space reserved for any remarks which the Disbursing Officer or the Divisional Officer may with
in respect of the execution of the work check of measurement on the state of contractor's account.)