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FORM 23
Division : ALAPPUZHA
(For Contractor :-This form Provides for(1)secured Advance and payment for Measured Work)
MNGP-2018-19-P.No.62/19 MANANGADI-
Name of work and Head of Account : KOOTTEZHATHU ROAD RENOVATION
IN WARD No.09
Remarks
Item No.
Providing and applying primer coat with bitumen emulsion (SS-1) on prepared
surface of granular base including cleaning of the road surfaceand spraying
4 75.69 630.000 75.690 630.00 m2 primerat the rate of 0.70 -1.0 kg/sqm using mechanical means as per '' 24 630.000 47684.70
technical specification clause 502
Providing and applying tack coat with Bitumen emulsion (RS-1) using
emulsion distributor at therate of 0.25 to 0.30 kg per sqm on the prepared
5 14.28 630.000 14.2800 630.00 m2 granular surfaces treated with primer & cleaned with Hydraulic broom as per ' 25 630.000 8996.40
Technical Specification Clause 503. ( 5.2.3a ModifiedHydraulic broom as per
Technical Specification Clause 503.
TOTAL 735901.55
Rounded 735902.00
GrandTotal of the value of the work done or supplies made to data (A)
Deduct value of work or Supplies shown in previous bills
Net value of work or supplies since the previous bill (B)
Figures(F) in words……………………………………………………………………..
Part II - Certificate and Signature
C. AUDIT SECTION
Checked again the calculation and verified the rate against the contract schedule, quantities against
estimate Provision and receipt and issues against scantioned data.
Accountant Accountant
Dated Signature…………
Certified that the Bill as Passed above
Officer authorising
has been ledgered
Payment Rank…
Paid in cheque
Divisional Officer
Paid in cash…
Received rupees (in words)
on account of this work(as a final payment in settlement of all demands
Left hand thumb impression)
Date…………..
Rupees
………………………………………………………………..
Full Signature of contractor STAMP
Witness
……………………………………………………………….
PART IV-MATERIALS ACCOUNT
Divisional or
Since receipt
General Store as per Since Issues Balance in hand
With Departmental
other works as per
Issue Note and
With Contractor
Transferred to
Quantity Cash book Total in
Serial no.
Remarks
in column4
Agencies
Description of Rate as in in hand Voucher No. hand
W.B.O
Unit This As per Total
Total
Materials Agreement as per upto
last c.c. bill date this bill issue
W.B.O. Issue
Issue
W. B.note
O. No.
note No.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
Certified that the work has been completed satisfactorily and no laibilities outstanding against the contractor in respect of this work.
Note:- Col.4 If materials not provided for in the agreement are issued vide paragraph 359 recovery will have to be made at the issue issue rate or market rate
at the time ofsupply whichever may be greater and should include storage charges vide paragraph 350 of K. P. W. D. Code.
Col.2 Vide paragraph 358 of the K.P.W.A.code.