TYPE OUT THE BELOW MATTER IN YOUR COMPANY LETTERHEAD

NO CLAIM CERTIFICATE
CLIENT TATA CONSULTANCY SERVICES
PROJECT
NAME OF CONTRACTOR
SCOPE OF CONTRACT .
P.O/W.O. REFERENCE
FINAL P.O VALUE
Sr. No. DESCRPTION AMOUNT (Rs)
Full & final settlement against the above said contract
1 (INCLUSIVE OF ALL TAXES if any)

Amount received for the above said contract before TDS

2 recovery and after retention as on date

Amount payable to us for the balance works for the above

said contract before TDS recovery and after retention as
3
on date

4 Total Retention Money withheld as on date

Amount withheld against non-submission of PBG (if any)
5
as on date
Amount Received by us as2.5% Retention money, before
TDS recovery, per contract (Clause 2.7) after completion
6 of 3 months from successful taking over i.e. After
xx/xx/xxxx. As per PCC, the warranty period starts from
xx/xx/xxxx for entire work.
Balance 2.5% Retention money payable to us, before TDS
recovery, as per contract (Clause 2.7) after completion of
8
12 months of warranty period. As per PCC, the warranty
period is expiring xx/xx/xxxx for entire work. As on
Withheld PBG amount payable to us, before TDS
9 recovery, after completion of warranty period i. e. on
xx/xx/xxxx.
10 Total Amount Payable to us as on date

It is hereby certified that the entire work done by us under above referred contract has been
measured, submitted and accepted by us as representing full & final settlement of all monies Rs. ----
-----------------/- due to us,to our satisfaction and that we shall have no claim(s) whatsoever,
concerning any work(s) or part thereof performed by us under the said contract on the Consultant(s)
and/or the Employer/Owner. We also hereby confirm that the above Final Bill will not be
subjected to any arbitration or recourse to Law/Court.

Place: Company name

Date:
Signature: