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| Cash Book Voucher No. | |
| Name of Contractor | |
| Name of Work | |
| Serial No. of this Bill | |
| Ref. to Work Order or Agr. | |
| Date of Layout | |
| Stipulated Dt: of Completion | |
| Dt: of actual completion of work | |
| Dt: of Measurement |
| Unit | Qty. executed since last certificate | Qty. executed upto date as per M.B. | s.n | Item of work or Supplies | Rate | AMOUNT | Remarks | |
|---|---|---|---|---|---|---|---|---|
| Upto Date | Since previous bill | |||||||
| 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | |
| G. TOTAL Rs:= | 0.00 | 0.00 | ||||||
| T.P. % = | 0.00 | 0.00 | ||||||
| G. TOTAL Rs:= | 0.00 | 0.00 | ||||||
| Allowed to Rs (Round Off) | 0.00 | |||||||
| FS Allowed Amount | 0.00 | |||||||
CERTIFICATE
1- Work has completed as per order & specification & site condition.
2- Water cement arranged by Contractor
3- Cement, Steel, Water arranged by contractor at his cost
4- Beneficery contribution deducted as per norms
5- Works executed are mentioned in UC/CC No. Dated serial No.
| Total Value of work done or supplies made to date | 0 | |
| Deduct value of work or suppliers shown in previous bill | ||
| Net value of work or supplies previous bill in figure & words | 0 |
1- The measurements were made by and are recorded at page to
measurement book No. / and were checked by name -
2- The connected measurement have been crossed off against this bill
Dated Signature of Contractor
Office preparing the bill
Dated Signature of Officer
authorising payment
Sub-Dn……….
Division………
Rank………….
| 1- | Total value of work done as per account 1 Cols. 6&7 | 0.00 | |||||
| 2- | Deduct amount withheld | 5% FDR DEPOSITED | |||||
| NET AMOUNT | 0.00 | ||||||
| FIGURES FOR WORK | |||||||
| ABSTRACT | A): From previous bill,s as per last running account bill. | (4) | |||||
| b): From this bill | 0.00 | ||||||
| 3. Balance upto date payment item (1-) | |||||||
| 4. Total amount of payments already made as per last running account Bill No. Vr. No. Dt: | |||||||
| 5. Payment now to be made as detailed below | |||||||
| Details of 2(b) | TDS % | 0.00 | |||||
| Labour welfare % | 0.00 | ||||||
| SD % | RTPPR RULE 2013 RULE 75 - 10% AMOUNT 50000/ FDR SUBMITTED BY FIRM | 0.00 | |||||
| GST % | 0.00 | ||||||
| Total deduction | 0.00 | ||||||
| a): By recovery of amount creditable to this work | |||||||
| b): By recovery of amount creditable to other work or heads of accounts | (5) | ||||||
| c); By Cheques | 0 | ||||||
| d): By Cash | |||||||
| Total of 2 (b) & 5(a to d) | 0 | ||||||
| Pay Rs: | 0 | (in words) | Cheque | ||||
| Cash | |||||||
| Dated initials of Disbursing Officer | |||||||
| Received RS: | 0 | (In Words) | Amt. in Vernacular | ||||
| demand for this work or supplies made | |||||||
| Dated the | Left hand thumb impression or | ||||||
| Witness of identification and payment | Full Signature of Contractor | ||||||
| Paid by me vide Cheque No. | Dated the | or Cash book entry dated | |||||
| CASHIER | |||||||
| Dated initials of person actually making payment | |||||||
The figures should be teted to see that it agrees with the total of items 4 and 5.
Here specify the nt amount payable vide item 5© and (d)
The payees' acknowledgement shoud be taken before the gross amount paid as per item (I.e.a to d)
Payment shoul dbe attested by some known person when the payees' acknowledgement is given by a mark seal or thumb imp.
Not required in the case of bill of suppliers.