7/27/2019 LSCC Final Bill CC Form

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Dated

Date of actual completion of work or supplies

i)

ii)

iii)

iv)

v)

1)

2)

L.S.C.C.

Rs

II. CERTIFICATES AND SIGNATURES.

P

Serial number of this Bill No. and date of his previous bill for this work

Total Lump sum amount as entered in the Contractor's agreement … … …. … … … …

Value of additional work done up-to-date as " authorized extras ", the details of which are given in

the attached statement in form P.W.D. VI-74 ( Inner )… … … ... … … … … … …

Total

Value of items actually measured under clause 62(a) and (b) of the preliminary specification of 

M.D.S.S. forming part of the contract, The details of which are given in the attached statement in

form P.W.D. VI-74 ( Inner ) … … … … … … … … … … … … … … … …

Add :-

Deduct :-

Reference to Agreement

I. ACCOUNT OF WORK EXECUTED.

Total Value of work done :-

The detailed measurements of authorized additions and alterations mentioned above and of the items of work

specified in item I of Account I of last bill are recorded at page … ... … of M.B.No … … … …. … and I am

satisfied that they are correct.

Dated Signature of the

Officer preparing the Bill

RankSignature of Contractor  AEE, (R&B) Section

I certify that the work has been completed in accordance with the prescribed specifications and after taking in to

account all the authorized additions and alterations and the value of work done date, conformably with the item of 

the contractor's agreement Rs. ___ ___ ___ ___ ___ ___ ___ ___ .

Dy. Exe Engineer (R&B)

[PTO

Name of The Work

FINAL BILL( See Chapter X Paragraph 303, Andhra Pradesh P.W. Account Code )

( To be used for Final Payments to contractors on Lump sum Contract )

Value as per Lump sum contract items of work covered by actual

measurements vide item (iii) above.

Rs

No. PWA XXII

Date of commencement of work

Schedule Docket No.Cash Book Voucher No.

LUMP SUM CONTRACT

Name of The Contractor 

P.Value of items omitted to the executed as " Authorized Omissions ",

the details of which are given in the form attached statement in the

form P.W.D. VI-74 ( Inner ) …

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7/27/2019 LSCC Final Bill CC Form

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1

i)

ii)

3

(a)

(b)

H

(c)

)

)

STAMP

*

#

2 Deduct :-

Rs P

III. MEMORANDUM OF PAYMENTS.

Rs P

Dated Signature of the Officer  

authorizing payment

By recovery of amounts creditable to this work … …

G

By Cheque … … … … … … … … … … … …

By recovery of amounts creditable to other works or heads

of account … … … … … … … … … …

IV. ACQUAINTANCE.

Rupees

Rank

Full Signature of Contractor 

Paid by me Cash/ Cheque No…. … … … … … … … dated… … … … … … …

*RupeesReceived (Rs

The payee's acknowledgement should be for the gross amount as per item 3 (a+b+c) Account III, both in words and figures.

Dated

# Witness

Pay (Rs

V. REMARKS.

Total value of work done up to date as per " F " of Account I of this Bill.

Amount to be with held at … … … … percent on amount in item I above and

credited to the head public works Deposits.

Up to date intermediate payment already made according to entry "K" of Account I

previous Bill no…. … … … Dated … … … … … …

Payments now to be made :

as above in full settlement of all demands on account of the contract.

Dated initials of person actually

making the payment.

Payment should be attested by some known person when the payee's acknowledgement is given by mark, seal or thumb impression.

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