This file dedicated to My dear Engineers.

My Sincere thanks to Sri. B. Srinivasulu, DEE, Sri. G. Rama Govinda Reddy,

DEE, My Colleagues and Engineering Friends.

File Name Bill Pre

Prepared on 30.08.2022
File Code 1.0
Purpose For recommendation of representations of contractor, additional
enclosures for bill and refund of deposits submission.

How to Use Fill the Respect cells in the Input Sheet.

Disclaimer Please ensure correctness of required sheet before taking the
printout.
For this file www.rwsengineers.com

SHEET NAME PURPOSE

Applic (WO) Contractor Representation for Work Order and Officers
Recommendation.
Applic (Dep) Contractor Representation for Deposit and Officers
Recommendation.
Applic (Exp.) Contractor Representation for Experience Certificate and Officers
Recommendation.
APTC-64 (FSD) APTC Form No.-64 for FSD Recommendation.
APTC-64 (EMD) APTC Form No.-64 for EMD Recommendation.
Indemnity Indemnity Bond for EMD & FSD Recommendation.
Movt Movement Slip
Check Slip Check Slip
HR(Elect) Hand Receipt for Electrical
HR(Other) Hand Receipt for Others
LS Final Lump Sump Contract Final Bill Form
LS Running Lump Sump Contract Running Bill Form
Cert-FB Certificate Final Bill
Cert-PB Certificate Part Bill
Rels & Disch Release and Discharge Certificate
EMD Exp Cert EMD Exemption Certificate.
 GENERAL INPUT
Name of the Work Providing Drinking Water Supply Project to Podili Mandal in Adoni
Name of the Contractor Constituency of Nellore District.
M/s. Veena Construction, Anakapalli, Visakapatnam.
Estimated Cost. 4.50 Lakhs
Name of the Grant NPI-HFA
Designation of Section Officer Assistant Executive Engineer
Name of the Mandal Vuravakonda
Name of the Sub-Division Palamaner
Name of the Department RWS&S
Name of the Division Palasa
Application for EMD/FSD EMD & FSD
DEPOSIT - APTC FORM - 64 - FSD
1. Type of Deposit FSD
2. Deposited By Executive Engineer, RWS & S Division, Ongole
3. Total amount of deposit 178,598.00
Rupees in words One Lakh Seventy eight thousand five hundred and ninety eight only
4. Date of deposit in Office / Court 05.10.2021
5. Cheque / Draft No. 2021-1597927
6. Date of deposited in Treasury 05.10.2021
7. Name of the Treasury / Sub-Treasury Executive Engineer, RWS & S Division, Ongole
8. District YSR Kadapa
Date/Vr No. Page No MB No
a). Date of Handing over of site 16.02.2018 4 80/A/14-15
b). EOAT granted Up to - - -
c). Date of final completion of work 23.07.2018 79 80/A/14-15
Agreement time (1/2/5 Yr) Two 26.07.2018
Final Bill Paid details 05.10.2021 52 80/A/14-15

Recorded Page No 53
MB No 80/A/14-15
DEPOSIT - APTC FORM-64 - EMD
1. Type of Deposit EMD
2. Deposited By Executive Engineer, RWS & S Division, Ongole
3. Total amount of deposit 47,100.00.
Rupees in words Forty seven thousand one hundred only
4. Date of deposit in Office / Court 27.01.2018
5. Cheque / Draft No. DD No. 291920, dt. 22.01.2018 of SBI, Vizayanagaram
6. Date of deposited in Treasury 27.01.2018
7. Name of the Treasury / Sub-Treasury Executive Engineer, RWS & S Division, Ongole
8. District Krishna
Date/Vr No. Page No MB No
a). Date of Handing over of site 16.02.2018 4 80/A/14-15
b). EOAT granted Up to - - -
c). Date of final completion of work 23.07.2018 79 80/A/14-15
Agreement time (1/2/5 Yr) Two 26.07.2018
Final Bill Paid details 05.10.2021 52 80/A/14-15
Recorded Page No 55
MB No 80/A/14-15
INDEMNITY BOND
Name of the Contractor Sri. Potluri Nagababu
Father Name of the Contractor Dasaradha Ramaiah
Age of the Contractor 45
Address of the Contractor Mamidikudur Village, Bhemavarama Mandal, EG District.
Technical Sanction No & dt : CR No. 23/2017-2018, dt. 19.11.2017 of the Superintending Engineer,
Agreement No & dt : RWS/2017-2018,
No. & S Circle,Dt.
Kakinada.
27.01.2018 08.07.2019 of the Superintending
Date Engineer,
04.01.2022RWS & S Circle, Kakinada.
Place Eluru
HAND RECEPIT FOR ELECTRICAL BILL
Name of the Scheme/office CPWS Satyasai, Ananthapuram
Service No. VJA3711
Company APCPDC Ltd.
Vide Bill No. & dt 2101257559, dt. 05.03.21
Amount 2,900,000.00
Amount in words Twenty nine Lakhs only
Recorded Page No 8
MB No 88/A/17-18
HAND RECEPIT FOR OTHERS
Name of the Scheme/office Towards payment of Security Deposit Charges for the New connection of
Amount 3.00 HP submersible pump set to JHC Layout vide Lr. No.
19,200.00
Amount in words Nineteen thousand two hundred only
Recorded Page No 8
MB No 44/A/19-20
APPLICATION FOR EXPERIENCE CERTIFICATE
MB No 69/A/14-15, 7/B/14-15, 75/A/14-15
Date 12.11.2019
WORK ORDER
Ad Sanction Proc No. 148/AME/Navaratnalu/Infra/2020, dt. 16.01.2021 of the Collector
Technical sanction & District
SDR No. Magistrate,
/2020-2021,Krishna, Machilipatnam.
dt. 19.02.2021 of the Deputy Executive Engineer,
Gram Panchayat RWS & S Sub-Division, Kuppam.
Addada
Agency M/s. Veena Construction, Anakapalli, Visakapatnam.
Resolution No & dt Rs.No. 24, dt. 26.11.2021of the Gram Panchayat, Santhabommali.
To
The Executive Engineer,
RWS&S Division, Affix of Rs. 5/- Court Fees
Stamp
Palasa

Sir,
I M/s. Veena Construction, Anakapalli, Visakapatnam. requested that issue the work order
for the Work Providing Drinking Water Supply Project to Podili Mandal in Adoni Constituency of
Nellore District. Estimated Cost Rs. 4.50 Lakhs as the Gram Panchyat, Addada has resolved to execute
the work on nomination basis. Hence, request authorities to issue the work order for excution of work on
nomination basis at estimate rates.

Signature of Contractor

SUBMITTED:-
Submitted and Recommended to the Deputy Executive Engineer, RWS&S Sub-Division,
Palamaner for favour of issue of work order for the work Providing Drinking Water Supply Project to Podili
Mandal in Adoni Constituency of Nellore District. Estimated Cost Rs. 4.50 Lakhs, under NPI-HFA Grant
which was administratively sanctioned vide Proc No. 148/AME/Navaratnalu/Infra/2020, dt. 16.01.2021 of the
Collector & District Magistrate, Krishna, Machilipatnam., technically sanctioned vide SDR No. /2020-2021,
dt. 19.02.2021 of the Deputy Executive Engineer, RWS & S Sub-Division, Kuppam.. The Gram Panchayat
Addada has recommended M/s. Veena Construction, Anakapalli, Visakapatnam. for entrustment of work vide
it's resolution no. Rs.No. 24, dt. 26.11.2021of the Gram Panchayat, Santhabommali. on nomination basis at
estimate rates.

Assistant Executive Engineer

RWS&S Section,
Vuravakonda
SUBMITTED:-
Submitted and Recommended to the Executive Engineer, RWS&S Division, Palasa for favour of
issue of work order for the work Providing Drinking Water Supply Project to Podili Mandal in Adoni
Constituency of Nellore District. Estimated Cost Rs. 4.50 Lakhs, under NPI-HFA Grant which was
administratively sanctioned vide Proc No. 148/AME/Navaratnalu/Infra/2020, dt. 16.01.2021 of the Collector
& District Magistrate, Krishna, Machilipatnam., technically sanctioned vide SDR No. /2020-2021, dt.
19.02.2021 of the Deputy Executive Engineer, RWS & S Sub-Division, Kuppam.. The Gram Panchayat
Addada has recommended M/s. Veena Construction, Anakapalli, Visakapatnam. for entrustment of work vide
it's resolution no. Rs.No. 24, dt. 26.11.2021of the Gram Panchayat, Santhabommali. on nomination basis at
estimate rates.

Deputy Executive Engineer,

RWS&S Sub-Division,
Palamaner

AP RWS Engg. Dept.

To
The Executive Engineer, Affix of Rs 5/- Court Fees
RWS & S Division, Stamp
Gudivada.
Sir,
We Agri Marketing Agencies, Subbaramaiah Street, Vijayawada-520001 request to issue the work order for the
Work Providing Water Supply to Houses for Construction Purpose at YSR Jaganna Colony in Addada-1 Layout of
Addada GP in Pamarru Mandal, Sub-work Part-A forProviding motor to bore well in JHC Layout of Addada-1 in
Addada GP of Pamarru Mandal Estimate cost Rs. 9.00 Lakhs as I have entered agreement for the work of cost, supply
and errection of motor to borewell. Hence request authorities to issue the work order for excution of work on
nomination basis at agreement rates.

Signature of Contractor
SUBMITTED:-
Submitted and Recommended to the Deputy Executive Engineer, RWS & S Sub-Division, Pamarru for
favour of issue of work order for the work Providing Water Supply to Houses for Construction Purpose at YSR
Jaganna Colony in Addada-1 Layout of Addada GP in Pamarru Mandal, Sub-Work Part-A for Providing motor to bore
well in JHC Layout of Addada-1 in Addada GP of Pamarru Mandal Estimate Cost Rs. 9.00 Lakhs, under NPI-HFA
Grant which is adminstratively sanctioned vide Rc.No. 148/AME/ Navaratnalu/Infra/ 2020, dt. 16.01.2021 of the
District Collector, Krishna, Machilipatnam and technically sanctioned vide DR No. /2020-2021, dt. 22.02.2021 of the
Executive Engineer, RWS & S Division, Gudivada.. As the agency Agri Marketing Agencies, Subbaramaiah Street,
Vijayawada-520001 entered agreement with the department for the work vide agreement No. /2012-2013, dt.
02.08.2012 of the Superintending Engineer, RWS & S Circle, Vijayawada and the agency willing to execute the work
on nomination basis at agreement rates.

Assistant Executive Engineer

RWS & S Section,
Vuravakonda
SUBMITTED:-
Submitted and Recommended to the Executive Engineer, RWS & S Division, Gudivada for favour of
issue of work order for the work Providing Water Supply to Houses for Construction Purpose at YSR Jaganna Colony
in Addada-1 Layout of Addada GP in Pamarru Mandal, Sub-Work Part-A for Providing motor to bore well in JHC
Layout of Addada-1 in Addada GP of Pamarru Mandal Estimate Cost Rs. 9.00 Lakhs, under NPI-HFA Grant which is
adminstratively sanctioned vide Rc.No. 148/AME/ Navaratnalu/Infra/ 2020, dt. 16.01.2021 of the District Collector,
Krishna, Machilipatnam and technically sanctioned vide DR No. /2020-2021, dt. 22.02.2021 of the Executive
Engineer, RWS & S Division, Gudivada.. As the agency Agri Marketing Agencies, Subbaramaiah Street, Vijayawada-
520001 entered agreement with the department for the work vide agreement No. /2012-2013, dt. 02.08.2012 of the
Superintending Engineer, RWS & S Circle, Vijayawada and the agency willing to execute the work on nomination
basis at agreement rates.

Deputy Executive Engineer,

RWS & S Sub-Division,
Pamarru
To
The Executive Engineer, Affix of Rs 5/- Court Fees
Stamp
RWS&S Division,
Palasa

Sir,
I M/s. Veena Construction, Anakapalli, Visakapatnam. requested that release the EMD &
FSD for the work Providing Drinking Water Supply Project to Podili Mandal in Adoni Constituency of
Nellore District. Est Rs. 4.50 Lakhs. which were paid and recovered from me in the above work. The
work was completed and the defect liability period as per agreement of Two years completed on dt.
26.07.2018

Signature of Contractor

SUBMITTED:-
Submitted and Recommended to the Deputy Executive Engineer, RWS&S Sub-Division,
Palamaner for favour of release and payment of EMD & FSD for the work Providing Drinking Water
Supply Project to Podili Mandal in Adoni Constituency of Nellore District. Estimated Cost Rs. 4.50
Lakhs. Agency M/s. Veena Construction, Anakapalli, Visakapatnam. as the work was completed and
Two years of defect liability period completed as per agreement conditions on dt. 26.07.2018. The
recoveries recorded V.P. No. 53 of MB No 80/A/14-15 and submitted for favour of pre-audit and
payment.

Assistant Executive Engineer

RWS&S Section,
Vuravakonda

SUBMITTED:-
Submitted and Recommended to the Executive Engineer, RWS&S Division, Palasa for
favour of release and payment of EMD & FSD for the work Providing Drinking Water Supply Project to
Podili Mandal in Adoni Constituency of Nellore District. Estimated Cost Rs. 4.50 Lakhs. Agency M/s.
Veena Construction, Anakapalli, Visakapatnam. as the work was completed and Two years of defect
liability period completed as per agreement conditions on dt.26.07.2018. This is submitted for favour of
pre-audit and payment along with MB No 80/A/14-15

Deputy Executive Engineer,

RWS&S Sub-Division,
Palamaner

AP RWS Engg. Dept.

 Dt :- 12.11.2019
To
The Executive Engineer,
RWS&S Division, Affix of Rs 5/- Court Fees
Palasa Stamp.

Sir,

I am M/s. Veena Construction, Anakapalli, Visakapatnam. request that issue of

Experience Certificate for the work Providing Drinking Water Supply Project to Podili Mandal in Adoni
Constituency of Nellore District. Est Rs. 4.50 Lakhs under NPI-HFA Grant. As the work was
completed with in the sanctioned period and commissioned as per agreement condition.

Signature of Contractor
SUBMITTED:-
Submitted and Recommended to the Deputy Executive Engineer, RWS&S Sub-Division,
Palamaner for favour of issue of Experience Certificate for the work Providing Drinking Water Supply
Project to Podili Mandal in Adoni Constituency of Nellore District. Estimated Cost Rs. 4.50 Lakhs
under NPI-HFA Grant, Agency M/s. Veena Construction, Anakapalli, Visakapatnam. as the work was
completed and commissied as per agreement conditions. The representation of the contractor herewith
submitted along with check slip, Format and MB No 69/A/14-15, 7/B/14-15, 75/A/14-15 for favour of
necessary action.

Assistant Executive Engineer

RWS&S Section,
Vuravakonda
SUBMITTED:-
Submitted and Recommended to the Executive Engineer, RWS&S Division, Palasa for
favour of issue of Experience Certificate for the work Providing Drinking Water Supply Project to
Podili Mandal in Adoni Constituency of Nellore District. Estimated Cost Rs. 4.50 Lakhs under NPI-
HFA Grant, Agency M/s. Veena Construction, Anakapalli, Visakapatnam. as the work was completed
and commissied as per agreement conditions. The representation of the contractor herewith submitted
along with check slip, Format and MB No 69/A/14-15, 7/B/14-15, 75/A/14-15 for favour of necessary
action.

AP RWS Engg. Dept.

 Deputy Executive Engineer,
RWS&S Sub-Division,
Palamaner

AP RWS Engg. Dept.

 APTC FORM - 64
(DEPOSIT REPAYMENT BILL)
For the Month & Year
(For Treasury use only)
Date:_________________________
District:………………………………..
DDO's TBR No ……………………… Trans ID :

పెద్ద పద్దు
TREASURY/PAO CODE Major Head

ఉప పెద్ద పద్దు
DDO Code Sub Major Head

చిన్న పద్దు
Minor Head

DDO Designation : సామూహిక ఉప పద్దు

Group Sub Head

DDO Office Name : ఉప పద్దు

Sub Head

Bank Branch Code సవివరమైన పద్దు

Detailed Head

ఉప సవివరమైన పద్దు
Bank Branch Name : Sub Detailed Head
Contingency Fund MH/
Non-Plan=N/Plan=P Charged=C/Voted=V
Service Major Head

. . . . . .. .. .... . . . . . .FSD. .. . . . . . . . . . . . . . . . . . . . . . . రూ. . .178598 . . . . . . . . . . .

. . . . ( ఏ రకం డిపాజిట్

అక్షరాల. . . . . . . ..One
. . Lakh Seventy eight thousand five hundred and ninety eight only. . . . . .. .. .రూపాయలు
. . . . . . . . . . . మాత్రమే
........

రెవిన్యూ స్టాంపు ఫై క్లెయిమ్ దారు

సంతకము చేయవలెను

స్త్తలం :
తేది : క్లెయిమ్ దారు సంతకము

క్లెయిమ్ దారు, చిరునామా

. . . . . . . . . . M/s. Veena Construction, Anakapalli, Visakapatnam.. . . . . . . . . . . . .

FOR USE IN TREASURY / PAY & ACCOUNTS OFFICE ONLY

Pay Rs……………………………..(Rupees………………………………………………………
…………………………………………………………………………………………………….
…………only) by Cash / Cheque / Draft / Account Credit / Adjustment.

NBST/
Bank Seal
AP RWS Engg. Dept.
 NBST/
Bank Seal
Treasury Officer / Pay & Accounts Officer
P.T.O

AP RWS Engg. Dept.

 డిపాజిట్ వివరాలు
Name of the work….Providing Drinking Water Supply Project to Podili Mandal in Adoni
Constituency of Nellore District. Est Rs. 4.50 Lakhs
1). ఏ రకం డిపాజిట్
. . . . . . . ... . . . . . .FSD. .. . . . . . . . . . . . . . . .
I. Information has to be furnished invariably on page No 2 of APTC - Form 64

a). Date of Handing over of site…16.02.2018….(Page No 4.M.B.No.80/A/14-15.)

b). EOAT Granted Upto date : -(Page No -…M.B.No…-….)

c). Date of final completion of work dt. 23.07.2018(Page No 79. M.B.No.80/A/14-15.)

2). డిపాజిట్ చేసినవారు

. . . . .. .. .. .. .. .. .. .. .. Executive
. Engineer, RWS & S Division, Ongole. . . . . . . . . . . .

3). అసలు డిపాజిట్ మొత్తంÁÖ.

. . . . . . . . . . . . . . . .178598.
.... ..............

4).కార్యాలయము/కోర్టులో. జమ
. . . .చేసిన
. . . . . . .05.10.2021
తేది . .... . . . . . . . . . . . . . . . .. .

5). చెక్కు/డ్రాఫ్ట్ నెం . . . . .. . . .. .. . . . . .

. . . . . 2021-1597927.

6). ఖజానాలో జమ చేసిన తేది

. . .. .. .. .. .. .. .. .. .. .. .. . .. .. .. 05.10.2021. . . . . . . . . . . . . . .

7). ఖజానా/ఉప-ఖజానా పేరు . .. .. .. .. .. .. .. .. Executive

. . . . . Engineer, RWS & S Division, Ongole. . . . . . . . .

8). జిల్లా. . . . . . . . . . . . . . . . . . ...................YSR

. . Kadapa. . . . . . . . . . . .

ఈ డిపాజిట్ అసలు జమ నమోదు చేసిన చోట తిరిగి చెల్లింపు కూడా నమోదు చేసి నేను సంతకము చేసినట్లుగా

ఈ మొత్తాన్ని ఇది వరకు చెల్లించలేదని ద్రువీకరిస్తున్నాను

I. Certifiecates to be noted on page No 2 of APTC form - 64

1. Certified that the deposit has not been drawn and paid previously

2. Certified that the final bill is paid vide Vr/Chq No.05.10.2021 Page No…52 MB No80/A/14-15….

3. Certified that necessary defect liability period (1/2/5 Years) has been completed on …26.07.2018…

and no defects are noticed during above period

4. Certified that there is no QC remarks are pending againest this work.

5. Certify that there no recoveries are due from the contractor.

6. Certified that no IR paras AG/LF Audit are pending at Sub-Division level.

Deputy Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division, RWS&S Section,
Palamaner Vuravakonda

శ్రీమతి/శ్రీ
. . . . M/s. Veena Construction, Anakapalli, Visakapatnam..
కు. .రూ. . . 178598. . . . . అక్షరాల
. . . . . . . . . . . . . One Lakh Seventy eight thousand five hundred and ninety eight
. . . o. . . రూపాయలు మాత్రమే చెల్లించమని కోరడమైనది

డ్రా చేసి అధికారి

FOR USE OF ACCOUNT GENERAL OFFICE

AP RWS Engg. Dept.

యిమ్ దారు

AP RWS Engg. Dept.

 తకము చేసినట్లుగా ద్రువికరిస్తున్నాను

లించమని కోరడమైనది

AP RWS Engg. Dept.

 APTC FORM - 64
(DEPOSIT REPAYMENT BILL)
For the Month & Year
(For Treasury use only)
Date:_________________________
District:………………………………..
DDO's TBR No ……………………… Trans ID :

పెద్ద పద్దు
TREASURY/PAO CODE Major Head

ఉప పెద్ద పద్దు
DDO Code Sub Major Head

చిన్న పద్దు
Minor Head

DDO Designation : సామూహిక ఉప పద్దు

Group Sub Head

DDO Office Name : ఉప పద్దు

Sub Head

Bank Branch Code సవివరమైన పద్దు

Detailed Head

ఉప సవివరమైన పద్దు
Bank Branch Name : Sub Detailed Head
Contingency Fund MH/
Non-Plan=N/Plan=P Charged=C/Voted=V
Service Major Head

. . . . . .. .. .... . . . . . .EMD. .. . . . . . . . . . . . . . . . . . . . . . రూ. . .47,100.00. . . . . . . . . . . .

. . . . ( ఏ రకం డిపాజిట్

అక్షరాల.. .. .. .. .. .. ..Forty
. . . seven thousand one hundred only. . . . . . . . . . . . . . . . . . . . . . . . .. .. .. .. . . . రూపాయలు మాత్రమే

రెవిన్యూ స్టాంపు ఫై క్లెయిమ్ దారు

సంతకము చేయవలెను

స్త్తలం :
తేది : క్లెయిమ్ దారు సంతకము

క్లెయిమ్ దారు, చిరునామా

. . . . . . . . . . M/s. Veena Construction, Anakapalli, Visakapatnam.. . . . . . . . . . . . .

FOR USE IN TREASURY / PAY & ACCOUNTS OFFICE ONLY

Pay Rs……………………………..(Rupees………………………………………………………
…………………………………………………………………………………………………….
…………only) by Cash / Cheque / Draft / Account Credit / Adjustment.

NBST/
Bank Seal
AP RWS Engg. Dept.
 NBST/
Bank Seal
Treasury Officer / Pay & Accounts Officer
P.T.O

AP RWS Engg. Dept.

 డిపాజిట్ వివరాలు
Name of the work….Providing Drinking Water Supply Project to Podili Mandal in Adoni
Constituency of Nellore District. Est Rs. 4.50 Lakhs
1). ఏ రకం డిపాజిట్
. . . . . . . ... . . . . . .EMD. .. . . . . . . . . . . . . . . .
I. Information has to be furnished invariably on page No 2 of APTC - Form 64

a). Date of Handing over of site…16.02.2018….(Page No 4.M.B.No.80/A/14-15.)

b). EOAT Granted Upto date : -(Page No -…M.B.No…-….)

c). Date of final completion of work dt. 23.07.2018(Page No 79. M.B.No.80/A/14-15.)

2). డిపాజిట్ చేసినవారు

. . . . .. .. .. .. .. .. .. .. .. Executive
. Engineer, RWS & S Division, Ongole. . . . . . . . . . . .

3). అసలు డిపాజిట్ మొత్తంÁÖ.

. . . . . . . . . . . . . . . .47,100.00..
.... ..............

4).కార్యాలయము/కోర్టులో. జమ
. . . .చేసిన
. . . . . . .27.01.2018
తేది . .... . . . . . . . . . . . . . . . .. .

5). చెక్కు/డ్రాఫ్ట్ నెం

. . . . . DD . . . . . .dt.. .22.01.2018
No. 291920, . . . . . . of SBI, Vizayanagaram. . . . . .

6). ఖజానాలో జమ చేసిన తేది

. . .. .. .. .. .. .. .. .. .. .. .. . .. .. .. 27.01.2018. . . . . . . . . . . . . . .

7). ఖజానా/ఉప-ఖజానా పేరు . .. .. .. .. .. .. .. .. Executive

. . . . . Engineer, RWS & S Division, Ongole. . . . . . . . .

8). జిల్లా. . . . . . . . . . . . . . . . . . ...................Krishna.

. . ...........

ఈ డిపాజిట్ అసలు జమ నమోదు చేసిన చోట తిరిగి చెల్లింపు కూడా నమోదు చేసి నేను సంతకము చేసినట్లుగా ద్రువి

ఈ మొత్తాన్ని ఇది వరకు చెల్లించలేదని ద్రువీకరిస్తున్నాను

I. Certifiecates to be noted on page No 2 of APTC form - 64

1. Certified that the deposit has not been drawn and paid previously

2. Certified that the final bill is paid vide Vr/Chq No.05.10.2021 Page No…52 MB No80/A/14-15….

3. Certified that necessary defect liability period (1/2/5 Years) has been completed on …26.07.2018…

and no defects are noticed during above period

4. Certified that there is no QC remarks are pending againest this work.

5. Certify that there no recoveries are due from the contractor.

6. Certified that no IR paras AG/LF Audit are pending at Sub-Division level.

Deputy Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division, RWS&S Section,
Palamaner Vuravakonda

శ్రీమతి/శ్రీ
. . . . M/s. Veena Construction, Anakapalli, Visakapatnam..
కు. .రూ. . . . 47,100.0. . . అక్షరాల
. . . . . . . . . . . . . Forty seven thousand one hundred only. . . . . . . . . . . .. . . . . . రూపాయలు మాత్రమే చెల్లించమని కోరడమైనది

డ్రా చేసి అధికారి

FOR USE OF ACCOUNT GENERAL OFFICE

AP RWS Engg. Dept.

 ... ....

యిమ్ దారు

AP RWS Engg. Dept.

చేసినట్లుగా ద్రువికరిస్తున్నాను

మని కోరడమైనది

AP RWS Engg. Dept.

 INDEMNITY BOND
Name of the Work Providing Drinking Water Supply Project to Podili Mandal in Adoni Constituency
of Nellore District. Estimated Cost. 4.50 Lakhs Technical Sanction No & dt : CR No. 23/2017-2018, dt.
19.11.2017 of the Superintending Engineer, RWS & S Circle, Kakinada. Agreement No & dt : No. /2017-2018, Dt.
27.01.2018 08.07.2019 of the Superintending Engineer, RWS & S Circle, Kakinada.. I Sri. Potluri Nagababu S/o.
Dasaradha Ramaiah Aged 45 Years and Resident of Mamidikudur Village, Bhemavarama Mandal, EG District. do
hereby abide myself to pay all the claims which may comes (a) under work man's compensation Act 1933 with any
statutory modification there and rules there under or other wise for or in respect of any damage or compensation
payable in connection with any accident or injury sustained (b) under minimum wages Act 1948 (c) under payment
of wages Act 1936 (d) under the contract (Regulation and Abolition) Act 1970 by me and work men engaged for
the performance of the business relating to the above contractor ie.Name of the Work Providing Drinking Water
Supply Project to Podili Mandal in Adoni Constituency of Nellore District. Estimated Cost. 4.50 Lakhs
Lakhs.Failing such payment of claims, of workmen engaged in the above work and to recovery if any effected in
the AG's audit or any other means I abide in accepting recovery of such claims collected from any of my assets or
works with the department
Date : 04.01.2022.
Place : Eluru.
Signature of the contractor
M/s. Veena Construction,
Anakapalli, Visakapatnam.
 MOVEMENT SLIP TO ACCOMPANY OF THE CONTRACTORS AND THE
SUPPORTERS

1 Name of the Division : RWS&S Division, Palasa

Providing Drinking Water Supply Project to Podili Mandal

a) Name of the work : in Adoni Constituency of Nellore District. Est Rs.4.50
Lakhs Grant NPI-HFA

b) Name of the contractor : M/s. Veena Construction, Anakapalli, Visakapatnam.

Date of measurement by the

2 :
Executive Engineer

Date of Check measurement by the

3 :
Executive Engineer

Dare of receipt of the bill in the Sub-

4 :
Division office

Date of transmission of the bill to the

5 :
pay and accounts office

Date of return of the bill by the pay &

6 accounts officer to the divisional :
officer with objectionable if any

Date of transmission of the bill to pay

7 and accounts officer after attending to :
the objections

Date of payment of the bill by the pay

8 :
and accounts officer.

Reasons for delay at any stage

9 counting the items no. referred to :
above.

Assistant Executive Engineer Dy. Executive Engineer, Executive Engineer

AP RWS Engg. Dept.
s RWS&S Section RWS&S Sub-Division RWS&SDivision
Vuravakonda Palamaner Palasa

AP RWS Engg. Dept.

 CHECK SLIP FOR SECURITY OF DEPOSIT RELESE BILL

Providing Drinking Water Supply Project to

1 Name of the work : Podili Mandal in Adoni Constituency of
Nellore District. Est Rs. 4.50 Lakhs

2 Grant : NPI-HFA
M/s. Veena Construction, Anakapalli,
3 Name of the Contractor :
Visakapatnam.

4 (a) Adminstrative approval No. :

(b) Estimate amount and estimate sanction No :

Agreement No., date and amout Supplemental

5 :
Agreement No., date and amount

Due date of completion as per agreement

6 :
condition.
7 Actual date of completion :
Whether extension of time sanctioned,
8 reference to the orders of the competent :
authority
9 Penalities imposed :

10 Penalities recovered :

11 Sales Tax recovery proposed :

12 Whether schedule for the sales tax enclosed :

13 Amount of Seigniorage prepaid :

14 Amount of NAC recovered :

15 Whether income tax recovered :

16 Whether latest ITC enclosed for final bill :

Whether 7.5% recovered from the running
17 :
A/c No,
18 Whether 2.5% recovered from the final bill :
(a) Validity of Band guaranty in time re-
19 :
validated or Not
(b) Whether originol B.G. along with
confarmation letter and certificate send to :
PAO with date.
(c.) NSC and KVP Bond value and date :

AP RWS Engg. Dept.

 (a) Whether all the items billed for are
20 :
covered under the origional agreement

AP RWS Engg. Dept.

 (b) I.P. and date of Payment and amount :
Whether supplemental agreement enclosed
21 for the items not covered under origional :
agreement value and date.

Whether the competent authority concluded

the supplemental agreement (value of the
original agreement, supplemental agrrement
22 :
sahll be with in the poers setteled in G.O.M.S.
No. 94, PR & RD Ext - III) Dept., dt.
06.03.1999
Whether level certificate was recorded by the
23 :
DEE
Whether level certificate was recorded by the
24 :
EE
Whether EE check measured the work and
25 :
date.
Whether SE check measured the work ( In
case of work costing more than Rs 50.00 Laks
26 SE has to invaribly checke measured at 1/3 :
stage 2/3 stage and before final payment and
date.
Whether work slip/Revised estimate
27 :
sanctioned and date.
Whether paper clipping Rejonders submitted
28 :
or not
29 Whether any QC remarks arised or not :
Whether the amount excess over total
30 agreement value and permission from :
competent authority.
Whether any audit paras arised and reply with
31 :
date

Assistant Executive Engineer Dy. Executive Engineer, Executive Engineer

RWS&S Section RWS&S Sub-Division RWS&SDivision
Vuravakonda Palamaner Palasa

AP RWS Engg. Dept.

 HAND RECEIPT
Name of Payee: M/s. Veena Construction, Anakapalli,
1 Pay by cash ……………………………
Visakapatnam.

2 Pay by Cheque………………………………………………………………………………..

3 Paid by me ……………………………………………………………………………………

Received.Twenty nine Lakhs only…the sum of Rs…. 2900000/-

Name of the work….Providing Drinking Water Supply Project to Podili Mandal in Adoni
Constituency of Nellore District. Est Rs. 4.50 Lakhs Lakhs

Date…………………
Witness……………………………………………………………………………………….

SIGNATURE OF PAYEE

AP RWS Engg. Dept.

 PURPOSE FOR WHICH PAYMENTS MADE Division : Palasa_________________________
Towards pyament of power Sub-Division : Palamaner_________________________
consumption charges of CPWS
Satyasai, Ananthapuram of Service Cash Book Voucher No__________________________
No. of HT Connection VJA3711 of Schedule Docket No____________________________
APSPDC Ltd. Vide Bill No.
2101257559, dt. 05.03.21 Month_______________________________________

HAND RECEIPT FORM

1 Job 2900000.00 1. Certified that the work is completed in a respects.
2. Certified that the final bill has been paid in C.B.Vr No.
3. Certified that there are No. dues to be recovered from
Rupees…Twenty nine Lakhs only
the contractor. Hence deposit may please released.

Recorded at Page No…..8……of Measurement Book No……88/A/17-18………

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Palamaner Vuravakonda

AP RWS Engg. Dept.

 HAND RECEIPT
Name of Payee: M/s. Veena Construction, Anakapalli,
1 Pay by cash ……………………………
Visakapatnam.

2 Pay by Cheque………………………………………………………………………………..

3 Paid by me ……………………………………………………………………………………

Received.Twenty nine Lakhs only…the sum of Rs…. 19200/-

Name of the work….Providing Drinking Water Supply Project to Podili Mandal in Adoni
Constituency of Nellore District. Est Rs. 4.50 Lakhs Lakhs

Date…………………
Witness……………………………………………………………………………………….

SIGNATURE OF PAYEE

AP RWS Engg. Dept.

 PURPOSE FOR WHICH PAYMENTS MADE Division : Palasa_________________________
Towards payment of Security Deposit Sub-Division : Palamaner_________________________
Charges for the New connection of 3.00
HP submersible pump set to JHC Layout Cash Book Voucher No__________________________
vide Lr. No.
Schedule Docket No____________________________
EE/O/MACHILIPATNAM/APCPDCL/De
mand Notice /F.No. /D.No. 290, dt. Month_______________________________________
27.05.21 of the EE, Operation Division,
APCPDCL, Machilipatnam

HAND RECEIPT FORM

1 Job 19200.00 1. Certified that the work is completed in a respects.
2. Certified that the final bill has been paid in C.B.Vr No.
Rupees…Nineteen thousand two 3. Certified that there are No. dues to be recovered from
hundred only the contractor. Hence deposit may please released.

Recorded at Page No…..8……of Measurement Book No……44/A/19-20………

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Palamaner Vuravakonda

AP RWS Engg. Dept.

 LUMPSUM CONTRACT FINAL BILL
(See Chapter X, Paragraph 303, Andhra Pradesh P.W. Account code)
(To be used for "FINAL PAYMENTS" to contractors Lump sump Contracts)

Cash Book Voucher No Dated Schedule docket No………….….……………

Name of the Contractor………. M/s. Veena Construction, Anakapalli, Visakapatnam.………
Name of the Work………... Providing Drinking Water Supply Project to Podili Mandal in Adoni Constituency of Nellore
District. ……… ……...….. Est Rs 4.50 Lakhs ………………..

Serial number of this Bill ………………………………………………...………...………… No. and date of his previous bill
for this work ………………………………………………………………………………. Reference to
Agreement………………………………………………..
*Date of commencement of work………………………………………………………………………………..
……………………………
Date and actual completion of work or
supplies…………………………………………………………………………………………….
1. ACCOUNT OF WORK EXECUTED
i) Total lump sum amount as entered in the contractor's agreement Rs. P.

ADD :-

ii) Value of additional works done up to date as "Authorised extras" the details of which are given in
the attached statement in form P.W.D. VI 74 (inner)

iii) Value of items actually measured under clauses 62 (a) & (b) of the preliminary specifications of
the M.D.S.S. forming part of the contract item 1 the details of which are given in the attached
statement in form P.W.D. VI 74 (inner)

Total
Rs. P. Rs. P.
DEDUCT :-
iv) Value of items omitted to be executed as "authorised omissions" the details of
which are given in attached statement in form P.W.D VI 74 (inner)

v) Value as per lump sum contract for items of work covered by actual
measurements vide item (iii) above

Net total value of work done

** II. CERTIFICATE AND SIGNATURES

1. Certify that the work has been completed in accordance with the prescribed specification and after taking into account
all the authorised additions and alternations the value of work done up to date conformable with the terms of the contractor's
agreement in Rs.

2. the detailed measurements of the authorised additions and alternations mentioned above and of work specified in item
1 of account of last bill are recorded
page.....................................................................................................................................................of Measurement Book No.

and I am satisfied that they are correct

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Signature of Contractor Palamaner Vuravakonda
*Date of handing over of site in the case of work or date of written order to commence supply in the case of supply of
materials

AP RWS Engg. Dept.

** This certificate must be signed by an officer of not less than the rank of Executive Engineer in respect of works costing
more than Rs. 500/- and of not less than the rank of Sub-Divisional Officer in respect of works costing Rs. 5000/- and less.

AP RWS Engg. Dept.

 III - MEMORANDUM OF PAYMENTS
1. Total Value of work done up to date as per "F" of Account 1 of this bill Rs. P.

2. DEDUCT :
i) Amount to be with held at percent on amount in item above and
credited to the head "Public Works Deposits"

ii) Up to date intermediate payment already made according to entry "K" of

Account 1 of Previous bill No…………………….. Dated…………………… C

3 Payments now to be made

Rs. P.
G
a) By recovery of amounts creditable to this work

b) By recovery of amounts creditable to other works or heads

c) By Cheque H

Pay ( Rs ………………………………………) Rupees

Dated Signature and rank of officer

authorising payment

* Here specify the net amount payable, vide item 3 (e) of amount III both in words and figures

IV - ACQUITTANCE

* Received ( Rs…………………………….)
as above in full settlement of demands on account of the contract

Amount in Indain Language II

Date………….…………….
Witness………………………
Signature of contractor

** Paid by me by Cash Cheque No…………………………………………………………………….. Dated………………………..

Dated initial of Person actually making

Payment
* The payee's acknowledgement should be for the gross amount as per item 3 (a+b+c) of account III, both in words and figures.
** Payments should be attested by some known person when the payee's acknowledgement is given by a marks seal or thumb
impression
V - REMARKS

AP RWS Engg. Dept.

AP RWS Engg. Dept.
 LUMPSUM CONTRACT RUNNING ACCOUNT BILL
See Local ruling 1 & 5 Under Article 125 in Section 5 of Chapter III of the Madras
(Account Code Vol. III)
(To be used for intermediate payments to Contractors on Lumpsum Contractors)

Cash Book Voucher No Dated Schedule docket No………….….…

Name of the Contractor………. M/s. Veena Construction, Anakapalli, Visakapatnam.………………..……………….

Name of the Work………... Providing Drinking Water Supply Project to Podili Mandal in Adoni Constituency of Nellore District.
……… ……...….. Est Rs 4.50 Lakhs ………………..

Serial number of the Bill No. and date of his Previous Bill for this work
Reference to agreement * Date of commencement of work

1. ACCOUNT OF WORK
Rs. P.
1 Value of items actually measured under clauses 62 (a) and (b) of the preliminary specification of the
M.D.S.S. forming part of the contract the details of which are given in the attached statement.

2 Value of measured up additions or alternations executed up to date as authorize extras the details of
which are given in the attached statement.

3 Approximate value of work done up to date excluding the items specified 1 and 2 above.

4 Deduct amout to be withheld Percent on Rs…………………………

5 Balance the "upto date" intermediate payments

(item 1+2+3-4) K

6 Deduct intermediate payment already made as show in entry 'K'

of this last Running account bill……………………………

7 Intermediate payment now to made item 5, 6 'D' -

8 Total payment now to made as detailed below :

Rs. P.
a) By recovery of amoount creditable to
This work 'G'

b) By recovery of amounts creditable to

othe works or heads of ac 'H'

c) By Cheque

* Date of handing over of site in case of work or date of written order to commence supply in this case of supply 'c' materials
AP RWS Engg. Dept.
The Total figures against item 9 should be tested to see that it agree with the figures againest item 7

AP RWS Engg. Dept.

 II CERTIFICATE AND SIGNATURES
1. I have satisfied myself to the best of my knowledge by………………………………………………………………. that
the value of work done up to date under item 3 of, I Account of work of this bill is not less tha Rs………………….. conformably
with the contractors agreement.

2. The detailed masurements of authorised additions and alternations up to date and of the items of work specified in item
1 of Account I of this bill are recorded at page……………………………………...…………….. Of Measurement Book
No…………………………….

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Signature of Contractor Palamaner Vuravakonda
Pay ( Rs ………………………………………) Rupees

Dated Signature and rank of

officer authorising payment

III - ACQUITTANCE
* Received ( Rs……………………………………………………………………………………….………….)
as above Intermediate payment in connection with the contract referred to above

Amount in Indain Language II

Date………….…………….
Witness………………………
Signature of contractor

** Paid by me by Cash Cheque No……………………………………………………….. Dated………………………..

Dated initial of Person actually making

Payment
* Here specify the method employed for estimating value of work of not less than that on a Sub_Divisionla Officer

Here Specify the net amount payable vide item 8 (c) of Account 1 both in words and figures

The payees acknowledgement should be for the gross amount paid as per item 8 (a+b+c) of Account 1,
both in words and figures

AP RWS Engg. Dept.

* Payment should be attested by some know person when the payee acknowledgement is given barmark,
seal or thumb impression

AP RWS Engg. Dept.

Name of the work :- Providing Drinking Water Supply Project to Podili Mandal in
Adoni Constituency of Nellore District.

Est Cost Rs :-4.50 Lakhs

FINAL BILL CERTIFICATES

1 Certified that the work is completed in all aspects as per agreement conditions.

2 Certified that ther are no further dues to be recovered from the contractor other
than proposed in this bill.
3 Certified that no liabilities are outstanding againest the contractor.

4 Certified that the contractor has accepted the measurements.

5 Certified that there are no IR Paras pending in this work.

6 Certified that the release and discharge certificate furnished by the contractor.

7 Certified that the work is completed satisfactorily.

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Palamaner Vuravakonda

AP RWS Engg. Dept.

Name of the work :- Providing Drinking Water Supply Project to Podili Mandal in
Adoni Constituency of Nellore District.

Est Cost Rs :-4.50 Lakhs

PART BILL CERTIFICATES

1. Certified that the work is in Progress

2. Certified that there are no dues to be recovered from the contractor.

3. Certified that the measurements taken by the tape.

4. Certified that the certificate of acceptance of measurements by the contractor.

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Palamaner Vuravakonda

AP RWS Engg. Dept.

Name of the work :- Providing Drinking Water Supply Project to Podili Mandal
in Adoni Constituency of Nellore District.

Est Cost Rs :-4.50 Lakhs

JOB WORK CERTIFICATES

1. Certified that the work is in progress as per agreement conditions.

2. Certified that the certificate of acceptance of measurements by the contractor.

3. Certified that the Job work has been completed satisfactory.

4. Certified that the Job work has been completed in time.

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Palamaner Vuravakonda

AP RWS Engg. Dept.

Name of the work :- Providing Drinking Water Supply Project to Podili
Mandal in Adoni Constituency of Nellore District.

Est Cost Rs :-4.50 Lakhs

RELEASED AND DISCHARGE CERTIFICATE

Certified that the this is valid release and discharges from any and all
claims and demands what so ever from all the matters arising out of or connected with the
contractor provided that nothing shall discharge or release me from any liabilities under this
contract.

Certified that I have received this bill in full and final settlement of all
claims and demands.

Signature of the contractor

M/s. Veena Construction,
Anakapalli, Visakapatnam.

AP RWS Engg. Dept.

Name of the work :- Providing Drinking Water Supply Project to Podili Mandal in Adoni
Constituency of Nellore District.

Est Cost Rs :-4.50 Lakhs

EMD & FSD EXEMPTION CERTIFICATE

This is to certify that the relief's provided by the Government vide GO Rt.No. 266
Fin(HR-V-TFR-A&L-EWF) Dept, dt. 15.02.2021 read with GO Rt. No. 2451 Fin(HR-V-TFR-
A&L-EWF) Dept, dt.07.10.2020 is made applicable to this contract as this work with name
Providing Drinking Water Supply Project to Podili Mandal in Adoni Constituency of Nellore
District. vide Agreement No._________________________________________is not under
dispute or wherein arbitration/ Court Proceedings have connected or are contemplated and the
contracting agency M/s. Veena Construction, Anakapalli, Visakapatnam. is not default as per
the above Government orders.

Dy. Executive Engineer, Assistant Executive Engineer

RWS&S Sub-Division RWS&S Section
Palamaner Vuravakonda

AP RWS Engg. Dept.