Providing irrigation facilities through borewell to the land of Smt Jayamma S c/o Pauti Shivanna in Madapattana village of Kushalnagara taluk in Kodagu district

Format for 3.2 (b)

SI.No Name of Work Estimated cost Tendered cost Cost of work executed Cost of work to be executed Date of agreement Stipulated period of completion Scheduled date of completion

Divisional Officer

Note:- The statement showing the value of existing commitments and On - Going works as well as the stipulated period of completion remaining for each of the works listed should be countersigned by the employer in charge, not below the rank of an Executive Engineer or equivalent.

WORK DONE CERTIFICATE

Name of the Department

Name of Division

1 Name of work :

2 Estimated Cost :

3 Agreement No. :

4 Name of Contractor :

5 Tendered cost :

6 Date of work order :

7 Stipulated period of completion :

8 Intended date of Complition :

9 Final Date of completion, (For completed work) :

10 Revised amount of work (including claims/extra/arbitration amount,if any) :

11 Cost of work executed :

12 Balance cost of work :

13 Whether final bill is paid :

14 Reasons for non completion of work in schedule period of completion :

15 Whether any penalties fine/stop notice/compensation/liquidated damage imposed/Imposed & canceled :

a) Earth Excavation :

b) Embankment :

c) Providing & laying M-15 :

d) Providing & laying M-10 :

f) Rubber & Earth Filling :

g) Providing & laying M-20

16 Remarks of the Engineer performance of the Contractor working style quality consciousness tendency of claims :

Divisional Officer