Claim Form II B Departmental Execution

Form-II B
Final Disbursement Claim format for Part-B scheme under RAPDRP for Departmental Execution
Name of Utility : _________________
Name of Part-B Town: ___________________________
Sanctioned Project Cost (Rs. Crs):
Sanction Date:
Completed Cost of project (Rs.Crs):
All amount in Rs. Lakh
Sl. No. Broad Descrption of work Work approval by Material Cost Details All Payment details of Erection Contracts Total cost of
as executed in town Competent Authority of executed
Utility items
Value of Date of Cost of Basis of Material Name & Contract Award value Invoice(s) /RA Invoice(s) /RA Invoice(s) /RA Invoice(s)/ RA Total Amount Cheque Number Date of
work approval Material used Cost claimed i.e. Address of Award No. & No. Date Bill Amount Bill Amount Paid /ECS Details/Tax Payment
Store Issue Voucher Agency Date Passed Challan Nos. w.r.t.
(SIV) No. /Purchase claim under Column
Order (PO) No./DI 13
No. Or any Unique
ref. No. and Date
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16=4+13
1
3 1. Sub Transmission System

Improvement Work
2. HVDS
3. Metering
4 4. Mobile Service Centre
5. Others
(As per Annexure B1, B2,
B3…..)
5
Total
Date: Authorised Signatory of Utility

Name
Designation
It is hereby cerified that:
i The information given as above is correct as per sanctioned DPR/as Executed , Contract/Purchase Order and other records maintained for the purpose.
ii Payment shown under column 13 is actually paid to and accepted by supplier/contractor/agency. In case of Departmental /Partial turnkey, the cost of material used is as per column 4.
iii Claims against project expenditure is limited to eligible project-areas and are as per approved Part-B DPRs by R-APDRP Steering Committee/as modified following RAPDRP guidelines.
iv Project implementation is satisfactory and deliverables by the suppliers/executing agencies are of the required quality, quantity and satisfaction as per R-APDRP Guidelines.
v The performance bank guarantee from the supplier / agency for supplies / works as per the contract (if applicable) has been obtained and kept on record.
vi Amount claimed for BoQ items has not been claimed in any other scheme of GoI /other agencies.
vii Income Tax and other statutory deduction in respect of the above payments have been made and deposited/arrangements have been made to deposit with the concerned authorities.
viii Value of Departmental Store Items (materials/equipments) utilised in the project and claimed are as per the utility's store procurement cost /store issue rate of the item. Further, it is certified that the store items used in the project were not covered in the scope of Contractor and no
payment against the same has been made to the Contractor.
ix The store items used/installed in the project were purchased post sanction of the project DPR.
x Distribution Transformers procured under R-APDRP scheme, have efficiency level equivalent / better than that of three star ratings of BEE, where ever BEE standard is applicable. For other DTs, where BEE standard is not applicable, CEA guidelines have been followed.
xi In case of new 11 KV feeders/sub-stations / DT installed after sanction of Part-A, provision has been made for installing AMR at appropriate points and has ensured /shall ensure integration with IT system proposed/installed in Part-A. Utility has completed GIS mapping of new assets
under Part B.
xii Claims of expenditure are as per clause 14.8 of the terms and conditions of sanctions of GoI & PFC Counter Part loans i.e. All claims for expenditure incurred are from the date of sanction of projects by R-APDRP Steering Committee/Monitoring Committee of IPDS.
xiii All payments to Contractors /Agencies have been /are being made through PFMS.
xiv UC for GoI loan in the prescribed GFR format is enclosed.
xv Projects are being implemented as per R-APDRP guidelines.
xvi Claims are based on RA Bills / MB and the same is being properly maintained by the utility.
xvii Form C has been issued to the Contracators /Suppliers as per applicability.
xviii The work executed departmentally by Utility's staff cannot be claimed under R-APDPR Part B.
xix Ineligible items as mentioned in declaration of DPR has not been claimed.
xx In case of any damage or loss either partially or totally or any reduction in value of the property/assets on which charge has been created in favour of the Corporation (PFC) as security towards loan granted by the Corporation, the borrower shall make good such loss by replacing the
hypothecated assets to the extent of value diminished due to such loss within a period of 30 days or as decided by PFC, or provide other assets of equivalent value as security to the Corporation.
Note:
1 The amount may be mentioned in Rupees lakh rounded off to thousand.
2 In case of partial turnkey both Form II A & Form II B can be used.

Claim Form II B Departmental Execution

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Form-II B

3 1. Sub Transmission System

Date: Authorised Signatory of Utility

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