Proforma C

PRADHAN MANTRI GRAM SADAK YOJANA ( PMGSY)

CHECK LIST FOR P.I.U. & S.T.A.
( For Indvidual Bridge works with length more than15 m )
(To be filled by PIU)

1. Location :- State: ASSAM District : MASALPUR Block : GOBARDHANA

2. Package No:
AS-11

3. Name of the Road: From SUKRANGBARI PATHAR To SUKRANGBA

RI GAON
4. Total Length of Road (Km) - 3.410 KM

5. Name of Proposed Bridge (if any) Br. No.-5/1

6. Length of Proposed Bridge (Excluding Approaches) ### m

7. Width of Bridge in 7.50 m (Carriage Way)

8. Through Route/ Link Route Nos as per Core Network.:

(i) Is the road a part of core network : YES / NO
if Yes, Sl no. of road CN-I : Sl no. of road CN -VI :
If Yes Through Route/ Link Route No. T- or L- 0 4 1

(ii) Name of the benefitted Habitation (s) (to be cross checked Sr.N Name of Village Population
with CN-VI) with population 1 SUKRANGBARI PATHAR 616
SUKRANGBARI GAON 220
Total 836
9. Whether the Road proposal was sanctioned earlier : Yes / No

(i) If Yes, please mention the Phase, MoRD Sanction letter No and Date of sanction :
Phase : MoRD Sanction No. Date

Length Chainage : From : To:

(ii) Cost of the Road work sanctioned: Rs : Lakhs

(iii) Whether any CD/ Causeway was Sanctioned at or nearby location with the road
proposal and whether the same was constructed or not (if yes, the details thereof with chainage:
No

(iv) Whether the roadwork has been completed or in progress and likely date of completion: No

(v) If not, How the connectivity and movement of traffic was ensured:

(vi) Reasons for not proposing the Bridge at the time of submission of Road proposal:

10. Estimated Cost (Rs. In Lakhs) Item Total Cost (Rs in Lakhs) Cost per m
Bridge Super Structure 2094087.84 62010.30
Bridge Sub Structure 1985984.37 58809.13
Foundation 12218518.20 361815.76
Others (Protection) 515281.57 15258.56
Subway 472915.00 14004.00
DPR 42000.00 1243.71
Total 17328786.98 513141.46
MoRD Share State Share
(MoRD share and State share to be calculated as per the norms of MoRD/NRRDA)
11. INDEX MAP (not to scale ) : Attached
saperately At Ch-4100.00M

Cross Rd. SUKRANGBARI PATHAR SUKRANGBA

Cross Rd.
Br. No.-5/1

12 Typical Sketch of proposed bridge showing schematic arrangement of spans

13. Typical Photographs of proposed Bridge Location.
Shown separetly
14. Type of Proposed Bridge :
(I) Submersible Structures like Vented Causeway or Submersible Bridge
(ii) Box Culvert
(iii) Bridge With RCC Piers and Abutments

a. Type of foundation Open / Raft /Well / Pile / Any other

b. Bearing Capacity at Foundation Level 60.00 ton per sqm
c. Arrangement of Spans

Total Span 2 No. of Vents Clear Span of Vent

d. Critical Levels Road top level (RTL) 101.68 mtrs.

Average Ground Level(AGL) 94.51 mtrs.
Low Bed level (LBL) 94.01 mtrs.
Ordinary flood level (FL) 95.01 mtrs.
Foundation level (FL) 81.01 mtrs.
Ht. of bridge h= (RTL-NBL) 7.67 mtrs.
Ht. of bridge H=(RTL-FL) 20.67 mtrs.
e. Catchment Area
(Catchment area should be based on hydrological survey or from toposheet)
Catchment area served Not well Hect
defined
Heaviest Rainfall 1600 mm/hr.
Basis of Design Discharge Dickens formula
Waterway required 46.00 M
Waterway provided 33.00 M
f. Scour Depth (m) 4.46 m
15. Cost Details Cost Rs.
A. General
Costs
Cost of Preparation of DPR (Limited to 1 % of Total cost of Bridge)
B. Brdige Components
Grade of
Description of Components Quantity Cost Rs. concrete
Dismantling
Labour for dismantling all members of the timber bridge (except piles) and stacking 31.00 26350.00
them at suitable places as directed (all members will be under custody of the
contractor
Earth worktillintaken over byofthe
excavation Department.)
foundation scarfingasand
of structures perjoining
drawings piles
& 25cm to 30cm
technical 355.98 40225.99
dia d
specifications, including setting out, construction of shoring and bracing, removal of
Well Foundation Providing and constructing 1.00 41153.00
stumps
temporary
Providing and and other
Island deleterious
12 m diameter
constructing one matter, dressingroad
for construction
span service of of
sides
towell and bottomlocation
foundation
reach island and8 back
for diafilling
mfrom onewit 25.00 56450.00
well.complete
pier location
Providing andtoas per of
another
laying clause
pier 1200
location
cutting edgeof MORTH
of mild steelspecifications.
weighing 40 K.G. per meter for 3.60 371167.20
Well foundation
Plain / Reinforced complete
Cementas perv drawing
concrete, in welland as per clause 1200
foundationcomplete as &1900 of MORTH
perdrawing and as 0.00 0.00
specifications
perWell
A. clause Curb 1200 . , 1500 & 1700 of MORTH specifications. I) RCC 66.26 586387.85
M -Well
B. 25 grade
steining Case - IIII)
: Using
RCC concrete
M- 25 grade mixer. 529.33 4244672.40
C. Bottom Plug Concrete to beCase placedI : Using
using concrete
tremie pipe. mixer. II) 189.53 1417289.02
PCC
E. Top grade
plug M-20 Case - I : Using concrete mixer. III) PCC grade M-15 31.21 187609.48
F. Well Cap Case - I : using concrete mixer. 156.37 1196376.01
I) Depth below Bed level up to 3.0m I) RCC M - 25 grade 3.00 13182.00
II) Beyond 3.0 m upto 10.0 m 7.00 44828.00
III) Additional depth beyond 10 m up to 20 m 5.34 45141.50
I) Depth below Bed level up to 3.0m 6.00 40182.00
II) Beyond 3.0 m upto 10.0 m 14.00 130578.00
III) Additional depth beyond 10 m up to 20 m 8.00 98546.49
Sand Filling in Well complete as per drawing and as per Technical Specification as 721.23 1036411.87
per MORTH
Supplying, Section
fitting and No. 1207
placing .
un-coated TMT bar reinforcement in foundation 36.75 2648404.60
complete
Supplying, fitting and placing uncoated specification
as per drawing and technical mild steel reinforcement in foundation 0.30 19912.80
(Refer to quantity
complete
Plain/Reinforcedas per drawing estimation)(TATA
Cement and Technical
concrete, MAKE
in TMT REBAR)
Specifications
Substructure as per as
complete MORTH Sectionand
per Drawing No. 132.55 1075386.76
1600
Technical
Case – I : Using Specifications
Concrete Mixer 0.00 0.00
F. RCCtoGrade
(Refer quantity M 25estimation) 0.00 0.00
(p).Height
Supplying,up to 5.0
fitting andmplacing TMT bar reinforcement complete in substructure 8.90 642028.70
complete asfitting
Supplying, per drawing
and placing and uncoated
technical specification
mild steel reinforcement in Substructure 0.34 22652.92
(Refer
complete
Supplying, to quantity
asfitting estimation)
per drawing
and andinTechnical
fixing position true Specifications
to line and as perelastomeric
level MORTH Section bearingNo. 213840.00 245916.00
1600
conforming to IRC : 83 (Pt. II) Section IX and Clause
Furnishing and placing reinforced / Prestressed cement concrete in superstructure 2005 of MoRT &H Specifications 122.40 1121551.20
complete
as per drawing
Supplying, including
fittingandand all accessories
Technical
placing as per
Specifications.
TMT bar drawing andcomplete
reinforcement Technical in Specifications.
superstructure 2.07 146643.10
RCC tensile
complete
High Grade as M per
steel25,drawing and technical
wires/ strands includingspecification
all acessories for stressing, stressing 0.00 0.00
Case
(Refer- to
(Refer
operations I : quantity
to Using
quantity Concrete
and groutingestimation)
estimation) Mixer as per drawing and Technical Specifications.
complete 0.00 0.00
II) T-beam & slab
Providing 19.00 278741.80
(a) Height and uptolaying5m cement concrete wearing coat M 30 grade including
reinforcementofcomplete
Construction pre cast as RCCperrailing
drawing and Technical
of M30 Grade in situSpecifications
with 20 mm nominal size 74.94 168689.94
(Refer to quantity
(Refer
aggregate,
Burried toJoint
quantity
true to estimation)
line and
(Providing andgrade,
layingtolerance
a burried of vertical RCC
expansion joint,post not to exceed
expansion gap being 1 in 0.00 0.00
500
20mm, center
Providing to center
covered
and with 2mm
fixing spacing
12mmthick between
thick, 200mm
corrugated vertical
wide post
copper not toinexceed
galvanised
plate wieldable
expansion 2000 mmcomplete
leaving
structural
joint steel 0.00 0.00
adequat
plate
as perasdrawing
Providing perand IS:2062, placedthick
& Technical
fixing 20mm symmetrical
Specification
compressible to centre
fibre line
boardof the join, resting
in expansion freely
joint over
complete 0.00 0.00
the
(Refer
as per to
Providing quantity
drawing
and and estimation)
& Technical
laying of Specification .
a strip seal expansion joint catering to maximum 22.50 20182.50
horizontal
Pile load test movement
on singleupto 70mm,
vertical pile complete
in accordance as perwith
approved drawings and standard
IS:2911(Part-IV) 0.00 0.00
specificatons
a)
BackInitial andbehind
filling to be Abutment
routine installed
load testby the manufacturer
, Wing Wall and return / supplier or their as
wall complete authorised
per drawing and 0.00 0.00
representative
(Refer
Technical to material
quantity e estimation)
specification
Granular 178.93 220439.30
Supplying, fitting, and fixing in position true to line and level cast steel rocker bearing 0.00 0.00
conforming to IRC:83
Supplying, fitting, and (Pt.-1)
fixing insection
positionIX true
and to
clause 2003
line and of MoRTH
level specifications
forged steel roller bearing 0.00 0.00
complete
conforming including
to IRC:83all accessories
(Pt.-1) sectionas IXper drawing
and clause and
2003Technical
Drainage spouts complete as per approved drawings and technicalspecifications
of MoRTH Specifications.
specifications. 16.00 137840.00
complete
(Refer including
to quantity
Reinforced all accessories
cementestimation)
concrete as per
Approach drawing
Slab andreinforcement
including Technical Specifications.
and form work 0.00 0.00
complete as
Providing andper drawing
laying and on
pitching technical
slopes specification .
laid over prepared filter media including 167.36 193138.45
boulder apron
Providing laid dryfilter
and laying in front of toe
material of embankment
underneath complete
pitching in slopes asas
perper
drawing
drawing and
and 83.68 146694.84
technical
Providing specifications
specifications.
and laying boulders on river bed for protection against scour with stone 132.41 175448.28
A. Stone/Boulder
(Qty as laid
per statement ofwire
boulders
Boulder weighing
Construction dry not less
without
of subway &Protection
than
crates
Bamboo .(work
40 br.
kg each
Qty ) complete
as as perofdrawing
per statement andwork
protection Technical
) 1.00 446565.00
(Qty as per statement
specification . of Protection work )
DPR Preparation
Cost of DPR preparartion for br no 1/1 1.00 42000.00
Total Cost of the Project (Rs) 17328787.00

Total Cost of the Project (Rs) (In Words)

16. Five Year Routine Maintenance
Year Cost in lakhs % Cost
I
II
III
IV
V
Total Maintenance Cost

17. Whether the Bridge has Geometrics as per latest Circular of NRRDA.: YES / NO
DO.#P-17035/1/2007-Tech. 30th September, 2010.
18. Whether the Cost etimates are as per standerd data analysis and S.S.R.
19. Sources and the Lead distances of Materials are as under
Material Source Lead Distance Material Source Lead Distance
Earth (Km) Cement Guwahati 125 Km
Murrum Emulsion Guwahati 125 Km
(Subgrade)
Aggregate Bitumen Guwahati 125 Km

Sand Steel Guwahati 125 Km

This is to Certified that,

1. Span details of bridge tallies with DPR & data uploaded on omms.nic.in. & there is no deviation.
2. Information furnished herewith is true to the best of my knowledge.
3. Total cost of the project, State share & MoRD share worked out by PIU is justified.
4. The proposal of bridge is missing bridge proposal on sanctioned road & in the same stretch as it was sanctioend in previous
phase under PMGSY.

DPR Prepared By DPR Checked by Checked & recommended

(Name & Sign) (Name & Sign) (Name & Sign)

Assitant Engineer Executive Engineer Suprintending Engineer

Counter Signatures of
Co-ordinator STA :
 To be filled by State Technical Agency
Name of the STA : Sashanka Borah
Name of Road : CONSTRUCTION OF RCC BRIDGE ON SUKRANGBARI PATHAR TO SUKRANGBARI GAON AT CH 165.00M

Name of Bridge (if any) : CONSTRUCTION OF RCC BRIDGE ON SUKRANGBARI PATHAR TO SUKRANGBARI GAON AT CH 165.

20. Is the proposed work is for CD/Causeway of any length or brigde with span excluding approaches less than YES / NO
15m.
STAs need not clear such proposals

21 Is the Proposal entered on the OMMS : Yes/ No

(Data entries to be verified by STA before Clicking the Propopsal)

a. Span of Bridge on web: m. b. Span of Bridge As per DPR m.

* Span of bridge: C/C distance along the centre line of the bridge between inner faces of dirt walls.

c. Whether type of foundation & resting strata as per survey report justified to be safe YES / NO

d. Whether Hydraulic design is checked & found to be adequete as per site requirements YES / NO

e. Whether RCC designs are checked and found to be economical & safe. YES / NO

f. Whether the provisions made by PIU are sufficient & essentia from economy point of view. YES / NO
22 If the Proposal is for a Bridge for which Road was already Sanctioned
If Yes, Have you verified and satisfied yourself with all the items listed at Sr. No. 7, by PIU Yes / N
Yes / N
Have you satisfied yourself that the road is a part of Core Network
23 Are you satisfied with the following
Engineering Surveys (L section, X sections must be verified) Yes / N
Soil/ Material Investigation Yes / N
Hydraulic Studie Yes / N
( Catchment for structures to be verified from topo sheet. Location and requirement of structures to be verified
from L section and catchment area to be marked on Topo Sheet Copy )

24 Is the design of the following elements as per relevant I S/ IRC codes

Foundations / Abutments / Piers / Deck Slab / Wing Walls Yes / N

25 Does the Estimation Conform to Standard Rate Analysis and SoR generated for the current Yes / N
Phase for PMGSY works and a copy of SoR provided to STA

26 Does the proposal have provisions for

PMGSY Logo Sign Boards and Information Board
Yes / N
27 Whether STA and Superintendent Engineer have visited the site? If Yes, Date of Visit :

Kindly indicate whether the program of visit was informed to NRRDA for prior approval ?
28 Secific Remarks, if any, by STA
( Specific remarks of STA about the overall Bridge Project are necessary on each DPR)

29. Certificates:
Certified that the proposal of bridge is checked & found to be it is missing bridge on sanctioned road & in the same stretch as it
was sanctioend in previous phase under PMGSY.

Certified that the Design and Estimation for the Proposed bridge are based on the latest Circular of NRRDA:vide DO.letter #P-
17035/1/2007-Tech. 30th September, 2010.

Certified that the Design and Estimation for the Proposed bridge are based on the data and SSR provided by PIU Engineers . The
Proposal after final Correction is entered on the OMMS.The Propasal may be considered for clearance.

Technical Scrutiny at STA Co-ordinator

Signature
done by: Signature STA:
Name Name Signature
Date Date Name
Date
To be filled by State Technical Agency
Name of the STA : Sashanka Borah
Name of Road : 0

Name of Bridge (if any) : 0

20. Is the proposed work is for CD/Causeway of any length or brigde with span excluding approaches less than
15m. YES / NO
STAs need not clear such proposals

21 Is the Proposal entered on the OMMS : Yes/ No

(Data entries to be verified by STA before Clicking the Propopsal)

a. Span of Bridge on web: m. b. Span of Bridge As per DPR m.

* Span of bridge: C/C distance along the centre line of the bridge between inner faces of dirt walls.

c. Whether type of foundation & resting strata as per survey report justified to be safe YES / NO

d. Whether Hydraulic design is checked & found to be adequete as per site requirements YES / NO

e. Whether RCC designs are checked and found to be economical & safe. YES / NO

f. Whether the provisions made by PIU are sufficient & essentia from economy point of view. YES / NO
22 If the Proposal is for a Bridge for which Road was already Sanctioned
If Yes, Have you verified and satisfied yourself with all the items listed at Sr. No. 7, by PIU Yes / N
Yes / N
Have you satisfied yourself that the road is a part of Core Network
23 Are you satisfied with the following
Engineering Surveys (L section, X sections must be verified) Yes / N
Soil/ Material Investigation Yes / N
Hydraulic Studie Yes / N
( Catchment for structures to be verified from topo sheet. Location and requirement of structures to be verified
from L section and catchment area to be marked on Topo Sheet Copy )

24 Is the design of the following elements as per relevant I S/ IRC codes

Foundations / Abutments / Piers / Deck Slab / Wing Walls Yes / N

25 Does the Estimation Conform to Standard Rate Analysis and SoR generated for the current Yes / N
Phase for PMGSY works and a copy of SoR provided to STA

26 Does the proposal have provisions for

PMGSY Logo Sign Boards and Information Board
Yes / N
27 Whether STA and Superintendent Engineer have visited the site? If Yes, Date of Visit :

Kindly indicate whether the program of visit was informed to NRRDA for prior approval ?
28 Secific Remarks, if any, by STA
( Specific remarks of STA about the overall Bridge Project are necessary on each DPR)

29. Certificates:
Certified that the proposal of bridge is checked & found to be it is missing bridge on sanctioned road & in the same stretch as it
was sanctioend in previous phase under PMGSY.
Certified that the Design and Estimation for the Proposed bridge are based on the latest Circular of NRRDA:vide DO.letter #P-
17035/1/2007-Tech. 30th September, 2010.
Certified that the Design and Estimation for the Proposed bridge are based on the data and SSR provided by PIU Engineers . The
Proposal after final Correction is entered on the OMMS.The Propasal may be considered for clearance.
Technical Scrutiny at STA Co-ordinator
Signature
done by: Signature STA:
Name Name Signature
Date Date Name