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    Sumia To Kagua Claim O3

    Uploaded by

    Justin Kubul
    This document is a finance form requesting payment for road maintenance works. It includes: 1) Details of the original contract amount, authorized variations, and amended contract totaling 9,980,500 Kina. 2) A breakdown of the value of work completed, materials on site, claims, and plant/construction payments totaling 8,000,000 Kina. 3) A calculation of the gross amount due of 3,000,000 Kina after deducting retentions, previous payments, and plant/construction advances. 4) Certification from various officials and the recipient signature, confirming the payment of 3,000,000 Kina.

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    © All Rights Reserved
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    Sumia To Kagua Claim O3

    Uploaded by

    Justin Kubul
    42 views2 pages
    This document is a finance form requesting payment for road maintenance works. It includes: 1) Details of the original contract amount, authorized variations, and amended contract totaling 9,980,500 Kina. 2) A breakdown of the value of work completed, materials on site, claims, and plant/construction payments totaling 8,000,000 Kina. 3) A calculation of the gross amount due of 3,000,000 Kina after deducting retentions, previous payments, and plant/construction advances. 4) Certification from various officials and the recipient signature, confirming the payment of 3,000,000 Kina.

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    Sumia To Kagua claim o3

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    This document is a finance form requesting payment for road maintenance works. It includes: 1) Details of the original contract amount, authorized variations, and amended contract totaling 9,980,500 Kina. 2) A breakdown of the value of work completed, materials on site, claims, and plant/construction payments totaling 8,000,000 Kina. 3) A calculation of the gross amount due of 3,000,000 Kina after deducting retentions, previous payments, and plant/construction advances. 4) Certification from various officials and the recipient signature, confirming the payment of 3,000,000 Kina.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    42 views2 pages

    Sumia To Kagua Claim O3

    Uploaded by

    Justin Kubul
    This document is a finance form requesting payment for road maintenance works. It includes: 1) Details of the original contract amount, authorized variations, and amended contract totaling 9,980,500 Kina. 2) A breakdown of the value of work completed, materials on site, claims, and plant/construction payments totaling 8,000,000 Kina. 3) A calculation of the gross amount due of 3,000,000 Kina after deducting retentions, previous payments, and plant/construction advances. 4) Certification from various officials and the recipient signature, confirming the payment of 3,000,000 Kina.

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    Finance Form (FF4B)

    Department of Works GENERAL EXPENSES Original: Financial Delegate


    CLAIM 03 (FOR CONTRACT PAYMENTS ONLY) Duplicate: Contractor
    Triplicate: Engineer’s File
    CONTRACT NAME: Sumia To Kagua Road Maintenance Works In Nipa Kutubu District
    Kagua Erave District, Southern Highlands Province FOR OFFICIAL USE ONLY

    Registration No. 1524


    ADDRESS: Cheque No. 58438
    PO Box 271 Mendi, Southern Highlangds Province

    Thursday, December 29, 2022

    CONTRACT PAYMENT DETAILS Line No. WORKING COLUMNS REMARKS


    KINA TOEA
    Original Contract Amount 1 9,980,500.00 Inlcusive of VAT
    Authorised Variations (Vo: No. ………to………………. 2 - Inlcusive of VAT
    Amended Contract Amount (1+ 2) 3 9,980,500.00 Inlcusive of VAT
    Value of Work Completed to Date 4 8,000,000.00 Inlcusive of VAT
    Materials on Site 4a - Inlcusive of VAT
    Claims 1-1 and 2-1 4b - Inlcusive of VAT
    Amount of Plant/Construction Paid in Advance 5 5,000,000.00 Inlcusive of VAT
    Total (4+ 5) 6 Inlcusive of VAT
    Less Retention 7 Inlcusive of VAT
    Previous Paid (Claim No. ____to _____) - Advance 8 - Inlcusive of VAT
    Repayment Plant/Construction Advance to date 9 - Inlcusive of VAT
    Total Deductions (7+8+9) 10 - Inlcusive of VAT
    Gross Amount Due (6-10) 11 3,000,000.00 Inlcusive of VAT
    Less Liquidated Damages for day(s) @ K 12 - Inlcusive of VAT
    NET AMOUNT DUE THIS CLAIM NO: (03) 13 3,000,000.00 Inlcusive of VAT
    Balance Amount now Available under Contract (3-6) 14 1,980,500.00 Inlcusive of VAT

    Amount of Claim No: 1.0 due in figures (PGK) 3,000,000.00


    Claimant’s Reference: TO BE COMPLETED BY DEPARTMENT
    KCL 135 Project No. Vote/Item Amount FMS No. Vote/Item Amount

    Dated: 277-2100-8113-225 3,000,000.00


    12/12/2022 3,000,000.00

    Registered ................................
    I certify this contract payment is correct as regards to rates of I certify that this account is correct as regards the rates of charges and the faithful
    charges and the faithful performance of the services performance of the services
    Not previously Paid ……………….… .

    Examined..............................
    ……………………………….. ………………………… ……………………………………. ………………………
    Date Rec. by PQ. Date: Supritendents /EngineersRep Date Finacial Delegate

    .............../................/..........................

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

    I certify that this statement is correct within the meaning of Section RECEIVED this …29th day of .....December........ 20 22....………. the sum of Kina ..Three Million Kina Only
    12(b) of the Public Finances (Management) Act 1978, as amended
    to date.

    Certifying Officer Date


    Signature of Recipient Date Witness Date
    File Conform Doc

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