TRANSPORTATION CHARGES CLAIM BI

me of the L-ii H & T Contractor :

de No. of the H & T Contractor :
Claim Bill for the month : OCT-DEC-17
Name of the RRC-cum-DSC : CWC,NABARANGPUR

Gate Pass-cum-Transit Pass Of Stock Transported As Per

CWC NGPR Gate Pass-cum-Transit Pass
SL No. Vehicle No. Total

No Date Rice

1 2 3 4 PHH AAY ANP WHEAT 10

1 DS230506/87/2017 1/9/2017 OD24 9185 138.40 _ _ 1.02 139.42
2 DS230506/80/2017 1/9/2017 OR10 8201 52.03 87.15 0.80 _ 140.25
3 DS230506/77/2017 1/9/2017 OR10 2133 97.50 48.65 0.4 0.08 146.27
4 DS230506/75/2017 1/9/2017 ORK 3435 41.59 83.65 1,00 0.7 126.31
5 DS230506/79/2017 1/9/2017 OR10 2122 126.70 _ _ _ 126.70
6 DS230506/78/2017 1/9/20017 OR10 9219 12.28 109.20 1,00 _ 122.48
7 DS230506/88/2017 1/9/2017 OR10B 1449 122.08 _ _ _ 122.08
8 DS230506/83/2017 1/9/2017 OR10A 0991 70.43 68.95 1.00 _ 140,38
9 DS230506/84/2017 1/9/2017 OR10D 0286 139.00 _ _ 0.17 139.17
10 DS230506/81/2017 1/9/2017 OSU 5415 138.38 _ 1,10 _ 139.48
11 DS230506/86/2017 1/9/2017 OR10A 2776 20.24 131,60 _ _ 151.84
12 DS230506/70/2017 1/9/2017 OR24 4313 8.50 119,00 1,00 _ 128.50
13 DS230506/74/2017 1/9/2017 OR10A 7086 128.01 _ _ _ 128.01
14 DS230506/91/2017 1/9/2017 OR18 4467 136.17 _ _ 0.24 136.41
15 DS230506/90/2017 1/9/2017 CG17H 4229 43.72 91,90 1,00 _ 136.62
16 DS230506/82/2017 1/9/2017 OR10D 1463 _ 121,78 1,10 _ 122.88
17 DS230506/85/2017 1/9/2017 OR10D 4320 _ 122,98 _ _ 122.98
18 DS230506/89/2017 1/9/2017 OD10 5177 76.31 45.37 1,10 _ 122.78
19 DS230506/76/2017 1/9/2017 ORK 6126 118.67 _ _ 5.08 123.75
20 DS230506/72/2017 1/9/2017 OR10C 5448 41.86 81,90 0,50 _ 124.26
21 DS230506/71/2017 1/9/2017 OR24 0620 63.36 64,05 0,50 _ 127.91
22 DS230506/73/2017 1/9/2017 OR10A 2241 125.96 _ _ 2.13 128.09
23 TOTAL
Approved Rate
Amount of T.C. claimed for Despatching of Qtl.______________ @ Rs._______________per Qtl.(Ref Col. No.15)
Recovery if any (Ref Col No.30)
Net amount claimed

he Contractor has despatched Qtl.__________

Certified that ______No.
Certified
of FPS(_____%
that theof
Contractor
the mandatory
has despatched Qtl.__________
above during the month and the cost of stock
declaration
to FPS as noted
of retailers)
above during
have been
the month
verified
and
bythe
me.cost
Theof stock has been deposited
been deposited in District office stock accepted by the FPS from the H & T Contractor as
mentioned above for those FPS has been cross checked
 & found correct.

Signature of the Counter Signature of the Signature of the

L-II H & T Contractor RRC-cum-DSC ACSO/I.S./ M.I. of the Block/ULB
ORTATION CHARGES CLAIM BILL FOR H & T CONTRACTOR(LEVEL-II)

Stock Delivered As Per FPS

FPS Acceptance Shortage If An
Name Of The Acceptance Note
Total
Retailer
No. Date Rice Rice

11 12 13 PHH AAY ANP WHEAT 10 PPH AAY

MAJHIGUDA DS230506/87 1/9/2017 138.40 _ _ 1.02 139.42
MAJHIGUDA DS230506/80 1/9/2017 52.03 87.15 0.80 _ 140.25
CHANDRAPUR DS230506/77 1/9/2017 97.50 48.65 0.04 0.08 146.27
MANIGAM DS230506/75 1/9/2017 41.59 83.65 1,00 0.01 126.31
MANIGAM DS230506/79 1/9/2017 126.70 _ _ _ 126.70
CHERCHETA DS230506/78 1/9/2017 12.28 109.20 1,00 _ 122.48
CHERCHETA DS230506/88 1/9/2017 122.08 _ _ _ 122.08
KHUTUBAI DS230506/83 1/9/2017 70.43 68.95 1.00 140,38
KHUTUBAI DS230506/84 1/9/2017 139.00 _ _ 0.17 139.17
PONDIKOTE DS230506/81 01/09/207 138.38 _ 1,10 139.48
PONDIKOTE DS230506/86 1/9/2017 20.24 131,60 _ _ 151.48
PATRI DS230506/70 1/9/2017 8.50 119,00 1,00 _ 128.50
PATRI DS230506/74 1/9/2017 128.01 _ _ _ 128.01
NAKTIGUDA DS230506/91 1/9/2017 136.17 _ _ 0.24 136.41
NAKTIGUDA DS230506/90 1/9/2017 43.72 91,90 1,00 _ 136.62
MAIDALPUR DS230506/82 1/9/2017 _ 121,78 1,10 _ 122.88
MAIDALPUR DS230506/85 1/9/2017 _ 122,98 _ _ 122.98
MAIDALPUR DS230506/89 1/9/2017 76.31 45.37 1,10 _ 122.78
KONTAMAL DS230506/76 1/9/2017 118.67 _ _ 5.08 123.75
KONTAMAL DS230506/72 1/9/2017 41.86 81,90 0,50 _ 124.26
DONGRA DS230506/71 1/9/2017 63.36 64,05 0,50 127.91
DONGRA DS230506/73 1/9/2017 125.96 _ _ 2.13 128.09
TOTAL

ef Col. No.15)

as despatched Qtl.__________
st of stock has been deposited in District office.
Shortage If Any

Rice

ANP WHEAT TOTAL

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