“ANNEXURE-IV(A)” (Para 23.1(d) of Section II) COMPLETION CERTIFICATE Name of Organization Postal address, Phone No., Email ID, Fax No Letter No. Date :-………. 1. Name of work 2. Contract Agreement (C/A) No. and date 3. (i) Name of Firm with address (ii) In case of Name and % share of individual JV……. firms. 4. Original value of contract agreement. 5. Final value of contract as completed. (if final bill paid) 6. Date of award of contract 7. Has the work physically been completed in all respect ( Yes / No ) as per contract agreement? 8. If yes, then actual date of physical completion. 9. Total payment made in above contract till the date of opening of present tender. 10. In case of composite work: Component of payment made in respect of similar nature of work e.g. earthwork /Track/Bridges etc. (as defined in eligibility criteria) out of the total payment made under Sr. No. 9 above. I hereby certify that above mentioned work has been physically completed in all respect as per contract agreement. Performance of the contractor while executing the work had been satisfactory. (Signature) Name and Designation of officer Mobile No. of officer Seal of officer Note:- (i) Submission of false certificates by tenderer shall lead to, forfeiture of EMD and other action including penal action (Annexure-II). (ii) Copy of certificate duly self attested shall be submitted along with tender document. (iii) Payment made as indicated in above certificate (At Sr. No. 9/ Sr. No. 10) will be considered as value of completed work for the purpose of eligibility under Para 22 (ii) of Instructions to tenderers and conditions of tender. (iv) Above format is for guidance only. Any certificate containing information asked for shall be considered
“ANNEXURE-IV(A)” (Para 23.1(d) of Section II) COMPLETION CERTIFICATE Name of Organization Postal address, Phone No., Email ID, Fax No Letter No. Date :-………. 1. Name of work 2. Contract Agreement (C/A) No. and date 3. (i) Name of Firm with address (ii) In case of JV……. Name and % share of individual firms. 4. Original value of contract agreement. 5. Final value of contract as completed. (if final bill paid) 6. Date of award of contract 7. Has the work physically been completed in all respect as per contract agreement? ( Yes / No ) 8. If yes, then actual date of physical completion. 9. Total payment made in above contract till the date of opening of present tender. 10. In case of composite work: Component of payment made in respect of similar nature of work e.g. earthwork /Track/Bridges etc. (as defined in eligibility criteria) out of the total payment made under Sr. No. 9 above. I hereby certify that above mentioned work has been physically completed in all respect as per contract agreement. Performance of the contractor while executing the work had been satisfactory. (Signature) Name and Designation of officer Mobile No. of officer Seal of officer Note:- (i) Submission of false certificates by tenderer shall lead to, forfeiture of EMD and other action including penal action (Annexure-II). (ii) Copy of certificate duly self attested shall be submitted along with tender document. (iii) Payment made as indicated in above certificate (At Sr. No. 9/ Sr. No. 10) will be considered as value of completed work for the purpose of eligibility under Para 22 (ii) of Instructions to tenderers and conditions of tender. (iv) Above format is for guidance only. Any certificate containing information asked for shall be considered
1455263280591_Tender%206%20Misc.%20for%20loading%2006%20(3).docx