K.F.

C FORM
24
(See Rule viii article 20 A)
COMPLETION REPORT

1. Name of Work
2. No. and date of sanction
3. Amount of A.S
4. Expenditure
5. Excess
6. Percentage of excess
7. Explanation of excess
8. Date of commencement of
9. Date of completion
10.
Major head
11.
Minor head
12.
Sub head
13.
Details of work

:
:

:
:
:

:
:
work :
:
:
:
:
:

Certified
that
the
above
work
was
commenced
on
. that I have inspected it personally and that the
work has been carried out satisfactorly in accordance with the estimate.

CHECK LIST FOR SUBMITTING Final Bill for the work UNDER
MPLAD
1.
2.
3.
4.

Name of work :
Estimate amount
A.S No and Date :
T. S No and Date

:
:

5. No and Date of Agreement

:
6. Amount Advance/Part bill drawn
:
7. Date of completion as per Agreement
:
8. Date of Commencement of work
:
9. Date of actual Completion of the work
:
10.
If the work is not completed in the agreement time,
State the reason for the delay and action taken
:
11.
Is the work handed over to the local body/Concerned
beneficiary department after completion
:
12.
1; Agency to whom the
work is handed over
:
13.
2 Date of handed over
:
14.
If the work is a Water Supply Scherme, whether electricity for the
project has
been received. If not state the reason
:
15.
Has the signboard carrying the inscription withname of MP has
been
prominently erected at the site?
:
16.
Is Hon. MP informed of the completion of the Scheme
:
17.
Is any Inventory purchased for the project?
:
18.
Does the expenditure include any compensation for land acquired/
(if yes
specify details)
:
19.
Does the expenditure include any supervision/centage charge? (if
yes
specify details)
:
20.
Is any portion of work executed on private land? (if yes specify
details)
:
21.
Is the asset created for individual benefit or commercial purpose?
(if yes
specify details)
:
22.
Details of Asset Created for entry in Asset Register (Length of the
Road
Dimensions of the buildings etc)
:
DECLARATION
I hereby declare that the information given above is true to the best of my
knowledge and I have examined the fesibility of this scheme proposed and
found them in order.
Seal

Signature

Implementing
Officer