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PB No 979, Mount-Poonamallee Road, Manapakkam, Chennai - 600089, Tamil Nadu, India

CIN - L99999MH1946PLC004768 Approved

WOM Bill Summary - EA422BIL1000190

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PB No 979, Mount-Poonamallee Road, Manapakkam, Chennai - 600089, Tamil Nadu, India

CIN - L99999MH1946PLC004768 Approved

WOM Bill Summary - EA422BIL1000190

Job Address : LE131218-WDFCC CTP 1 AND 2 - PACKAGE D (DFCC) - SDC Monarch, Plot No. D236, 3rd floor,, Near Amrapali Circle,
Hanuman Nagar,, Vaishali Nagar, PIN CODE- 302020, SOLAN, Rajasthan, India, 302021
Vendor Address : S0145205 - RUSTAM ENTERPRISES (rel141150) - VILLAGE LAMANATEHSIL PISANGANDIST
AJMERPISANGANRajasthanIndia305202NAZIR KHAN9001084792rel141150@rediffmail.com
Company PAN No : AAACL0140P Vendor PAN No : BVJPK9534J - VALID

Accounting Center : SZ000010-Shared Services Centre - Accounting

Center
Supply From : 08BVJPK9534J2ZZ Supply To : 08AAACL0140P
7ZD
WO No : EA422WOD0000254 Dt : 25-May-2020 WO Type : Regular Labour With Out Materials

WO From : 19-Feb-2020 To : 20-Mar-2021 Bill Due Dt : 03-Feb-2021

Running Bill No : 2 Dt : 02-Feb-2021 Bill Type : Running Bill

Bill From : 21-Jul-2020 To : 30-Sep-2020 BU : Railway Systems

SJV No: LE/SZ000010/FSJ/20/INR Dt : 17-Feb-2021

/2310492

Values In : INR

Item Upto Previous Bill This Bill Total Amount

Amount Amount

Total as per Enclosed Annexure 251885.16 176974.04 428859.20

Deductions

COA Description Prev. Bill Amount This Bill Amount Total Amount

00011075 - TDS U/S 194C-PYT TO

1601.00 1125.00 2726.00
CONTRACTORS/SUBCONTRACTORS

00012114 - RETENTION 5337.00 3749.00 9086.00

00083291 - Rounding off in SC Bills 0.16 0.04 0.20

Total Deduction 6938.16 4874.04 11812.20

Balance : 417047.00
Total as per ServiceAllocation Annexure : 176974.04

Paid Upto Last Bill : 244947.00

This Bill Payment Details

Bank Voucher Number Date Cheque Number Date Amount

1040751 18-Feb-2021 CITIN21126942477 18-Feb-2021 45000.00

7003488 20-Feb-2021 VAJ 20-Feb-2021 25518.00

1070697 01-Mar-2021 CITIN21133838467 01-Mar-2021 40000.00

1083574 03-Mar-2021 CITIN21135183693 03-Mar-2021 30000.00

1097471 06-Mar-2021 CITIN21137246373 06-Mar-2021 31582.00

This Bill Paid : 172100.00

Amount Payable : 172100.00

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PB No 979, Mount-Poonamallee Road, Manapakkam, Chennai - 600089, Tamil Nadu, India

CIN - L99999MH1946PLC004768 Approved

WOM Bill Summary - EA422BIL1000190

WO Prepared By Passed By Authorised By

OM NARAYAN RAJPUT PREETHI S RAM SURESH

Received From -Larsen & Toubro Limited, Construction.-Indian rupee One Lakh, Seventy-Two Thousand, One Hundred and Zero
Paise Only-Full and Final settlement of all dues of workdone, Supplies made as per above Work Order and that we have no
Further claims on Company in this Connection. We accept all the Rates and Measurements as emboided in the above Bill, Without
any dispute whatsover

Signature & Date

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