Annexure - XXIV

BHUVA POLYPLAST PVT. LTD.

Survey No. 105, Plot No. 1&2; Rajkot - Gondal Highway, VIII.: Bhunava,Tal.: Gondal Dist.: Rajkot 360311(Gujarat) India

ADVANCE CLAIM REQUEST FORM

Date :- 05/10/2018

To
Finance Department
Gujarat Green Revolution Company Ltd.
GOG , Implementing Agency (SPV)

Sub:Request letter to release advance payment regarding.

Ref:TPA approval of Registration number 1819-KCT-2824 by GGRC dated 29-08-2018.

With reference to above subject and reference ,please release the advance payment of Rs.15,639.00 as per the
GGRC norms for the MIS registration number 1819-KCT-2824 of Mr/Mrs/ RABARI JETUBEN MANGABHAI of
CHITROD(Village) of (Taluka) of KUTCH (District) as per technical sanction number

We will oblige by the terms and conditions of tri party agreement Executed on 20-08-2018

We undertake that any statutory liability arising on account of receipt of this advance payment will borne by us.

Details mentioned here in above pertains to particular MIS application and respective Technical Sanction only.

Regards
For BHUVA POLYPLAST PVT. LTD.

Authorised Signatory
Seal and Stamp of Comapny
 Annexure - XXIV

*1819-KCT-2824* 1819-KCT-2824
BHUVA POLYPLAST PVT. LTD.
Survey No. 105, Plot No. 1&2; Rajkot - Gondal Highway, VIII.: Bhunava,Tal.: Gondal Dist.: Rajkot 360311(Gujarat) India

ADVANCE CLAIM VOUCHER

Individual Application/Registration No. Type of Other group members Reg. No. Total area of all members sharing
Application common water source (Hac)

1819-KCT-2824 NL 1819-KCT-2824 0.80

Adv. Claim Voucher No : BPPL/2018-19/DIS-154 Adv. Claim Voucher Date : 24/08/2018
Technical Sanction No : GGRC/TS-NL/2018-2019/BHUVA/1819-KCT-2824 Technical Sanction Date 08/08/2018
MIS System Buyer : RABARI JETUBEN MANGABHAI MIS Type : Drip
Village : CHITROD Survey No : 57/2
Taluka : RAPAR Crop : POMOGRANATE-COTTON(Inter)
District : KUTCH Area (Ha) : 0.80(0.800)
Range selected for
3.04 X 3.04 Lateral Spacing (Mtr): : 3.04-1.520
subsidy Cal(MtrXMtr) :
(A) HEAD UNIT
Sr. No. Description of Product Remarks Crop Size Unit Qty. Rate Amount
1 Screen Filter 40m3/hr x 2.5"/3"/4" N/A N/A 40 NOS 1.00 1716.77 1716.77
2 Inlet Manifold (PP) for HA 2.5" x 300 mm for N/A N/A 2.5 NOS 1.00 740.98 740.98
single Filter with flanges
3 Outlet Manifold (PP) for HA 2.5" x 182 mm for N/A N/A 2.5 NOS 1.00 580.50 580.50
single Filter with flanges
4 Ventury Injector Assembly With Valve & Without N/A N/A 2 NOS 1.00 3338.42 3338.42
Manifold 2"
5 Air Release Valve 1" N/A N/A 1 NOS 1.00 30.78 30.78
6 PRSSURE GAUGE 2" (Glycerine) N/A N/A 2 NOS 2.00 177.62 355.24
7 2.5" PP Ball Valve with Flenge Ends N/A N/A 2.5 NOS 2.00 838.47 1676.94
8 2.5" By Pass Tee (FE) PP N/A N/A 2.5 NOS 1.00 409.53 409.53
9 GI Fittings N/A N/A 0 NOS 1.00 662.48 662.48
Total : 9511.64

Individual Sharing cost : 9511.64

(B) FIELD UNIT EXCLUDING SECONDARY TRANSPORTATION
Sr. No. Description of Product Remarks Crop Size Unit Qty. Rate Amount
1 PVC pipe 75 mm x 4 kg/cm2 N/A POMOGRANATE-COTTON(Inter) 75 Mtr 84.00 58.80 4939.20
2 2.5" PP Ball Valve with Flenge Ends N/A POMOGRANATE-COTTON(Inter) 2.5 NOS 1.00 838.47 838.47
3 Flush Valve 75 mm N/A POMOGRANATE-COTTON(Inter) 75 NOS 1.00 84.74 84.74
4 LLDPE Plain Laterals 16mm diameter, 2.5 N/A POMOGRANATE-COTTON(Inter) 16 Mtr 2750.00 6.41 17627.50
Kg/Cm2 - Class II
5 On line Dripper - 8 LPH N/A POMOGRANATE-COTTON(Inter) 8 NOS 900.00 2.43 2187.00
6 Grommet - 16 mm N/A POMOGRANATE-COTTON(Inter) 16 NOS 100.00 1.63 163.00
7 Barbed Start Connector / Jointer/ Take Off/ Nipple N/A POMOGRANATE-COTTON(Inter) 16 NOS 100.00 1.36 136.00
16mm
8 End Cap (Line End) - 16 mm N/A POMOGRANATE-COTTON(Inter) 16 NOS 100.00 1.24 124.00
9 Barbed Start Jointer 16 mm N/A POMOGRANATE-COTTON(Inter) 16 NOS 200.00 1.36 272.00
10 Emmitting Pipe - 16 mm 1to4 LPH , 50cm N/A POMOGRANATE-COTTON(Inter) 16 Mtr 2700.00 9.53 25731.00
11 PVC / HDPE Fittings N/A POMOGRANATE-COTTON(Inter) 0 PERHAC 0.80 1175.25 940.20
Total : 53043.11

Total(A+B) : 62,555

For, BHUVA POLYPLAST PVT. LTD.

Authorised Signatory
 Annexure - XXIII
BHUVA POLYPLAST PVT. LTD.
Survey No. 105, Plot No. 1&2; Rajkot - Gondal Highway, VIII.: Bhunava,Tal.: Gondal Dist.: Rajkot 360311(Gujarat)
India

ADVANCE RECEIPT ACKNOWLEDGEMENT

Receipt No. : - Print Date : 30-October-2018

Received with thanks from GGRC ( GOG Implementing agency (SPV) ) vide Cash/Cheque/Demand Draft on behalf of benificiary farmer
as per details given bellow :

Reg No : 1819-KCT-2824
MI System Buyer : RABARI JETUBEN MANGABHAI

Sr. No. Chq. / DD No. Chq. / DD Date Bank Details Amount Rs. Technical Sanction No. Adv. Claim Voucher Adv. Claim
No Voucher
Date

1 15639.00 GGRC/TS-NL/2018-2019 BPPL/2018-19/DIS-154 24/08/2018

/BHUVA/1819-KCT-2824

TOTAL AMOUNT Rs. 15639.00

Amount in words: FIFTEEN THOUSAND SIX HUNDRED THIRTY-NINE Only

Receipt will be valid subject to realization of Cheque. For, BHUVA POLYPLAST PVT. LTD.

Authorised Signator with

name ,designation and
seal of the company.