Reference to “Sub-Contractor” and “Contractor” to be consistent with the

terms of the Work Order/Sub-Contract

Final Account Statement (Sub-Contractor)

RE: Project
Statement of Final Account – Work Order/Sub-Contract* No. [***]

We enclose herewith our final valuation of the work done in respect of the
following Work Order/Sub-Contract*:

Work Order/Sub-Contract* No [***] Description

Please sign and chop the enclosed “Statement of Final Account” in the space
provided to confirm your agreement to the above and return to us for our
retention.

YF

PM

Encl

* Delete as appropriate
Reference to “Sub-Contractor” and “Contractor” to be consistent with the
terms of the Work Order/Sub-Contract

Reference :

Date :

Main Contract :

Sub-Contract / Work Order* No. :

Sub-Contract Works :

STATEMENT OF FINAL ACCOUNT

I/We, the undersigned, hereby confirm that the figures indicated in the attached
Summary of Final Account are correct and that the Final Sum of

$xxxxx [In words]

represents full and final settlement of the account for the completion of the above Work
Order/Sub-Contract* Works and discharges all payments for works executed, claims,
liabilities or charges of any kind whatsoever, in contract and in tort, in respect of this
Works Order/Sub-Contract*.

The outstanding balance and retention, if any, shall be released to you in accordance
with the conditions stipulated in the *Sub-Contract / Works Order*.

I/We further undertake to indemnify the Contractor, [Insert Entity], against any claims
arising or expense incurred due to any defects in workmanship or materials used within
the scope of the Work Order/Subcontract Works.

Agreed and signed by the Subcontractor:

(Signature and company chop)

For and on behalf of:

Date:

Prepared by Checked by Approved by

Q.S. / Contracts Commercial Department. Project Manager

Signed : Signed : Signed :

Date : Date : Date :

*Delete as appropriate