Payment Request - UNESCO CAIRO OFFICE
PO Responsible Officer
Submitted by: Dr. Bisher IMAM swan §> Date: 17/10/2017
If SES not created in DUO/SP or FABS by the Responsible Officer-
Signature of delegated person Name. Signature .........Date:
Justification documents prepared & checked by:
Assistant PS Name: Ms. Hoda ABDEL-MEGUID Signature Date: 17/10/2017
UNESCO FRN 3240297476 (G/L 6012504) for UNDP AMEX issued air-tickets:
A. #3 &5 & 6-7 & 17 18 & 22 & 24 (8 Experts’ ATKTS) = 64,765 EGP
B. # 1-2 & 8-16 & 19-21 & 23 (15 Experts’ ATKTs) = 10,155 USD
Contract valid period [including amendments if any] From 26107/2017 to 31/21/2017
Services have been delivered by the Contractor & considered satisfactory in conformity with TORS
REF: FULL Payment to UNDP AMEX Delivered by contractor on: 16/10/2017
Requested for payment by PS responsible on: Amount (B): 10,175 USD >
SES no 2: s-vseseeelivered by contractor on Date .-- fegistered in financial
systems by PS responsible on Date AMOUNE ses Currency
If the Payment Request refers to more than one installment please provide reason
Checked by: 1! (7, Heh
Certified by: Xorg
amod 19- fo- QetT
AO Visa [Certify correct] ESO Dates 49,5 2
Visaby: Director, UNESCO Cairo Office
Dr. Ghaith FARIZ Signature cece Date
AO Unit
Received by ADMIFIN [Name AO/AA ssvesesese] OM: Date.
Retumm to [Office Name/AA PS. : esesene) OM: Dat
Reason for reject: i : .
Inv Ref. sun PROOGSSD BY nnn sone Date
Payment REF ernnecnninnennne PYOo@SSEd DY serves Dale
Scanned invoices loaded on FABS corresponding record on Date
Attachments:
1, Original Invoice(s) dully signed by responsible officer
2, Justification documents related to type of contract:
2. Certificates of Delivery and Acceptance by Beneficiary if Purchase Order
3. First page of the UNESCO Acceptance Reports dully signed by PS Responsible
4. Copy of Contractlamendments: B22 fi/y —7
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