APPLICATION FOR EXTENSION OF TIME OF COMPLETION OF WORK

1. Name of work :

2. Agreement No. :
3. Name of contractor :
4. Date of commencement of work :
5. Date of completion of work as per Agreement :
6. Physical progress of work achieved :
7. Reason for non completion of work :

8. Date up to which extension is sought for :

9. Details of previous extension granted if any :

I hereby agree to complete the above work in all respects within the extended time of
completion now applied for without claiming any enhanced rate of any other additional claims.
Place:
Date:

Signature of the contractor

REMARKS OF THE DEPAETMENTAL OFFICERS

10. Physical progress of work :

11. Reason for non-completing the work :

12. Period of extension of time of

completion recommended :

13. Penalty if any imposed for the

present extension :

14. Remarks :

ASSISTANT ENGINEER ASSISTANT EXECUTIVE ENGINEER EXECUTIVE ENGINEER