Special Note/Chcek List towards approval of Extension of Time pertaining to the

Building portion work as per OPWD code volume-1,Para-3.5.30

1.a)Name of the work : Constn. of Drug wire house of VSS.MCH.Burla

(First Floor back side) for 2010-11.

b)Belongs to which Administrative : Works Deptt.Govt.of Odisha.

Department.

2.a)Name of (R&B) Division. : Bargarh (R&B)Division.

b)Name of the (R&B) Circle. : Norhern Circle (R&B)Sambalpur.

c)Name of the Revenue District. : Sambalpur.

3.a)Name of the Contractor/Agency : Sri Jyotiranjan Tripathy.

b)Class of Contractor : “A” Class.

4.a)Agreement No. : 48 P1 of 2010-11.

b)Value of the agreement : Rs.55,70,125/-

5.Estimated cost of the work. : Rs.75,57,000/-

6.a)A.A. No. & Date. : NRHM L.No.15439/23.12.2009

b)R.A.A.No. & Date. : Not applicable.

7.a)A.A. Amount. : Rs.73,53,000/-

b)R.A.A. Amount. : Not applicable.

8.Whether R.A.A. for the work is required : Not applicable.

9.Till to date position of allotment received : -

expenditure incurred and balance amount
of allotment available with the division.
(Furnish the information financial year
wise along with detailed reference of
allotment received).

Approved vide Letter No- B-I-WD-20/2003 37496 (9),

Dt.- 27.08.2003 of Chief Engineer, Buildings,Orissa,Bhubaneswar. Page - 1
 Sl. Finanncial Allotment received. Expenditure Incurred Balance amount Remarks.
No. Year. Avialable
Without With Without With Without With
P.C. P.C. P.C. P.C. P.C. PC.

1 2011-12 47,26,491/-
2 2012-13 8,43,610/-
3
4
5
6
7
8
9
10
11

10.a)Technical sanctioned amount. : Rs.55,21,880/-

b)Letter No. & Date Technical sanction :T. S. by S.E.N.C.(R&B)No.58/2010-11

c)Authority accorded the Technical sanction : S.E.(R&B)Sambalpur.

11.Date of commencement of the work : 19.12.2010

12.Stipulated date of completion of the work. : 18.06.2011

13.Time/Period stipulated to complete the work : 6(Six) month.

14.Proposed/Actual date of commopletion of the work : 23.03.2013

15.Whether the revised work programme as per : Yes.

E.O.T.application is annexed with the proposal.
16.Actual time required/ to be required to : 27 month 5 days.
complete the work in all respect.
17.Period for which extension of time is applied for. : 21 (Month) 5 (Days)

18.Present physical progress of the work : Work completed.

19.a)Whether the work is completed in all respect. : Work completed.

b)If so, Xerox copy of the completion : -

certificate be furnished.

Approved vide Letter No- B-I-WD-20/2003 37496 (9),

Dt.- 27.08.2003 of Chief Engineer, Buildings,Orissa,Bhubaneswar. Page – 2
20.a)If completed whether the building is handed : Not applicable.
Over to the concerned funding Department.

b)

21.Date of submission of E.O.T. application by : (Due to personal problem E.O.T.

The concerned Agency/Contractor(Should be 30 application submitted in delay).
Days)before the stipulated date of completion or
within 30 days from the date hindrance as per
OPWD code volume-I Para- 3.5.30)

22.a)Actual date of receipt of E.O.T. application :

in S.O’s office.

b)Date of Submission of E.O.T. application to :

S.D.O’s office (Mention the letter No. & Date)

c)No. of days remained in S.O’s office for disposal :

the case.

23.a)Actual date of receipt of E.O.T. application in :

S.D.O’ Office.

b)Date of submission of E.O.T. application to E.E’s :

office (Mention the letter No. & Date).

c)Nos. of days remained in S.D.O’s office for : -

disposal the case.

24.a)Actual date of receipt of E.O.T. application in : -

E.E.’s office.

b)Date of submission of E.O.T. application to : -

S.E.’s office (Mention the letter No. & Date).

c)No. of days remained in S.D.O.’s office for : -

disposal the case.

Approved vide Letter No- B-I-WD-20/2003 37496 (9),

Dt.- 27.08.2003 of Chief Engineer, Buildings,Orissa,Bhubaneswar. Page – 3
25.a)Actual date of receipt of E.O.T. application in : -
S.E’.office.

b)Date of submission of E.O.T.application to C.E’.s : -

office (Mention the letter No. & Date).

c) Nos. of date remained of S.E’.s office for : -

disposal the case.

26.a) Actual date of receipt of E.O.T. application in : -

the Chief Engineer’s office.

b)Date of submission of E.O.T. application to : -

Works Department, Government of Odisha.
(Mention the letter No. & Date )

c)Nos. of days remained in C.E’s office for : -

disposal the case.

27. Whether the E.O.T. application has been :

received from the Contractor in proper time as
per the clauses laid down in the agreement.

28. a)Whether the E.O.T. proposal was placed in the :

Technical Committee as per Works Department
Letter No.-18379, dt:- 10.10.2001.

b)Mention the date, time, venue of Technical :

Committee.

c)Whether the minutes of such Technical :

committee meeting processed to Works
Department.(Mention the letter No. & Date)

29.Whether the reasons stated in the E.O.T. : Not attributable.

Application are attributable to the contractor
concerned or to any Departmental lapses.

Approved vide Letter No- B-I-WD-20/2003 37496 (9),

Dt.- 27.08.2003 of Chief Engineer, Buildings,Orissa,Bhubaneswar. Page – 4
30.If the reasons of delay is partly attributable to the : Furnished.
Contractor but there is ground for granting
extension, an undertaking of the contractor not to
claim escalation during the extended period is to
be furnished.
31.If the delay is due to change of designs/site the : Does not arise.
Circumstances for such changes may be stated
(Permission letter may be furnished).
32.If the delay is due to heavy untimely rainfall, : Attached.
Whether a certificate is furnished the competent
authority showing the details of rain fall during
the period of hindrances.
33.Whether the Contrctor has furnished ”No : Attached.
CLAIM CERTIFICATE “ for the extension of
time applied for in stipulated from(Signature of
the Contractor must be attested by the concerned
Executive Engineer)
34.Whether any amount is withheld pending : No.
decision of extension of time.

35.Whether splitting up approval has previously : No.

given. If so, furnish the letter No & date of
concerned appropriate authority.

36.Mention the letter No. & Date of the Tender :

approving authority.

37.Mention the Letter No. & date of the tender : S.E.N.C.(R&B)sambalpur vide
accepting authority. L.No.6435/30.11.2011

38.a)Actual amount of Work done within the time : Rs.13,81,790/-

stipulated under orginal agreement.

b)Mention the percentage of work done within : 24.80%

the Original Agreement period.

c)Amount of work executed beyond the : Rs.41,88,311.00

stipulated time of Original agreement.

d)Amount of work done under supplementary : Does not arise.

Agreement.( If any ).

e)Total amount of work done both under original : Does not arise.
& supplementary agreement.
 Approved vide Letter No- B-I-WD-20/2003 37496 (9),
Dt.- 27.08.2003 of Chief Engineer, Buildings,Orissa,Bhubaneswar. Page – 5
39.Amount of actual payment made to the : Yes.
Concerned agency/contractor through different
running bills towards execution of this work.Till
to date position of payment made to the
contractor (i. e. up to submission of this
Extension of Time) to be furnished in the
Proforma furnsiehd below.
Sl. Reference of Reference Total Cumulative Measurements recorded vide Remarks
No. Voucher No.& of amount of mount of M.B. Page Date of
date of running running running No. No. Measureme
Running bills bills. bills. bills. nt
1 2 3 4 5 6 7 8 9
st
1 222DL/3.06.2011 1 .R/A. 6,49,143/- 923 1-12 10.05.2011

2 01 DL/3.09.2011 2nd.R/A 7,32,648/- 13,81,790/- 923 20-42 18.06.2011

3 151 Dl/17.11.2011 3rd.R/A. 7,45,851/- 21,27,642/- 786 28-101 1.10.2011

4 669DL/29.12.2011 4th.R/A. 16,91,201/- 33,30,831/- 786 114- 17.9.2012

123
5 743DL/29.03.2012 5th.R/A. 13,95,660/- 47,26,491/- 786 138- 20.03.2012
182
6 576DL/20.03.2013 6th.R/A. 8,43,610/- 55,70,101/- 922 89-97 23.03.2013

40.a)Whether the extension of time has granted : Does not arise.

Previously (Mentioned the time of extension
granted along with the reference of Letter No &
date of the concerned authority)
b)If so, whether the E.O.T. is granted with benefit : Does not arise.
of price escalation or without benefit of price
escalation ?
41.Hindrances on account of which extension of : Attached.
time is applied. Justify the nos. of days for each
hindrances with date of occurnce
(In a separate sheet).
42.Whether the reasons of hindrances stated by the : Yes.
Concerned Contractor on the body of the
Extension of Time application are seems to be
true, genuine correct and based on valid ground.

43.Whether clause-2 of the Agreement invoked for : -

slow progress of work.
Approved vide Letter No- B-I-WD-20/2003 37496 (9),
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44.Reasons as to why

(..............)Compensation will not be levied on the

Contractor

(..............)Benefit of price escalation will not be

Curtailed/disallowed

45.Whether the information furnished in the special : Yes.

note/ check list are true to the best of knowledge
of the Executive Engineer concerned.

46.Recommendation of concerned Executive Engineer :

with signature with date & Seal.

47.Recommendation of concerned Superintending :

Engineer with signature with date & seal.

48.Recommendation of the Chief Engineer(Buildings), :

Odisha with signature with date & seal.

N.B:- Proposal must be accompanied with the Extension of Time application of the Contractor
along with due recommendation of all concerned departmental officers. No claim certificate of
contractor concerned, certified copy of the agreement and all other supporting documents as
instructed vaide this office letter No. 37496 (9), dt. 37-08-2003.

Proforma copy of the special note/check list

towards grant of Extension of time is approved.

Chief Engineer (Buildings),Odisha.

Approved vide Letter No- B-I-WD-20/2003 37496 (9),

Dt.- 27.08.2003 of Chief Engineer, Buildings,Orissa,Bhubaneswar. Page – 7

NO CLAIM CRTIFICATE.

1.Certified that I will not claim any compensation on any account from the Department for the
delay in completion of the work:” Constn. of Drug wire house of VSS.MCH.Burla(First Floor back
side) for 2010-11.”

.Under Agreement No. 48 P1 of 2010-11

for which I have applied for time extension.

2. Certified that I will claim /I will not claim the benefit of price excalation charges during the
period of extension.

Place:- Burla.

Date :- Signature of the Contractor.

Signature of Sri

Is hereby attested

Executive Engineer

(R&B) Division.

Approved vide Letter No- B-I-WD-20/2003 37496 (9),

Dt.- 27.08.2003 of Chief Engineer, Buildings,Orissa,Bhubaneswar. Page – 8