Date of Submission

EXPENSE CLAIM 10 June 2024

PERSONAL INFORMATION
Contact Address
Name - Md. Faizan Ansari (42000805)
Number Wadi Naka-10, Near CNG Gas Pump, Amravati Road,
Nagpur MH 440023
Designation Junior Engineer 9589282040
Local Traveling for Breakdown, Material Purchase and Courier Claim
Purpose :
Claim Date – 01/06/2024 to 10/06/2024 – Imprest Amount – 10000/-
Mode of Payment Amount
1. TRAVEL FARE (As per reverse) ( Attach CC Cash INR
the Necessary Bills) 0:00
Remarks by Finance department
if any

Mode of Payment Amount

2. HOTEL EXPENSES / FOOD( Attach CC Cash INR
Necessary Bills)
Remarks by Finance department
if any

Mode of Payment Amount

3. LOCAL TRAVEL EXPENSES (As per CC Cash INR
reverse) Attach Bills ₹
Cash
3,624.00
Remarks by Finance department
if any

Mode of Payment Amount

4. MISCELLANEOUS EXPENSES (As per CC Cash INR
reverse) Attach Bills ₹
Cash
5,963.00
Remarks by Finance department
Local purchase, xerox and courier
if any

TOTAL EXPENSES (1+2+3+4) Mode of Payment Amount

CC Cash INR
₹
Cash
9,587.00

Claimer / Associate HOD HR Authorized Signatory

Note : Travel expense claim to be submitted within 15 days of return from the trip.
Date Description Type Amount
01-06-2024 DTDC Purchase 140
01-06-2024 Gajanan Engineering Works Purchase 150
Petrol expenses (Wadi Depo to Dattawadi to wadi depo for Material
01-06-2024 Local 64
purchase - 8 Km.)
Petrol expenses (Breakdown Bus. No. MH40CD9397 Wadi Depo to Sadar to
02-06-2024 Local 224
Wadi Depot. 28 Km)
Petrol expenses (Breakdown Bus. No. MH31FC3817 wadi Depo to
04-06-2024 Local 328
Bahudara fata to Wadi Depot. 41 Km)
05-06-2024 Saifee Traders Purchase 220
05-06-2024 Manmandir Tours & Travels Purchase 350
Petrol expenses (Wadi Depo to Ganeshpite to wadi depo for Courior - 36
05-06-2024 Local 288
Km. )
Petrol expenses (Breakdown Bus. No. MH40CD9384 wadi Depo to
05-06-2024 Local 496
bharamni fata to Wadi Depot. 62 Km)
07-06-2024 Sagar Travels Purchase 340
Petrol expenses (Wadi Depo to Ganeshpite to wadi depo for Courior - 36
07-06-2024 Local 288
Km. )
Petrol expenses (Breakdown Bus. No. MH40CM0109 wadi Depo to
07-06-2024 Local 496
bharamni fata to Wadi Depot. 62 Km)
08-06-2024 National Traders Purchase 60
08-06-2024 Gopal Hardware Purchase 40
08-06-2024 Varma Travels Purchase 220
08-06-2024 Haharashtra Bearing & Belting Co. Purchase 4293
Petrol expenses (Wadi Depo to Ganeshpite to wadi depo for Courior - 36
08-06-2024 Local 288
Km. )
Petrol expenses (Wadi Depo to Gandhi bag to wadi depo for Material
08-06-2024 Local 304
purchase - 38 Km.)
Petrol expenses (Breakdown Bus. No. MH40CM1979 wadi Depo to Defance
08-06-2024 Local 144
gate to Wadi Depot. 18 Km)
09-06-2024 Gajanan Engineering Works Purchase 150
Petrol expenses (Breakdown Bus. No. MH40CM0112 wadi Depo to
09-06-2024 Local 496
bharamni fata to Wadi Depot. 62 Km)
Petrol expenses (Wadi Depo to Dattawadi to wadi depo for Material
09-06-2024 Local 64
purchase - 8 Km.)
Petrol expenses (Breakdown Bus. No. MH40CM1975 wadi Depo to Defance
09-06-2024 Local 144
gate to Wadi Depot. 18 Km)