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Disbursement Claim format under IPDS for 3rd Tranche GoI Grant release in case of Partial Turnkey/Departmental Execution
Name of Utility :- _________________
Name of Project /Circle: __________________________
Approved project cost: Rs_______ Crs
Award Cost: Rs_______ Crs
Value of BoQ items yet to be awarded: Rs_______ Crs
GOI Grant sanctioned (60% /(85% in case of Sp Cat States) : Rs.______Crs GoI Grant No:______
Counterpart loan sanctioned (30% /(10% in case of Sp Cat States) : Rs.______Crs FI Loan No: ________ Name of FI/Bank: ______________
Utility's Contribution (10% /(5% in case of Sp Cat States) : Rs.______Crs
Table-I Summary of Claim Amount in Rupees Crs
Sl. Brief Work approval by Competent Cost of Material Erection Cost Total
No. description of Authority of Utility used claimed Taxes & Duties Directly paid by Discom Executed
work Approved Value Date of Cost
of work approval Challan No Date Amonut claimed
1 2 3 4 5 6
1 As per Annexure
- B
As per Annexure
2 - B
Total
Table II: Project expenditure details in case of departmental /partial turnkey execution:
All amount in Rs.crs
Sl. Brief Work approval by Competent Material cost details All Payment details of Erection Contracts
No. description of Authority of Utility
Approved Value Date of Cost of Material Basis of Material Name & Award value Invoice Nos. Invoice Date Invoice Total amount Cheque
work of work approval used Cost claimed i.e. Address of /Bill paid Number /ECS
Store Issue Agency, Amount Details/Tax
Voucher (SIV) Contract Chalan Nos.
/SRV/DI/ Purchase award No. & and date of
Order (PO) No. Date payment wrt
to Column 10
1 2 3 4 5 6 7 8 9 10 11
1 As per Annexure
- B
2 As per Annexure
- B
Total Amount :-
Date: Authorised Signatory of Utility
It is hereby certified that:
i The information given as above is correct as per sanctioned DPR/Contract/Purchase Order and other records maintained for the purpose.
ii Payment shown under column 9 actually paid to and accepted by supplier/contractor/agency.
iii Claims against project expenditure is limited to eligible project-areas and are as per approved DPRs/work awarded.
iv Project implementation is satisfactory and deliverables by the suppliers /contractors are of the required quality, quantity and satisfaction as per IPDS Guidelines.
v The performance bank guarantee from the supplier / agency for supplies / works as per the contract (if applicable) has been obtained and kept on record.
vi Amount claimed for BoQ items has not been claimed in any other scheme of GoI /any other funding agencies.
vii TDS and other statutory deduction in respect of the above payments have been made and deposited/arrangements have been made to deposit with the concerned authorities.
viii The variation in BoQ is as per IPDS guidelines.
ix 1) High value items have been procured as per the technical specifications finalised by Committee-A constituted by MoP
2) Distribution Transformers under IPDS scheme have been procured/being procured as per:
a. Standard ratings, meeting the loss levels of Energy Efficiency Level-2 specified in IS 1180(Part-1):2014
b. All the distribution transformers procured/being procured under IPDS after 01.08.2016 have Standard Mark of the Bureau of Indian Standards, after obtaining license for BIS certification.
x
Value of Store Items (materials/equipments) utilised in the project and claimed (if any) are as per the utility's store procurement cost /store issue rate of the item and details are as per Appendix-B.
Further, it is certified that the store items used in the project were not covered in the scope of Turnkey Contractor and no payment against the same has been made to the Turnkey Contractor.
xi The store items used/installed in the project were purchased post sanction of the project DPR.
xii All claims of expenditure are as per the terms and conditions of sanctions i.e. All claims for expenditure incurred are from the date of sanction of projects by IPDS Monitoring Committee.
xiii All payments to Contractors /Agencies have been /are being made through PFMS.
xiv UC for GoI Grant in the prescribed GFR format is enclosed.
xv Utility's Contribution as per guidelines have been arranged and received.
xvi Financial sanction of lenders (FI/Banks) for 30% of approved project cost (10% in case of Special Category States) have been received and copy of sanction letter is enclosed.
xvii Recommendations of PMA supported by a report on expenditure, progress and constraints (if any) for timely completion of project has been received and is enclosed.
xviii As per IPDS guideline Para 8.1 (Chapter IV), Audit report and certificate (if due) from Independent Chartered Accountant has already been submitted /is enclosed.
xix Projects are being implemented as per IPDS guidelines.
Authorised Signatory of Utility
Date: Name:
Designation:
Note:
1 The amount may be mentioned in Rupees Crs rounded off to two decimal places
2 In case of store items, payment details like cheque no. & date would not be required in the claim form.
Verified by PMA:
Name of PMA
(Signature)
Authorised Signatory of PMA
Name:
Designation
Date:
Form-II
Disbursement Claim format under IPDS GoI Grant release in case of Partial Turnkey/Departmental Execution
Name of Utility :- _________________
Name of Project /Circle: __________________________
Approved project cost: Rs_______ Crs
Award Cost: Rs_______ Crs
GOI Grant sanctioned (60% /(85% in case of Sp Cat States) : Rs.______Crs GoI Grant No & date:______
Counterpart loan sanctioned (30% /(10% in case of Sp Cat States) : Rs.______Crs FI Loan No & date: ________ Name of FI/Bank: _________
Utility's Contribution (10% /(5% in case of Sp Cat States) : Rs.______Crs Order No & date: ________
Table-I Summary of Claim (Details at Table-II) Amount in Rupees Crs
Sl. Brief Work approval by Competent Cost of Material Erection Cost Total
No. description of Authority of Utility used claimed Taxes & Duties Directly paid by Discom Executed Cost
work Approved Value Date of approval claimed
of work Challan No Date Amount
1 2 3 4 5 6 7 8 9=4+5+8
1
As per Annexure
- B
2
Total
It is hereby certified that:
i The information given as above is correct as per sanctioned DPR/Contract/Purchase Order and other records maintained for the purpose.
ii Payment shown under column 9 of Table II, actually paid to and accepted by supplier/contractor/agency.
iii Claims against project expenditure is limited to eligible project-areas and are as per approved DPRs/work awarded.
iv Project implementation is satisfactory and deliverables by the suppliers /contractors are of the required quality, quantity, standards, specifications and satisfactory as per IPDS Guidelines.
v The performance bank guarantee from the supplier / agency for supplies / works as per the contract (if applicable) has been obtained and kept on record.
vi Amount claimed for BoQ items has not been claimed in any other scheme of GoI /any other funding agencies.
vii TDS/GST and other statutory deductions in respect of the above payments have been made and deposited/arrangements have been made to deposit with the concerned authorities.
viii 1) High value items have been procured as per the technical specifications finalised by Committee-A constituted by MoP.
2) Distribution Transformers under IPDS scheme have been procured as per Standard ratings, meeting the loss levels of Energy Efficiency Level-2 specified in IS 1180(Part-1):2014 as
modified from time to time.
3) All the distribution transformers procured under IPDS after 01.08.2016 have Standard Mark of the Bureau of Indian Standards, after obtaining license for BIS certification.
ix Value of Departmental Store Items (materials/equipments) utilised in the project and claimed are as per the utility's store procurement cost /store issue rate of the item. Further, it is certified
that the store items used in the project were not covered in the scope of Contractor and no payment against the same has been made to the Contractor.
x The store items used/installed in the project were purchased post sanction of the project DPR.
xi All claims of expenditure are as per the terms and conditions of sanctions i.e. All claims for expenditure incurred are from the date of sanction of projects by IPDS Monitoring Committee / date
allowed as per sanction.
xii All payments to Contractors /Agencies have been made through PFMS.
xiii UC for GoI Grant in the prescribed GFR format is enclosed.
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xiv Utility's Contribution as per guidelines have been Utilized.
xv Financial sanction of lenders (FI/Banks) for 30% of approved project cost (10% in case of Special Category States) have been received and utilized.
xvi Recommendations of PMA supported by a report on expenditure, progress and constraints (if any) for timely completion of project has been received and is enclosed.
xvii As per IPDS guideline Para 8.1 (Chapter IV), Audit report and certificate (if due) from Independent Chartered Accountant has already been submitted /is enclosed.
xviii Projects have been implemented as per IPDS guidelines.
xix Claims are based on RA Bills / MB and the same is being properly maintained by the utility.
xx The assets created out of the grant have been accounted for as per applicable Accounting Standard.
xxi The material(s) / equipment(s) (including store items in case of partial turnkey/departmental execution) claimed have been used for the approved project/scheme.
xxii Materials/Equipment/Civil/Erection works, for which above claim has been made are as per guidelines. Further, the word "IPDS" have been embossed on all the material erected under IPDS
scheme.
xxiii TPCEA has carried out the inspection of the works implemented in aforesaid circles on sample basis and accordingly has inspected the quality of material/equipment supplied at site and
execution of works under the project. It is certified that the observations indicated in TPCEA reports have been complied
xxiv Any deviation from specification mentioned in SBD has been duly approved by State DRC and its commercial/financial implication, if any, has been settled before submitting the claim for
disbursement to Nodal Agency.
xxv Insurance cover has been obtained/renewed as per Utility’s policy for the material supplied and paid for and the same is valid as on date.
xxvi 100% feeder metering has been achieved in project area.
Authorised Signatory of Utility
Date: Name:
Designation:
Note:
1 The amount may be mentioned in Rupees Crs rounded off to two decimal places
2 In case of store items, payment details like cheque no. & date would be required if value of single store item exceeds Rs. 5 Cr.
3 For Turnkey works, claims to be submitted in Form-I
Verified by PMA:
Name of PMA
(Signature)
Authorised Signatory of PMA
Designation
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