EV/QS-01/REV-01/NOV-18

ABC CONSTRUCTIONS LTD

PB# 1234, Adressline1, Addressline2.
Phone - 123456789; Fax - 123456780

APPLICATION FOR PAYMENT- NO: INTERIM X

AS AT: PENULTIMATE
FINAL
Date of Application :

CLIENT'S REF. NO:

CONTRACT
CLIENT ABCC REF. NO.
CONSULTANT
CONTRACT PRICE (ORIG) (REV)
COMMENCEMENT DATE COMPLETION DATE

SUMMARY OF VALUATION

BILL DESCRIPTION AMOUNT (AED)

SUB TOTAL '1'

ADJUSTMENTS........% OF BILL NO.
ADD / DDT
SUB TOTAL '2'
ADD: PROVISIONAL SUMS
SUB TOTAL '3'
ADD: MATERIALS ON SITE
.........%OF...................................
SUB TOTAL '4'
DDT: RETENTION ....% of SUB TOTAL 3 / 4
ADD:...% OF............... RELEASE OF RETENTION**
SUB TOTAL '5'
ADD: ADVANCE PAYMENT
DDT: ADVANCE PAYMENT RECOVERY
SUB TOTAL '6'
DDT: PREVIOUS VALUATIONS NO……….

AMOUNT DUE THIS VALUATION NO. .....

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 EV/QS-01/REV-01/NOV-18

PROJECT MANAGER / SITE AGENT CERTIFIED BY THE ENGINEER / CLIENT

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