BEFORE THE NOTARY PUBLIC: BHUBANESWAR

AFFIDAVIT

I, Sri Suvendu Das, age about 55years S/o Jayaram Das, Present and Permanent address Plot
No.497/3208, UCO Bank colony, Jharapada, Bhubaneswar-751006 Dist: Khurda do hereby solemnly
affirm and state as follows:

1. That I hereby undertake that, I will not claim compensation or any amount form the P.H.
Department for delay in completion of the work “Laying of pipe line including raw water rising
main, Clear water rising main and Distribution pipe line in connection with the work: Water Supply
to Vyasanagar municipality under UIDSSMT”.
2. That, I am deponent of this affidavit to produce the same before the concerned authority.
3. That, the facts stated above are true to the best of my knowledge and belief.

“Sworn before me” Deponent.

Deponent.

NOTARY, BHUBANESWAR
 Dt-

To,
The Executive Engineer,
P.H.Division-II, Cuttack
Cuttack.

Sub: Time extension for the work “Laying of pipe line including water rising main, clear water rising
Main & Distribution pipeline in connection with the work: supply to Vyasanagar municipality under
UIDSSMT.”

Dear Sir,

This reference to the above we wish to apply for time extension for the reasons as enclosed.
Kindly allow us extension of time.

Thanking you,

Yours sincerely,

For Suvendu Das