Ref No: 22837 Date: 07/07/2023

From: Category : L- 110

Narayan Bhagoji Sutar Residential 1st main,19th Cross, Kengeri 560060

Assistant Executive Engineer Address :
Employee No: 10262 Duty Point : Deepanjali Nagar, Shanthinagar, Jakkur office,
Vadayarpura Casting yard, hennur casting
yard, yelhanka Stn Bagalur stn, Kodigehalli
stn etc
Distance : 1999

Sub : Conveyance Reimbursement Claim

The details of fuel consumed and vehicle maintainance for the period, from 1/6/2023 to 30/6/2023 pertaining to
usage my own vehicle bearing Reg. No.KA41MA0392 . is enclosed here with.

a) Fuel Bills
Sl. Details Bill No Date Qty. Rate Bill
No. ( ltrs ) Amount
1 sell 9473 5/6/2023 28.35 123.47 3500
2 sell 9745 13/6/2023 29.97 123.47 3700
3 sell 10017 20/6/2023 28.35 123.47 3500
4 sell 10269 28/6/2023 29.16 123.47 3600
Total 115.83 14300
b) Vehicle Maintainance
Sl. Details Bill No Date Bill
No. Amount
1 INSURANCE 9138 19/6/2023 4053
2 SERVICE 01917 22/6/2023 7205
Total 11258
c) Driver Expenses Rs. 12000

Total Rs. 37558

I Certify that i have incurred an expenditure of Rs 12000/- towards engaging the driver, for the month of June-
2023.

The amount of Rs. 37558/-( Rupees Thirty Seven Thousand Five Hundred and Fifty Eight only ) claimed
towards conveyance for the month of June - 2023 may please be reimbursed to me.

Encl 1) Fuel bills in Original

2) Maintainance bills in Original
Your faithfully

Narayan Bhagoji Sutar

Assistant Executive Engineer
VERIFICATION BY FINANCE SECTION
The employee is eligible for the reimbrusement not exceeding Rs as per BMRCL Circular/Office Order
dated ..........

Payment of Rs....................... may be released.

Assistant
Approved for Payment