Payment Request – UNESCO CAIRO OFFICE

Submitted by: Dr. Bisher Imam Signature………......................... Date: 18/10/2017

PO Responsible Officer

If SES not created in DUO/SP or FABS by the Responsible Officer:

Signature of delegated person Name .........................Signature ……………………….Date:

Justification documents prepared & checked by:

Assistant PS Name: Ms. Fatma Khattab Signature ……… ……………Date: 18/10/2017

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UNESCO FRN 3240294741 (G/L 6012504) for UNDP Amex issued Air tickets,
A. # 20 participants ATKTs= 180, 805 EGP

Contract valid period [including amendments if any] from 24/06/2016 to 31/12/2017

Services have been delivered by the Contractor & considered satisfactory in conformity with TORs

SES no 1: (Second Instalment) Delivered by contractor on: 30/09/2017

Registered in financial Systems by PS responsible on: 18/10/2017 Amount: 180, 805 EGP
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SES no 2: ………………………..delivered by contractor on Date …………… registered in financial
systems by PS responsible on Date ………….. Amount ……………… Currency

If the Payment Request refers to more than one installment please provide reason:
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Checked by:

Certified by:

AO Visa [Certify correct] YES /NO Date:

Visa by: Director, UNESCO Cairo Office

Dr. Ghaith FARIZ Signature............................ Date: …………….
AO Unit
Received by ADM/FIN [Name AO/AA ……………………………] on: Date.....................................
Return to [Office Name/AA PS………………………………….…] on: Date ………………………..
Reason for reject: …………………………………………………………………………………………..
…………………………………………………………………………………………………………………...
Inv Ref: ........................................ Processed by ……..………..…….…………….. Date
Payment Ref: ................................ Processed by …………..……………………….. Date
Scanned invoices loaded on FABS corresponding record on …………………………Date
Attachments:
1. Original Invoice(s) dully signed by responsible officer
2. Justification documents related to type of contract:
2. Certificates of Delivery and Acceptance by Beneficiary if Purchase Order
3. First page of the UNESCO Acceptance Reports dully signed by PS Responsible
4. Copy of Contract/amendments