PAYMENT CERTIFICATE SUMMARY SHEET

INTERIAM PAYMENT NO. retention

DATE OF MESUREMENT
PROJECT:- Drainege Ditch lot -1
CLIENT:- East Hararge Zone Health Office Format Amount (Birr)
CONTRACTOR:- ABDISA, ALFIYA FI SHARIKKOTA Main Contract before Vat 828,326.00
SUPERVISOR:- Supplementary Contract -
LOCATION:- AWWEDAY CITY
15%Vat 124,248.90
Previos payment with VAT -
Date No Amount Total Sum with Vat 952,574.90
IPC 1 220,858.93
IPC 2, 284,020.52 Excuted Work Amount (Birr)
IPC 3 Total volume up to date before VAT 20,699.74
Final Final 257,838.67
Total 762,718.12
VAT(15%) 3,104.96
Retention without VAT Total volume up to date with VAT 23,804.70
Date No Amount (Birr) Deductions
1 23,805 Previous Payments with VAT
2 Rebate (%)
3 Retention (2.5%) with VAT
Advance Repayment (20%) with
Final VAT
Total 23,804.70 Total Deductions -
Add pevious cumulative retention
Advance payment with VAT Net due to pay 23,804.70
Advance taken (Birr) 190,514.98 Net due to pay before VAT 20,699.74
Advance Repaid 1 190,514.98 Net payment this time VAT 3,104.96
Advance Repaid 2 Net paymet this time withVAT 23,804.70
Advance Repaid 3
Advance repaid final
Advance repaid to date 190,514.98
Advance Remain 0.00

We certify that the contractor is know entitled to the sum of birr 23804.70 (Twenty three thousand and eighty hundred
four birr & 70/100 ) Birr only

Checked by Approved by

Name:_______________________ Name:_____________
Sign:________________________ Sign:_____________