प्रगत पदार्थ एवं प्रक्रम अनुसन्धान INDENT FORM NO.

: 01

संस्र्ान - 462 064 FOR USE BY PURCHASE

Sr. No. of Indent

Monitoring
Register
Purchase of Goods& Services without quotation *
Up to ` 15, 000/- (For Non-R&D items and Up to ` 1,00000/- (For - R&D items )

Certified that funds are available for the Purchase of proposed item(s) under the
Project No. NA B/H : सीएसआईआर ने ट फैलोशिप आकस्मिक अनु दान संख्या-31/041(0071)/2015-EMR-I

COFA/FAO/SO (F&A)

TO BE FILLED BY THE INDENTOR: DATED:

Name of Indentor: शितेंद्र कुमार शतवारी Phone No(s). 9454770619

ID No. & Designation: 20EE15A35005, पी एच डी शवद्यार्थी Name of Division: ए सी एस आई आर

Name & Designation of Project Leader: डा एन. सतीि, वररष्ठ वैज्ञाशनक

Project No.: NA Project Starting Date: 10.08.2015 Ending date: 11.08.2020

सीएसआईआर ने ट फैलोशिप
Total estimated Cost `.: रु 24900/- B.H.:
आकस्मिक अनु दान संख्या-
31/041(0071)/2015-EMR-I

The following items are required for (purpose): Testing of developed material
S. No. Required item with detailed specifications Qty. Estimated cost of Availability Signatures of Stores
each item in in C/Stores Stores In-
charge SO (Stores)
Rupee
1 Tensile specimen 70 340/-

2 Thermal conductivity specimen 20 55/-

1. Certified that the specifications are complete and correct to meet the requirements fully.
2. Certified that no previous advance is outstanding in my name. Further, I undertake to adjust this advance also within FIFTEEN working
days from the date of withdrawal of advance.
3. Mode of payment (advance/payment to the firm)

Signature of the Indenter Signature of Project Leader

Name & Designation शितेंद्र कुमार शतवारी Name & Designation डा एन. सतीि, वररष्ठ वैज्ञाशनक
, पी एच डी शवद्यार्थी
Approved a sum of 24900/- (रुपया)only
under Budget Head : सीएसआईआर ने ट फैलोशिप आकस्मिक अनु दान संख्या-31/041(0071)/2015-EMR-I

Project Leader / Stores& Purchase Officer

(For R&D) /(Non-R&D)

Document1 Page 1 of 4
 CONTINGENT ADVANCE
AMPRI/ Pur Adv. No. Dated _____________________ Budget Head...........................

Amount `________________________(Rupee____________________________________________________________)

Advance is required by Dr./Sh./Smt. ……………………………...................................................................

.for the purchase of _____________________________________including freight/ scooter charges etc. It is also certified by the

indentor that no previous advance is outstanding against his name. Cheque may be prepared in favour of Indentor/Project Leader.

Assistant (S&P) SPO/DO

II- REIMBURSEMENT /ADJUSTMENT

(To be filled by the Indentor / Project Leader)

It is certified that the procurement/repair was very urgent and immediate nature which necessitated such purchase/ repair and

expenditure made out of my own pocket/Advance . The rates charged by M/S ……………………………………………… for

purchase/repair of ………………………………………………………….. is reasonable and as per prevailing market rates.

The amount of `. ………………………..…. may kindly be reimbursed /Adjusted ..

Indentor Project Leader

(To be filled by Purchase Division)

Reimbursement/Adjustment Of `. …………………………………………………………...…………………..…. may be made to

Sh/Smt./Dr. …………………………………………. towards procurement of …………….………………..….……….. from
M/S …….… … … … … … ………………………………….….

Assistant(S&P) SPO/DO

Document1 Page 2 of 4
III- PAYMENT AGAINST BILL

(1) The Bill No. ………………………..….. dt. ……………………. for `. …………………….…………………………

is enclosed for making payment to M/S ………………………….…… ………………………………………….. .. . . . . ..

Bank name & A/C No. Branch name IFSC Code

towards the supply of ……………………………………………………………..

(2) Certified that all the articles detailed in the vouchers attached to the bill and in those retained in my office have been
accounted for in stock register. The relevant store issue voucher has been filled and issued by store and the copy is enclosed.

(3) Certified that the purchases billed for have been received in good condition and according to specifications that the rates paid
are not in excess of the prevailing market rates and that suitable notes of payments have been recorded against the indents and
invoices concerned to prevent double payments.

(4) Certified that –

(a) The expenditure on conveyance hire included in this bill was actually incurred, was unavoidable and is within the
schedule scale of charges for the conveyance used and
(b) The government servant concerned is not entitles to draw travelling allowance under the ordinary rules for the journey
and is not granted any compensatory leave and does not and will not received any special remuneration for the
performance of the duty which necessitated the journey.

(Indenting Officer)

In view of the above certificates by Indentor, the bill/ voucher no. …………………………..………………..………of

M/S ……………….………………..………………………………………………..……… for `………….. ……………………..

for the purchase/repair of …………………………………………………..……………. may be passed for payment.

Assistant (S&P) SPO/DO

IV- FOR USE BY FINANCE & ACCOUNTS SECTION

Passed for payment of `……………………..… (Rupee __________________________________________________________
Payment by cheque /DD No. …………….…….………… date …………………………………..

Dealing Asstt. S.O. (F&A) COFA/FAO

Document1 Page 3 of 4
 ANNEXURE –‘A’

CERTIFICATE FOR PURCHASE OF GOODS& SERVICES WITHOUT QUOTATIONS

Up to ` 15, 000/- (For Non-R&D items and Up to ` 1,00000/- (For -R&D items)

a) “I Shri/Ms. /Dr. …………………….……..………………………..., am personally

satisfied that these goods purchased are of the requisite quality and specification and
have been purchased from a reliable supplier at a reasonable price”.

b) “ It is further certified that the required item is for specific use of the R&D and
will be utilized for the project titled

c) “It is certified that the item is not available in the store.”

Sanctioned ` …………….(Rupee……………………………………………..………only)

Indenting Officer Project Leader/ Stores & Purchase Officer

Document1 Page 4 of 4