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Job No.

ID No. *

Name of the Indentor *

Contact Number *

Division Name *

Permission from HOD/HoC/PL (For works in Main Lab and Pilot Plants)

Name of HOD/HoC/PL (For works in Main Lab and Pilot Plants)

Location of Work *

Nature of Work *

Type of Work *

Fund Head * (If Other, please provide the Project Number for Fund Allocation (Check all that apply.)

P-06 (Lab. Maintenance)

P-701 (Staff Quarter Maintenance)

P-50 (Works Capital)

P-702 (Staff Quarter Capital)

Other:

Work Description *

Justification of Work *

Stipulated Time

Drawing / Sketch (if any)

To be Filled by Engineering Division

Remarks

Job Allotted to

Materials Supplied (if any)

Expected Cost

Status of Job (Check all that apply)

Completed

Partially Completed

Site Visited

Date of Completion (Actual)

Actual Cost (after execution)

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