Extension of Time APWD Format

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Form No.

3
APPLICATION FORM FOR EXTENSION OF TIME, Water Resource Department, DIBRUGARH, ASSAM
To
The Executive Engineer
Water Resource Department
Dibrugarh Division,
Dibrugarh
“Through the Assistant Executive Engineer, W.R.D. East Sub Division,” Dibrugarh
Sir,
I hereby apply for the extension of the time with details as follows:
1. Name of Work: “Construction of Revetment, Geo-bag Apron in Mothalla – Oakland bank
protection work along the Brahmaputra river, Dibrugarh for Lot 1 and Lot 2”.
2. Date of issue of Work Order: Letter of Acceptance No. AFRERM (P)/PROJ/23-2010/(Pt-I)/68
dated 20.02.2012.
3. Period for Completion as per tender: 16 (Sixteen) months period from November 2011 to
March 2013.
4. Period for which extension of time has been given previously :
(a) 1st extension up to ………………… vide EE No……………
(b) 2nd extension up to ……………….. vide EE No……………
(c) 3rd extension up to ………………… vide EE No……………
(d) 4th extension up to ………………… vide EE No……………
5. Period for which extension is applied up to: 30-04-2015.
6. Reasons for which extension sought for :-
(a) Issue of work order at the last part of the 1st Working Season.
(b) Late finalization of sizes of Concrete Block.
(c) Non finalization of the rates and specification of the additional item of works.

Signature of the Contractor


A.E.E. No. _____________ Dated:
Submitted to the Executive Engineer, W.R.D., Dibrugarh with following details and remarks.
1. (a)Tender No. : AIFRERMA/DIB/M-O/BPW/EAST of 2011/1.
(b) Date of completion as per original tender as extended :
2. Tender value including supplementary items.
3. Items 1,2,3,4 & 6 of the contractor’s petition verified and corrected where necessary with
initials.
4. Extension recommended. Up to :
Not Recommended

Asst. Executive Engineer, WRD East Sub Division


Checked Above Details Order of the Executive Engineer,
T.C. Where extension refused.
Dealing Assistant, S.D.O.(T.C.) 1. Extension refused intimate
Extension Granted Up to___________ with Contractor
penalty of Rs. _________ for 2. Issue order Clauses.
disproportions process 3. (a) (b) (c) of tender (F - 2).
2 & 3 tender H.

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