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Document - irpmu.railnet.gov.in

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FORM-14<br />

RECEIPT CERTIFICATE (FOR SUPPLY ONLY)<br />

From: Sr. Section Eng<strong>in</strong>eer/Signal/ IRPMU/NC Railway/Juhi/Kanpur<br />

No.<br />

Date:<br />

1 Contract No<br />

2 Name of Work<br />

3 Item No. As <strong>in</strong> Rate Schedule<br />

4 Description of Item.<br />

5 Material <strong>in</strong>spected by<br />

6 Dispatch particular & date<br />

7 Qty as per dispatch particular<br />

8 Qty received<br />

9 Qty short received<br />

10 Condition of Stores Received<br />

11 Name of Firm & Address<br />

12 Place of receipt<br />

13 Date of receipt<br />

14 Ledger No.<br />

15 Name & designation of Stores Incharge<br />

--------------------------------------<br />

Signature of Stores-<strong>in</strong>-Charge<br />

Signature of contractor Page 99 of 104 Dy CSTE/Proj/IRPMU/CNB

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