ANNEXURE IV
GOVERNMENT OF GOA
PUBLIC WORKS DEPARTMENT
WORKS DIVISION ……………………..
(INSTALLATION BILL)
No. ______________________
Name of consumer _______________ House No. _________________
Owner ___________ Water Connection ___________
Tenant_________________________________________________________________
Address ____________________________________ Meter No. _________________
_____________________________________ Size ___________________
____________________________________ Initial Reading ______________
Consumer Code No. Amount
Expenses with Commu :Labour ___
nication) : Materials ___
(a) : 10% of admn (1st Art.)
: 11 of Water supply
: bye-laws
Sum
Charges, Art, 32 of : Connecton fees
Water supply bye-
Laws (b) : Meter installation fees
: Testing fees
GUARANTEE Deposit (Art 33 of water supply Bye-Laws)
(c) Sum
Expenses with domici- : (Labour)
le installation) : (Materials)
(d) : (10% for Admn)
: Testing fees
Sum
Figures
(e) Total
Rupees ______________________________________________________________
______________________________________________________________
Received the of amount of this by ________________ prepared by _____________
_______________ _________________ ___________________
Cashier Verified by Approved by