APPLICATION-CUM-BILL FOR REFUND OF PERFORMANCE SECURITY  

        To 

             The...................... 
             (Purchase Officer) 
             ......................... 
             ........................ 

        Sir, 

             The refund of Performance Security Deposit amounting to Rs__
        (Rupees......................................only) against.... 
        us and therefore its repayment may please be arranged.  Necessary
        receipt duly stamped is given hereunder in Part-B. 

        2.    It is certified that I/We, have not received any complaints
        from the consignees regarding non-receipt, shortage or defects in
        the stores supplied under the contract. 

                                             (Signature of Contractor) 

                                    PART - B 

             Received from...........................the sum of Rs...... 
        amount in refund of my/our Performance Security Deposit in full  
        in respect of  

        Contract No...................................... 

        Station..................................................... 

        Dated..........................(Contractor's dated signature) 

             (Revenue Stamp for sums exceeding Rs.20/- should be affixed)

                                    PART - C 

                     (TO BE FILLED BY THE PURCHASE OFFICER) 

             It is certified that no demands against the above contractor
        are outstanding in the record of this Office and that the instant
        Security  Deposit  is  free from Government claims  in  terms  of
        Clause  7(4),  18 and 18 - A of General Conditions of Contract as
        far as A/T No................................is concerned and can
        be refunded to the Contractor by A/C Payee Cheque. 

                                              Signature..................

        Designation...................       Designation............... 

                                   PART - D 

         (FOR USE IN CONTROLLER/DEPUTY CONTROLLER OF ACCOUNTS OFFICE) 

             Pay Rs.....................................(Rupees........