FORM 3 : PROFORMA FOR ROADS AND BRIDGE WORKS

1 Administration Sanction 2 Estimate Stage 3 Technical Sanction

(1) Road Information (2) Bridge Information
Administrative Sanction Received Date Auto Fill Administrative Sanction Received Date Auto Fill (Option to Add more Reaches) (Option to Add more)

GO No. Estimate Prepared By Technical Sanction Authority Sub-Division Sub-Division

GO Date Is Land Acquisition Involved Yes / No Ref 3A Technical Sanction No. Parliamentary Constituency Parliamentary Constituency
(dd/mm/yyyy)
GO Amount Is R & R Involved Yes / No Ref 3B Technical Sanction Date Legislative Constituency Legislative Constituency
(Rs. In cr.) (dd/mm/yyyy)
Road No. Is Electrical Utility Shifting Involved Technical Sanction Amount Road Name Road Name
Government/HOD in association with IT-CCC

Fill from RMS Yes / No Ref 3C1 Fill from RMS Fill from RMS
(Rs. In cr.)

EE/SE/CE as per Limit*

Road Name Auto Fill Is Pipelines Utility Shifting Involved Yes / No Ref 3C2 Total Length (km) calculated Road No Fill from RMS Road No Fill from RMS

Road Classification Is Telecom Utility Shifting Involved Yes / No Ref 3C3 Job No. (CRF/EAP) Road Unique ID Fill from RMS Road Unique ID Fill from RMS

EE
Name of the Work Is Tree Cutting Involved Yes / No Ref 3D IBM Value (for EPC Works) Nature of Work Nature of Work

Head of Account Is Forest Clearance Involved Yes / No Ref 3E1 Remarks Start chainage (km) Start chainage (km)

Sub Head (Scheme) Is Wildlife Clearance Involved Yes / No Ref 3E2 Attach Copy of TS Click to Attach End chainage (km) End chainage (km)

HOD Is Environment Clearance Involved Yes / No Ref 3E3 Road Information Yes Ref 1 No. of Bridges Type of Bridge

District Is Encroachment Involved Yes / No Ref 3F Bridge Information Yes/No. Ref 2 Culvert / Other structures (No.) Bridge No.

Division Estimate Submission Date Submit Bridge Length

(dd/mm/yyyy)
Remarks No. of Piers
Estimate Recommendation Authority
EE/SE as

Limit*

Attach Copy of GO Click to Attach Approach Length A1(m)

per

Estimate Recommendation Date Submit

(dd/mm/yyyy) Approach Length A2(m)
SUBMIT
Targets of Above are entered in Form 2a and monitored in 3A - 3F

Submit

* Based on AS Limit - EE - upto 40 lakhs, SE > 40 lakhs and upto 2 cr., CE > 2cr. * Based on AS Limit - EE - upto 40 lakhs, SE > 40 lakhs and upto 2 cr., CE > 2cr.
Note: For all EAP the CE is responsible Note: For all EAP the CE is responsible

2a LA/ R&R/ Utility Shifting/ Forest Form 9 C: Work Completion and

4 Bid Information 5 Agreement Information 6 Revisions
Clearance DLP
Work Completion Date Auto Fill
Bid Inviting Authority Agreement Concluding Authority Land Required Revised A/S No.
EE/SE/CE as per

Govt./ HOD in
asso. IT-CCC
(Acre) Final Bill Paid Yes/No.
Limit*

Bid Invitation Date Agreement No. Land Available % Available Revised A/S Date
(dd/mm/yyyy) (Acre) (dd/mm/yyyy) Final Bill Date
Last Date of Receipt of Bids Agreement Date Land to be Acquired Revised A/S Amount (dd/mm/yyyy)
(dd/mm/yyyy) (dd/mm/yyyy) (Acre) Final Bill Amount

EE/SE/CE As per
Bid Approving Authority Agreement Amount R&R - Project Affected Families Revised TS No.
#

(Family/No) Completion Report

EE/SE/CE/CoT as per Limit

Click to Attach

Limit*
Date of Submission to COT if COT Mode of Contract Electrical Utility Shifting Revised TS Date
(km) (dd/mm/yyyy) Final DLP Date
EE/SE as per Limit**

Date of Receipt of Approval if COT Contract Period Water Utility Shifting Revised TS Amount (dd/mm/yyyy)

EE

EE
(km) Quarterly Inspection Date
Bid Approving Date Date of Commencement Trees to be Cut Working Estimate Date (dd/mm/yyyy)
(no.) Inspection Report Click to upload
Bid Approving Letter Click to Attach Scheduled Date of Completion Auto Fill Forest Clearance Working Estimate Amount
(acre) Defects Identified Yes/No.
Date of Issue of LOA Remarks Wildlife Sanctuaries Supplementary Agreement No.

EE/SE As per Limit**

(acre) Rectification Done ? Yes / No
Name of Contracting Agency Attach Copy of Agreement Click to Attach Environment Clearance Supplementary Agreement Amount
EE/SE as per Limit**

(acre) Rectification Report Click to Upload

Contractor Registration No. SUBMIT Supplementary Agreement Date
Encroachments (dd/mm/yyyy) DLP Completion Report Click to Upload
Continue to 9a
Name of the Engineer for Target (no) Revised Completion Date
Other (dd/mm/yyyy)
Remarks Remarks
CFMS ID Remarks
Attach Copy of LOA Click to Attach Attach Copy of Revised DocumentsClick to Attach
EE

Continue to 9b Detail Status-Ref.

Progress Form 3 A - E
All the above must have options to add more fields as all
SUBMIT works may have multiple revisions

* Based on TS Limit - EE - upto 40 lakhs, SE > 40 lakhs and upto 2 cr., CE > 2cr. ** Based on Agreement Value - EE - upto 40 lakh, SE >40 lakhs and upto 2 cr. * Based on AS Limit - EE - upto 40 lakhs, SE > 40 lakhs and upto 2 cr., CE > 2cr. * Based on AS Limit - EE - upto 40 lakhs, SE > 40 lakhs and upto 2 cr., CE > 2cr.
# Based on TS Limit - EE - upto 40 lakh, SE> 40 lakhs and upto 2 cr., CE > 2cr., CoT > 10 cr. Note: For all EAP the CE is responsible ** Based on Agreement Value - EE - upto 40 lakh, SE >40 lakhs and upto 2 cr. ** Based on Agreement Value - EE - upto 40 lakh, SE >40 lakhs and upto 2 cr.
** Based on Agreement Value - EE - upto 40 lakh, SE >40 lakhs and upto 2 cr. Note: For all EAP the CE is responsible Note: For all EAP the CE is responsible
Note: For all EAP the CE is responsible