Turnover of CCTV Equipment
Date: _____________________
This is to certify that the equipment and vehicles listed below were turned over to the recipient
PMO or disposed of in accordance with 8990's Engineers instructions.
ITEM/DESCRIPTION
QUANTITY
UNIT
Certified by
________________________________
ITECH-RAR Representative
(signature over printed name)
Equipment received by:
Confirmed by:
________________________________________
_________________________ON SITE P<O
(signature over printed name)
(ADB Staff Member)
(signature over printed name)
Date: ____________________
Date: _____________________
Note: Consultants normally submit this certificate with their final claims, within a week or two of
completing the assignment. At the latest, you must submit this certificate within 90 days of completion
if you are a consulting firm or within 60 days of completion if you are an individual consultant.
ADB Form No. 705/01
Revised April 2010