支 付 | | 帐户支 | | 付款日期
| 发票金额 | | 准电传 |
百分比 | | 付金额 | |
| | | 日期) |
------|------|-----|------|------
| | | |
| | | |
| | | |
| | | |
| | | |
| | | |
| | | |
| | | |
------|------|-----|------|------
| | | |
---------------------------------
STATEMENT OF EXPENDITURE (SOE)
Annex 2.
Fol: (Ⅰ) Expenditures on goods and civil works under contracts val-ued less than US
$ 200000 equivalent
(Ⅱ) Works carried out by foree account
Date____________Application No.___________Summary Sheet
No.____________
Category No.______________IBRD Loan, IDA Credit or Cofin-
ancier Ref.No.__________
------------------------------------
1 | 2 | 3 | 4 | 5 | 6 |---|------|-----|-----|------|-----|
| | | | | Total |
| |Contract | | |Amount of |
| Name | |Breif | | |
| and | or | | | Invoices |
| Address |Purchase |Descrip- | Currency | |tem | of |Order No. |tion of | |Coveted |No. | Contractor|and Date |Coods, | and Tctal |by Appli- |
|/Supplier |(or |Works, | Amount of |cation |
| |other | of | Contract |(Net of |
| |Ref) |Services | |Reten- |
| | | | |tion) |---|------|-----|-----|------|-----|
| | | | | |
| | | | | |
| | | | | |
| | | | | |---|------|-----|-----|------|-----|TOTALS| | | | | |------------------------------------
-----------------------------------
7 | 8 | 9 | 10 | 11
------|------|------|-------|------
| | | |
| | | |
| | Amount | |
| Invoice | paid | |
| Amonunt | from | | Date
|