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<table cellspacing="0" cellpadding="0" border="0" class="myTable" style="border-width:0;width:555pt">
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<td align="center" colspan="7" style="border-width:0"><font style="font-size:22pt;font-weight:bold;">住宅专项维修资金实际使用分摊表</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">一、小区名称</font></td>
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<td style="border-width:0" colspan="7"><font style="font-size:14pt;"> 香珺苑一期</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">二、维修项目概况</font></td>
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<td values="" style="border-width:0" bindtype="0" rowspan="3" colspan="7" datasource="" type="textarea' styles='line-height:37px"><font style="font-size:14pt;"> 1、香珺苑一期_香珺苑一期栋25单元电梯，已维修完毕，结算金额：8,600.00元，<br>审价费用：400元,合计：9,000.00元。
<br> 总合计：9,000.00元</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">三、施工日期</font></td>
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<td type="textarea' styles='line-height:37px" colspan="7" datasource="" values="" style="border-width:0" bindtype="0"><font style="font-size:14pt;"> 开始日期：2021-01-15；结束日期：2021-01-16。</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">四、施工单位</font></td>
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<td type="textarea' styles='line-height:37px" colspan="7" datasource="" values="" style="border-width:0" bindtype="0"><font style="font-size:14pt;"> 1、沈阳远大智能工业集团股份有限公司江苏分公司</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">五、验收结论</font></td>
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<td style="border-width:0"><font style="font-size:14pt;"></font></td>
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<td type="textarea' styles='line-height:37px" colspan="7" datasource="" values="" style="border-width:0" bindtype="0"><font style="font-size:14pt;"> 合格
<br> 验收时间：2021年01月16日</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">六、参与验收人员</font></td>
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<td type="textarea' styles='line-height:37px" colspan="7" datasource="" values="" style="border-width:0" bindtype="0"><font style="font-size:14pt;"> 业主方、物业方、施工方</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">七、公示时间</font></td>
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<td type="textarea' styles='line-height:37px" colspan="7" datasource="" values="" style="border-width:0" bindtype="0"><font style="font-size:14pt;"> 2021年12月21日至2021年12月21日。</font></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;font-weight:bold;">八、分摊清册</font></td>
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<td align="center">序号</td>
<td align="center">房屋地址</td>
<td align="center">房屋面积(㎡)</td>
<td align="center">结算应拨金额(元)</td>
<td align="center">自筹金额(元)</td>
<td align="center">分摊金额(元)</td>
<td align="center" style="border-width:0 0 0 1px"></td>
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<tr style="height:14pt">
<td align="center">1</td>
<td align="center">香珺苑25单元201室</td>
<td align="center">137.8000</td>
<td align="center">489.58</td>
<td align="center">0</td>
<td align="center">489.58</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">2</td>
<td align="center">香珺苑25单元202室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">3</td>
<td align="center">香珺苑25单元301室</td>
<td align="center">137.8000</td>
<td align="center">489.59</td>
<td align="center">0</td>
<td align="center">489.59</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">4</td>
<td align="center">香珺苑25单元302室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">5</td>
<td align="center">香珺苑25单元401室</td>
<td align="center">136.8900</td>
<td align="center">486.34</td>
<td align="center">0</td>
<td align="center">486.34</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">6</td>
<td align="center">香珺苑25单元402室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
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<tr style="height:14pt">
<td align="center">7</td>
<td align="center">香珺苑25单元501室</td>
<td align="center">137.8000</td>
<td align="center">489.58</td>
<td align="center">0</td>
<td align="center">489.58</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">8</td>
<td align="center">香珺苑25单元502室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">9</td>
<td align="center">香珺苑25单元601室</td>
<td align="center">137.8000</td>
<td align="center">489.59</td>
<td align="center">0</td>
<td align="center">489.59</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">10</td>
<td align="center">香珺苑25单元602室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">11</td>
<td align="center">香珺苑25单元701室</td>
<td align="center">137.8000</td>
<td align="center">489.58</td>
<td align="center">0</td>
<td align="center">489.58</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">12</td>
<td align="center">香珺苑25单元702室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">13</td>
<td align="center">香珺苑25单元801室</td>
<td align="center">137.8000</td>
<td align="center">489.59</td>
<td align="center">0</td>
<td align="center">489.59</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">14</td>
<td align="center">香珺苑25单元802室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">15</td>
<td align="center">香珺苑25单元901室</td>
<td align="center">137.8000</td>
<td align="center">489.58</td>
<td align="center">0</td>
<td align="center">489.58</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:14pt">
<td align="center">16</td>
<td align="center">香珺苑25单元902室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:16pt">
<td align="center">17</td>
<td align="center">香珺苑25单元1001室</td>
<td align="center">137.8000</td>
<td align="center">489.59</td>
<td align="center">0</td>
<td align="center">489.59</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:16pt">
<td align="center">18</td>
<td align="center">香珺苑25单元1002室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:16pt">
<td align="center">19</td>
<td align="center">香珺苑25单元1101室</td>
<td align="center">137.8000</td>
<td align="center">489.58</td>
<td align="center">0</td>
<td align="center">489.58</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:16pt">
<td align="center">20</td>
<td align="center">香珺苑25单元1102室</td>
<td align="center">115.6100</td>
<td align="center">410.74</td>
<td align="center">0</td>
<td align="center">410.74</td>
<td style="border-width:0 0 0 1px"></td>
</tr>
<tr style="height:16pt">
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:1px 0 0 0"></td>
<td style="border-width:0"></td>
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<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
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<td style="border-width:0"></td>
<td align="right" colspan="3" style="border-width:0"><font style="font-size:14pt;">申请人:无锡市弘泰物业管理有限公司（盖章）</font></td>
<td style="border-width:0"></td>
<td style="border-width:0"></td>
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</tbody></table>
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<td style="border-width:0;width:76pt"></td>
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<td style="border-width:0" colspan="2"><font style="font-size:14pt;">年 月 日</font></td>
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