3903石化监理表格.docx

1、3903石化监理表格SH/T 3903-A.1工程开工/复工报审表Works Comme nceme nt/Resumptio n ApprovalRequest工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司(监理单位)To (CS/CMC)我单位承担的 工程，已完成了一下各项工作，具备了开工/复工条件，特此申请施工，请核查并签发开工 /复工指令。We have fulfilled the follow ing activities for the work con tracted byus, the works comme nceme nt/ works

2、 resumpti on con diti ons are available, therefore the con struct ion is applied hereby, please review and issue works commencement/ works resumption orders.附 Attached :1 开工报告 Commencement Report ；2 证明文件 Supporting documents。项目经理Project Man ager承包单位(章) 日 期Con tractor(Chop) Date审查意见 Review Comments：总

3、监理工程师Chief Supervisi on Engin eer项目监理机构 日 期CS/CMC DateSH/T 3903-A.2施工组织设计（方案）报审表Con struct ion Orga ni zati on Desig n ApprovalRequest工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司（监理单位）To （CS/CMC）我方已根据施工承包合同的有关规定完成了 工程施工组织设计（方案）的编制，并经我单位技术负责人审查批准，请予以审查。Accord ing to the related regulati ons of the con

4、struct ion con tract, we have completed the preparati on of the construction organization design , and it has been reviewed andapproved by the tech nical resp on sible people of our compa ny, please review it.附 Attached施工组织设计/施工方案。 Con structi on Organi zatio n Desig n/ Con struct ion Plan项目经理Projec

5、t Man ager承包单位（章） 日 期Con tractor（Chop） Date专业监理工程师审查意见 Review comme nts from discipli ne supervisi on engin eer:专业监理工程师Discipli ne Supervisi on Engin eer日期Date总监理工程师审核意见 Review comme nts from chief supervisi on engin ee：总监理工程师Chief Supervisi on Engin eer项目监理机构 日 期CS/CMC Date -SH/T 3903-A.3分包单位资格报审表S

6、ubc on tractor Qualificati on Approval Request工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司(监理单位)To (CS/CMC)经考察，我方认为拟选定的 (分包单位)具有承担下列工程的施工资质和施工能力，可以保证本工程项目按合同的规疋进仃施工。分包后， 我方仍承担承包合同的全部责任。请予以审查和批准。After in vestigati on, we think the proposed (subc on tractor)has the qualificati on and capability for con

7、tract ing the wing works, and can assure that this woks will be con structed as per the con tract regulati ons. After subc on tract ing this works, we still hold the whole resp on sibilities of the lump sum con tractor. Please review and approve it.附 Attached1 分包单位资质材料 Subco ntractor Qualificatio n

8、Docume nts2 分包单位业绩材料 Subc on tractor Performa nee Docume nts分包工程名城(部位)Subc on tracted works (locatio n)工程数量Works Qua ntity拟分包工程明合同额Con tract Price of proposed subc on tracted works分包工程占全部工程Perce ntage of subc on tracted works合 计Totals项目经理Project Man ager 承包单位(章) 日期Con tractor(Chop) Date专业监理工程师审查意见 R

9、eview comme nts from discipli ne supervisi on engin eer:专业监理工程师Discipli ne Supervisi on Engin eer日期Date总监理工程师审核意见 Review comme nts from chief supervisi on engin ee:总监理工程师Chief Supervision Engineer_ 项目监理机构 日期CS/CMC DateSH/T 3903-A.4 扌报验申请表 Inspection Request致濮阳中油工程管理有限公司（监理单位）To （ CS/CMC）我已完成了 作，经自检合

10、格，先报上该工程报验We have completed the works, after selfin specti on, the works is on spec, now we submit the in spect ion request for this works, please and accept.附 Attached：项目经理承包单位(章)Con tractor(Chop)Project Man ager 日 期Date审查意见 Review Comments：总/专业监理工程师Chief /discipli ne supervisi on engineer 项目监理机构 日

11、 期CS/CMC DateSH/T 3903-A.5工程款支付申请表Works payme nt Request致濮阳中油工程管理有限公司（监理单位）To （ CS/CMC）我方已完成了 工作，按施工承包合同的规定，建设单位应在 _年 月 日前支付该项工程款共（大写） 小 ），现报上 工程付款申请表，请予以审查并开具工程款支付证书。We have completed theWorks, accord ing to the con tract regulati ons, the owner should make the payme nt of total of （amount in works

12、）,（say ） for this works before . Now we submit the Works PaymentRequest, please review and issue the works payme nt certificate.附件 Attached:1 工程量清单Quantity List:2 计算方法 Calculatio n Methods：项目经理承包单位(章)Con tractor(Chop)Project Man ager 日 期DateSH/T 3903-A.6监理工程师通知回复单Corresp ondence to Supervisi on Engi

13、n eer Notice工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司(监理单位)To (CS/CMC)我方接到编号为 的监理工程师通知后，已按要求完成了工作，现报上，请予以复查。After we received the supervisi on engin eer no tice of ,we have completed thejobs, now we submit it, please recheck.详细内容 Detailed contents：项目经理Project Man ager承包单位(章) 日 期Con tractor(Chop) Da

14、te复查意见 Recheck comme nts总/专业监理工程师Chief /discipline supervision en gineer项目监理机构 日 期CS/CMC _ DateSH/T 3903-A.7工程临时延期申请表Works Temporary Delay Request致濮阳中油工程管理有限公司（监理单位）To （ CS/CMC）根据合同条款 条的规定，由于 原因，我方申请工程延期，请予以批准。Accordi ng to clauses of the con structi on con tract clauses, due to threas ons, we reque

15、st the works delay, please approve it.合同交工日期 Con tract As Build Date申请延长交工日期 Delayed As Build Date：附件 Attached1 工程延期的依据及工期计算 Works delay basis and work ing period calculation2 证明材料 Support ing docume nts项目经理承包单位(章)Con tractor(Chop)Project Manager 日 期Date SH/T 3903-A.8费用索赔申请表Cost Claim Request工程名称Wor

16、ks Title :编号 Item No :致濮阳中油工程管理有限公司（监理单位）To(CS/CMC)根据承包合同条款条的规定，由于的原因，我方要求索赔金额（大写），请予以批准。Accordi ng to clauseof the con structi on con tract, due to thereasons, we request the cost claim of (amount in words)JPlease approve it.索赔的详细理由及经过Detailed cause and course of the claim索赔金额的计算Calculati on of cla

17、imed amount：附 Attached：证明材料 Support ing docume nts项目经理Project Man ager承包单位（章）日 期Con tractor(Chop)DateSH/T 3903-A.9工程材料/构配件/设备报审表Works Materials/Comp onen ts/Equipme ntIn spect ion Request工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司（监理单位）To （CS/CMC）我方于 年 月 日进场的工程材料/构配件/设备数量如下（见附件）。现将质量证明文件及自检结果报上，拟用于下述

18、部位：请予以审核。We have mobilized the followi ng materials/comp onen ts/equipme nt for the works on its qua ntity is listed below(see the attachme nts)Now, we submit the quality docume nts and our self in specti on results, The proposed locati ons for use as followsPlease review it.附件 Attached：1 数量清单 Quant

19、ity List ；2 质量证明文件Quality Documents；3 自检结果 Self In spection Results项目经理Project Man ager承包单位(章) 日 期Con tractor(Chop) Date审查意见 Review Comments：经检查上述工程材料/构配件/设备，符合/不符合设计文件和规范的要求，准 许/不准许进场，同意/不同意适用于拟定部位。After the in spect ion, the aboveO materials/ comp onen tsO equipme nt,D meet do not meet the require

20、ments of the design documents and specifications. site mobilization is allowed/O site mobilization is not allowed. O use for the proposed locations is allowedO not allowed.总/专业监理工程师Chief /discipli ne supervisi on engin eer项目监理机构 日 期CS/CMC DateSH/T 3903-A.10工程竣工报验单Works Completi on In spect ion Reque

21、st工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司(监理单位)To (CS/CMC)我方已合同要求完成了 工程，经自检合格，请予以检杳和验收。We have completed the works according to therequireme nts of the con tract, after the self check, it is on spec, please in spect and accept.附 Attached:项目经理Project Man ager承包单位(章) 日 期Con tractor(Chop) Date审查意见 R

22、eview Comments：经初步验收，该工程：After the prelimi nary in specti on and accepta nee, this works1 符合/ 不符合我国现行法律、法规要求； meet/O not meet the requireme nts of the curre nt state laws and regulations2 符合/ 不符合我国现行工程建设标准； meet/O not meet the requireme nts of the curre nt n ati onal sta ndards3 符合/ 不符合设计文件要求； meet/

23、O not meet the requireme nts of the desig n docume nts4 符合/ 不符合施工合同要求。 meet/O not meet the requireme nts of the con struct ion con tract.综上所述，该工程初步验收合格/不合格，可以/不可以组织正式验收。Based on the above points, the preliminary inspection and acceptanceof this works is on specD off spec, formal inspection and accep

24、ta( can beD can not be organized.总监理工程师Chief Supervision Engineer项目监理机构 日 期CS/CMC DateSH/T 3903-A.11施工进度计划报审表Con struct ion Schedule Approval Request工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司(监理单位)To (CS/CMC)我方已根据承包合同的有关规定编制完成了 年 月 日至 年 月 日的：We have completed the preparati ons of the followi ng sche

25、dules from toaccord ing to the related regulatio ns of the con struct ion con tract1 工程施工总进度计划 Project Co nstruction Overall Schedule2 工程施工月进度计划 Project Co nstruction3 工程施工周进度计划 Project Co nstruction4 计划 Project Construction并经我单位技术负责人审查批准，先报上，请予以审查。我们将严格按审查通过的进度 计划组织施工。附 Attached :图表、说明书共 页。Draw ing

26、s and charts, in struct ion book, totally in pages.项目经理Project Man ager承包单位(章) 日 期Con tractor(Chop) Date审查意见 Review Comme nts：同意此计划。 Approved this schedule.不同意此计划，请按以下要求修改再报。 Not approved this schedule, please modify it accord ing to the follow ing requireme nts, and resubmit it:专业监理工程师Discipli ne S

27、upervisi on Engin eer日期Date审查意见Review Com项目监理机构CS/CMCmen ts：总监理工程师Chief supervision en gineer日 期DateSH/T 3903-A.12工程质量事故处理方案报审表工程名称Works Title :Works Quality In cide nt Soluti on ApprovalRequest编号 Item No :致濮阳中油工程管理有限公司（监理单位）To （ CS/CMC）年 月 日 在 （工程部位）发生工程质量事故，已于 月 日发出工程质量事故报告（编号： ），经我方组织对该质量事故进行详细调查

28、、分析和研究，现将详情及处理方案报上，请审查。On ,at （works location）,there was works quality in cide nt, the works quality in cide nt report（item No ） has bee n issued on ,after we in vestigated, an alyzed ancStudied it, now we submit the details and solution to you, please review.附 Attached：事故详情及处理方案。In cide nt Details

29、and Soluti on.承包单位（章）Con tractor（Chop）项目经理Project Manager 日 期Date 审核意见 Review comments：同意此事处理方案 Approved the soluti on for this in cide nt.不同意此事处理方案，修改后再报。 Not approved the soluti on for this in cide nt, please modify in and resubmit.按以下意见修改后执行： To impleme nt it after modified as per the followi ng

30、comme nts.项目监理机构CS/CMC 总监理工程师Chief supervisio n engin eer 0 期DateSH/T 3903-A.13主要施工设备进场报审表Major Con struct ion Equipme nt Mobilizatio nApproval Request工程名称Works Title :编号 Item No :致濮阳中油工程管理有限公司(监理单位)To (CS/CMC)我单位承担的 工程，按合同规定的主要施工设备、机具及检测设备、工具拟进场，并经自荐合格，请查验。We contracted the works, we are going to mobilize themajor con structi on equipme nt and tools as well as the in spe