CONCESSION REQUEST

Part A - To be completed by SUPPLIER

Project No. 44QS4700

1. Name & Location

2. Request No. CR

3. Issue No.

Client: NIRMA LIMITED.

4. Date raised

5. PO No.

4th Stream Soda Ash at New

Location
6. Description:

7. PO Item No.

8. Supplier Ref. No.

9. Sub-Order No.

10. Tag/Equipment No.

11. Sub-Supplier

12. Sub-Assembly Part No.

13. Drawing & documents affected by Request:

14. Description of Request

15. Attachments
Yes
No
LIST: -

16. Justification
Signature:
17. Effect on delivery:
______________If Granted

Position:
18. Effect on Cost if granted

______________If not
Increase?
Decrease?
Unchanged?
Granted
OTHER FACTORS AFFECTED: (Delete if not applicable) Attach additional sheets providing details
Strength
Function
Code Compliance
Integrity/Reliability
Maintenance
Performance
Interchange ability
QA/QC
Contractual
Approval by CA
Safety/Fitness
Item Life

PART B: - To be completed by Jacobs

1.Resolution Category
2.Amendment to PO
Level 1 - Engineering,
Supply Mgmt. Project & Client
Level 2 - Level 1 + Cert.
Authority

5.
6.

Yes

No

Reference No.

3.Design Change

4.CA Approval

Requirement
Yes

Yes

No

Reference No.

No

Letter No.

Conditions of Acceptance/Usage/Reason for rejection

Decisions

Approved

Engg. Discipline

Yes

No

Signature

Name

Purchase

Yes

No

Signature

Inspector/Supplier
Surveillance
Coordinator

Yes

No

Date

Project Manager
Client
Certifying Authority

Yes
Yes
Yes

No
No
No

Inspection Report Ref:

Concession Request (CR)

Concession Request

Form No. : 290400786.doc

Date

7.

CR Close-out

Requisition No: - 44 QS4700-000-V-11-0012

Procedure For Concession Request Origination & Completion
When a vendor wants to request for a Concession Request, he shall contact the Inspection Manager
(or JE inspection Coordinator) who shall provide a serial number for the request. The Concession
request, properly numbered, shall be addressed to Inspection Manager.
The Q.C. Reports with a complete Concession Request section or a Concession Request shall be
submitted to the Originating Engineer for their evaluation by Inspection Manager (or JE inspection
Coordinator). The request may be submitted to the client Representative and / or A Certifying Authority
when the Originating Engineer has confirmed that this was required.
The Inspection Co-ordinator shall notify the vendor/ contactor of the final decision by returning a copy
of the completed Concession Request Form. Distribution to other Project Personnel shall be
confirmed to project requirements.
The Inspection Co-ordinator / Inspector shall Verify that the deviation approved by the Concession
request has been incorporated into design and / or project documentation.
The Inspection Co-ordinator / Inspector when the vendor / contractor has complied with the condition
approved by the Concession Request, shall complete the ` CR Close Out box on the sellers copy of
the CR form attachment. If a concession has been requested for an order with no inspection, the CR
will be closed out by the appropriate discipline.

Form No. : 290400786.doc