Ae FORM 11 - CoV MAU 11 - KE HOACH NGHIEM THU NGAY g Haypylaul INSPECTION DAILY PLAN ‘A. GENERAL PARTICULARY THONG TIN CHUNG From a Project name Noabt git Td Vinh Tién as | coves To Referencetio. ~~~ | CGV 6SGmMPLIMI Nguoi nen Nguyén Truong Son Senos — [SAY Work tem Date of submission Gong vise Nfhom thu : a chain | ‘Dear Sir/Madam, Chao Ong/Ba, ‘We would like to request youl to witness the following as follow f Chiing t6i kinh mdi Ong/Ba nghiém thu cac cng vige nhu bBn dui Description of works Noi dung Location Time In charge for inspection Nguoi nghigm thu Romark Ghi chi. Vite. THO gi: % 5 | ane Contractor} Pureprojects. 4 | Nghiern thu Ev oan Nhan | Nguy8n Truong Phuc Son. Mr B,_ ACKOWLEDGE/ XAC NHAN Requested by contractor Nawoi yéu edu \n Received by Pure Projects Representative /Nguoi nhan bor Dal dian | Dates Nga Pure Project = | Dater Ngay: Laine apf ff fuere Te Aw | este Comments !¥ kién: Revon: amended by ‘aporove By Tote! Linu: This request must bo submitted atleast 24 hours before the inepection time / Phibu nay pha 4uge NOP trude théi diém nghigm thu it nhat 24 gio” A/st-hugust-2015 Pare Projects J Page Loft PURE PROJECTSaN" Gem CONG HOA XA HOI CHU NGHIA VIET NAM. Dc lap - Ty Do - Hanh Phiic SOCIALIST REPUBLIC OF VIETNAM Independence - Freedom — Happiness Cha ay 24, ddl d sgh Gro fNevien eae BIEN BAN NGHIEM THU VAT Tu ACCEPTANCE OF MATERIAL DELIVERY Tén cong técl names of works S6/ No: CGV SSGHPLIMFACL EX. LL / € iq Cong trinh/Project: CGV SSG” = Hang Muclitems: Trang tr! n6i ngoai thét/ 1D work package * ~ ja diém xay dyng/ Location: Cao Oo S58 Yan Thanh Te.HoM 4. Déi tugng nghiém thu/Project item: .. Vi ttif Location of inspection: Lau § / Floor 2.Thanh phan tham gia nghiém thu/ Parties involved in the inspection process: a) Dai dign Tu van gidm sét: C6ng ty trach nhiém hu han Pure Viét Nam/ Representative of Pure Viet Nam Co.,Ltd, ‘Ong/ Mr: Nguyén Truong Son Chie vu/ Position: Project Manager SS Ongl Mr: Chite vu/ Position: .. Ong! Mr: Chite vul Position: b) Dai dién don vi thi céng: Céng Ty Cé Phan Thiét Ké va Xay dung Dat Phuc. Ong/ Mr: Boan Nhan Phic Chite vul Position: Site Manager Ongi Mr: : ‘Chire vul Position: 3.Thoi gian nghiém t shulfoceptance time: Bat abu! Begin: Te | food Lkldddeye, Két thiic/ Finish: ‘le pig 2 GAL. e See 4. Danh gia céng vige thwe hign/Evaluation of construction works done: a) Tai ligu cin ctr nghiém thu/ On supporting documents for inspection a, V6 tai figu lam cn ete nghiém thu/ On supporting documents for inspection = HO so’ thau, hop ding xdy dung $6: 60/HDTC2015-HPL ky ngay ... thang .... nim 2015 Tender documents, Contract agreement: Contract No 60/HDTC2015-HPL is made on , 2015 HO so thidt ké ban vé thi céng doe Chi du tu phé duyét va nhéng thay déi thidt ké dé duge chap nhan/ Documents of construction drawings approved by the Project Owner and the approved design change ~— Tiéu chuan, quy pham xay dung duge ap dung / Criteria and standard applying to construction Hd so thdu va hop ding xay dung/ Tender documents, Contract agreement = Tailigu chi dn ky thuat kam theo hop ddng xay dung The specification enclosed with the Contract Documents Revision: AL31-August 2015 ‘amondad by: Pure Projects Page tof 2 ‘Approved by:- Cac tiéu chuan kf thuat rigng/ Other related technical Specifications: > Bign phap thi cong duoc duyét/ Approved Method statement (if any) Nhat ky thi cong, nhat ky gigm sét ol chii du tur va cdc van ban khac o6 lién quan dén ai tong nghiém thu/Construction diary, supervision diary of the owner and other documents related with the objects inspected: Danh sach dinh kém / Attached list — Cac tai liéu thi nghiém, quan trac, két qua thi nghiém mau kiém nghiém cia déi twgng nghiém thu / Documents of testing, monitor; results of testing samples of the objects inspected No: Danh séch dinh kem / Attached list ~ Bién ban nghiém thu vat ligu/Acceptance of material No: CGV SSG/HPLIMI-ACLEY. 01/0 3 ALL C ~ Bién ban nghiém thu ndi bé céng vige xy dung/ Internal inspection of construction work No: Phiéu yéu cu nghiém thu/Request for. acceptance No: CGV SSG/HPLIMI-OPL.E. — Chi thi/Ghi nh6/Xac nhan céng trvdng (néu c6)/ Site instruction/Memo/Confirmation (if any). Danh séch dinh kém / Attached list b) Vé chat long xay dtng/ On quality of construction work - Dinh kém bang Checklist/Attach tables Checklist, 5, Kat luan/Conclusions: [chap nhan/ Accepted — [[] Khéng ch4p nhan/ Unaccepted —_["] Khde/ Others: ping y cho trién khai cdc céng vide tiép theo/ agree fo proceed fo next construction work [)Khéng dong y trién khai céng viée tiép theo/ not agree fo proceed to next construction work + Yeu cdu sika chttal Repairing demands’... ~ Théi gian stra chtva/ Repairing period of time: * Note: Vide xde nhan bign ban nghiém thu nay khong logi trey hodic lam gidin tréch nhiém ota nha thau trong viée sia chia céc khuyét tat (néu cd)cda céc bé phan / két céu duge nghiém thu/ The minutes of acceptance does not release the responsibility of the contractor for any defects. NHA THAU TU VAN GIAM SAT CONSULTANT Ky tén/ Sign ae Awl 2 Ho va tén/ Full name Boan Nhan Phtic Nguyén Truéng Son Ronioay, — PuePrgeas Poge 2012 PURE PROJECTS ‘Approved byCee” G vennsenee CONG HOA XA HOI CHU NGHIA VIET NAM Béc lap - Ty Do - Hanh Phuc SOCIALIST REPUBLIC OF VIETNAM Independence ~ Freedom — Happiness BIEN BAN NGHIEM THU NOI BO va Tu INTERNAL ACCEPTANCE OF MATERIAL DELIVERY Tén céng tao! names of works: + Céng trinh/Project: CGV SSG / 43 - Hang Myctitems: Trang tri ndi ngosi, thd ID work package = Bia diém xy dyng! Location: Cao Oc SSG Van Thanh Tp.HCM 4. Déi tung nghiém thu/Project item: d. Vitri/ Location of inspection: Lau 5 / Floor 5 2.Thanh phan tham gia nghiém thu/ Parties involved in the inspection process: - Bai a din im phy (réu ¢6) /Representative of Sub Contractor (if any “Ghire vul Position: seventies CHUG VY! Position: = Dai dién cia giam sat iRopresentative of Supervisor Ong/Mr. Duong Tuan Hién Chitc vy/Position: Site eee ‘OngiMr. = Chive vu/Position: ebaeiaee ~ Bai dién cia QAQC nha thau/Represeniative of QAQC for contractor Ong/Mr: Tran Vinh Tién Chir vy/Position: Site Supervisor Ong/Mr: Chite vy/Position: 7 a.Thet oi gian nighigm th ‘thu/Acceptance time. Tes? ey debifddof. tats , ahd : : 4. Danh gia céng viée thye ‘igniEvaluation of construction works done: thu’ On supporting documents for inspection a. V6 tai ligu lam ean ete nghiém thu/ On supporting documents for inspection Hé so thdu, hop déng x4y dung Sé: 6O/HDTC2015-HPL ky ngay ... thang .... nam 2015 Tender documents, Contract agreement: Contract No 6OfHDTC2015-HPL is made on , 2015 — Hd so thiét ké ban vé thi cong duro Chii dau tu phé duyét va nhting thay d&i thiét ké 4& Guo chap nhan/ Documents of construction drawings approved by the Project Owner and the approved design change ~ Tiéu chudn, quy pham xay dyng durge ap dung / Criteria and standard applying to construction — Hd so thdu va hyp ding xay dyng/ Tender documents, Contract agreement - Tai ligu chi dan ky thuat kém theo hop déng xay dyng/ The specification enclosed with the Contract Documents - Cac tiéu chudn ky thuat riéng/ Other related technical Specifications Revision: Ar St-Avgust 2016 a ‘amended by Pure Prosets Page t of2 PUF ‘Approved by.= Bin phap thi cng duoc duyét/ Approved Method statement (if any) — Nhat ky thi céng, nhat ky gidm sét ella chil dau tu va cde van ban khac c6 lién quan dén ai twong nghigm thu/Construction diary, supervision diary of the owner and other documents related with the objects inspected: Danh séch dinh kém / Attached list — Céc tai liéu thi nghiém, quan trac; két qua thi nghiém mau kiém nghiém cia adi tung nghiém thu ! Documents of testing, monitor; results of testing samples of the objects inspected No: Danh sich dinh kém / Attached list _Blén bn nghiém thu vat ligu/Acceptance of material No: CGV SSG/HPUMI-ACL.£. ed 4 ~ Phigu yéu edu nghiém thu/Request for acceptance No: CGV SSG/MPLIMIIDP/..PX Ah / oy ~ Bin ban nghiém thu n6i b6 céng viée xay dung/ Intemal inspection of construction work No; — Chi thi/Ghi nhéiXae nhan céng trurong (néu c6)/ Site instruction/Memo/Confirmation (if any). b) Vé chat lugng xay dyng/ On quality of construction work = Dinh kém bang Checklist/Attach tables Checklist 5. Két luan/Conclusion: / ACCEPTED. | [y “UNACCEPTED Hae Sub-Contractor (if any) Signature: Date: Representalive of ‘Supervisor Contractor Signature: Duong Tuan Hién Date: IW Iyew Representative of Signature: Tran Vinh Tién Date: WV H/o QAQC Contractor vin gus 2015 Sere raerst tes at oonioiby Bue Pro age 20f2 PURE PROJECTS ‘approved by.he FORM 7C — CHECK LIST (ITP) MATERIAL CLI MAU 7G - NGHIEM THU VAT TU BAU VAO 2 vavnentne ‘A. GENERAL PARTICULAR! THONG TIN CHUNG From Project name ane Doan Nan Phe Proloc a covess rr Reforonco no. | Cov agGmPY ee same [SRAREAY Location js Para inspectionday |» ¢/// 7/001 V_ oe | aus 20d 80 0 ms oe [specter | needed 220. No, Description of works ae Ykién Remark Stt © NQi dung Reference ‘Comments. Ghi cha. | | Documents 8 so tai feu + | ovina! crticat onamg cult x, xt rng | 2 | cualty Certicate Chimg chi ehAt Iwona 3. | imported Bi /Phigu nhap hang 4. | Packing List ;Danh myc hang hoa 5. | Toot Report Kt qu thi nghibn UW | Check /Kiém tra ‘Check un-damaged, fab-package condlion T + im tra tinh tang toan ven (nguyen dei, nguyen vy kién) ZL | shee oe, p0 W kiém tra ma hiéu, ching loai Z ‘Check quantity fc 3 | idm tra s8 tyong v/ ‘Check using siltation (brand new or second hand) / 4° | Kiém tra tind trang sir dung (mdi 100% hay 68 qua V si dung) g | hers Knte B._ACKOWLEDGE / XAC NHAN 7 ConartrRereseave al BS ILL na ets Pure Projects Representative /Dai Pure Projects: Dato! Nga AW Client Representative [Bai dign Ghd Bau Ter Datel Ngays fovsion: —”A/SI-kuput.205 fnondedby: Par jee page sot ‘Approved by