Sponsor/Contractor’s Brief Form

Please return to PGPA after completion PGPA/ESC/000__/20_17___

PGPA/WAR/000__/20_17___
CNL Sponsoring Department /Workgroup:
Project Title & Description (please give details
Project Location:
Expected date of mobilization and demobilization
Expected date of Kick off meeting with internal stakeholders:
Job/Project Expected Duration:
Is the job in phases? - (Yes / No):
If yes, how many phases and what’s the timing?

Name of EPC/Main Contractor/Subs if Any/Available:

List all visible resources (equipment) that would be required to execute project:
State duration that the respective equipment will be required:
Total number of workers required for the project:
Where will they be accommodated – CNL facility / Houseboat(s) / contractor work barge/
Community?
Any other useful information about the contractor/project:
Sponsoring Department/Unit:
Project Rep Name: Signature: Tel. Ext Email: Date:
Contractor’s Rep Signature:
Name: E-mail Tel Date:

TO BE COMPLETED BY CONTRACTOR

Contractor’s Name:
Contractor’s Address:
Contractor’s Phone #:

Contractor’s Project Manager/Tel Contact:

Is this the contractor’s first job with CNL? Yes / No:

is this the contractor’s first job in this area? yes / no:

Number of contractors’ staff:

Total number of workers required from community:

Workers’ skills/qualification and number required from Community:

List the respective skills and number of workers to work on site:

Community worker’s salary and sub- contract payment plan?

What sub-contracts (equipment, fabrication, mechanical, electrical, equipment and general
supplies, etc) will contractor extend to the community?
Name of subs if any:

Contractor/PMT expected to complete and submit LCC data to PGPA and NCD- LCC unit at
end of contract execution. Sample attached.

PGPA Project Focus Persons:

Name: Signature: Tel.Ext: Email: Date:
PGPA Coord - Project:
Name: Signature: Tel. Ext: Email: Date:

PGPA Superintendent
Name: Signature: Tel. Ext: Email: Date: