Client: (PMC): Contractor:

REQUEST FOR INSPECTION (RFI)

Project : Project No.
SUBJECT WORK REQUESTED FOR INSPECTION LOCATION RFI No.

REVISION

DATE IN

DATE OUT
Approved Drawing Ref.

PMC REMARKS

INSPECTION RESULTS
Code Status Date Signature
A  Work is accepted
Revise & Submit: Work may be accepted subject to incorporation of changes
B 
indicated.
C  Work not accepted. Rework, adjust, and, resubmit.
D  Not ready. Resubmit when ready.

CONTRACTOR PMC

This review does not relieve the contractor of his Above subject works have been visually inspected by
Responsibility under the terms & Conditions of the contract nor the Consultant and found acceptable/ Not acceptable as per the code
Authorized additional compensation with respect to time & cost. given above.

We hereby submit/ resubmit for inspection of above subject works and

confirm herewith that above works are completed and ready for
inspection as stated above all in
accordance with the specification, drawings, and consultant instruction.
Contractor to complete the information below.

Name: Name:

Position: Position:

Signature Signature:

Date: Date: