Segment 3

SITE INSTRUCTION

Contractor : Ref. No. : SI-AMD-

Project : Date :

Subject :

Details of Instruction(s):

Reference Document(s):
Please see attached file for reference

COST Implication: TIME Implication:

Reason(s) for Instruction:
Has cost Has time implication
Confirmation of verbal instruction implication
Has NO time
Change in design Has NO cost implication
Revised work methodology implication
To be assessed (may
Use of alternative material To be assessed or may not have)
Adjustment in scope of work (may or may not
have)
Unsafe working condition
Non-compliance with the Drawings and Specification Reference Pay Reference Activity
Item(s): Item(s):
Others (specify): see details of instruction

Prepared by [sign as appropriate]:

Bridges,
Pavements & FOE & Non- COMREL/
ESH QA/QC Drainage & Lines & Grades
Earthworks FOE Right-of-Way
Structures

Reviewed by: Approved by:

1Contracts & Claims Manager, AMD AVP – Asset Management Dept.