OFFICE OF THE PRESIDENT

NATIONAL HOUSING AUTHORITY

Elliptical Road, Diliman, Quezon City

MATERIAL ACCEPTANCE REQUEST

MAR NO. _____
PROJECT NAME:
LOCATION: DATE:
PROJECT TYPE: TIME:
IMPLEMENTING OFFICE: LOCATION:
CONTRACTOR:
SPECIFICATIONS: MANUFACTURER/SUPPLIER:

Shop Drawings Bill of Materials Test Results

ATTACHMENTS:
Others (specify) Mill Certificate

NO. OF TEST TEST COMPLIANCE

UNIT QTY MATERIAL DESCRIPTION REMARKS
SAMPLES REQUIREMENT RESULTS PASSED FAILED

COMMENTS

REQUESTED BY: (Authorized Contractor’s Representative)

Name : ………………………………………………. Company : ……………………………………………….
Signature : ……………………………………………… Date : ………………………………………………
Designation : ………………………………………………
To be filled up by NHA Project Engineer / Representative

APPROVED DISAPPROVED
INSPECTED BY: NOTED BY:

NAME NAME
Site Engineer District Manager