LIST OF DOCUMENTS

CONSTRUCTION FLY OVER CISAUK

KABUPATEN TANGERANG

DOCUMENTS STATUS
NO.
NAMES OF DOCUMENT REMARKS
FILE ORIGINAL COPY ATTACHMENT
DOCUMENT DOCUMENT DOCUMENT

A.01 CONTRACT DOCUMENT

1 a. Contract Aggrement (Original) √
b. Justification MC.0 (Addendum.01 /VO No.01) √
c. Addendum No.2 (Variation Order No.02) √
d. Addendum No.3 (Variation Order Final Quantity)
2 Particular Condition of Contract √
3 General Condition of Contract (Dok.Kontrak)
4 General Specification (Dok.Kontrak)
5 Performance Security √
6 Pre Award Meeting (Rapat Pra Kontrak)
7 Surat Penyerahan Lapangan √
8 Advance Payment Guarantee √
9 Notice to Commencement of Works (COW) √
10 Minutes of Pre Construction Meeting √
11 Quality Control Plan (QCP)/Rencana Mutu Kontrak (RMK) √
12 Work Programme (Schedule of Works) √
Modification of Contract (Variation Order) (Included Engineer
13
Justified)
√

14 Request of Works
15 Interim Payment Certificate (IPC) including √
- Quantity Data √
- Quality Data √
16 Monthly Progress Report √
17 Shop Drawings √
18 Notice/Instruction from Engineer √
19 Minutes of Show Cause Meeting (if any) √
20 Notice for Test on Completion by GS √
21 Request for Taking Over of the Works by GS
22 Taking Over Certificate by Engineer
23 Calculation of Price Adjustment √
24 List of Defect and Deficiencis
25 No Objection Letter (NOL) from IDB
26 Approved As Built Drawings by the Engineer
27 Photograph Documentation (0%, 50%, 100%)
28 Recomendation of BPK Audit
29 Evidance payment for delay damages (if any)
30 Insurance Policy
31 Guarantee for Secend Half Retention Money (if any)
32 Others

Page 01/03
 CHECKLIST AS BUILT DOCUMENTS CIVIL WORKS PACKAGE
ISLAMIC DEVELOPMENT BANK (IDB)
Development of Trans South - South Java Road Project (TRSS)
LOT 1 TAMBAKREJA - BANTARSARI

Package No. : LOT 1 TAMBAKREJA - BANTARSARI

Length of Road : 6.15 KM
Contract : KH.02.03/PJN.II.JATENG/PPK-PSW/IV/2019
Contractor : ISTAKA - TRIE MUKTY ( JO)
Consultant : PERENCANA DJAYA & ASSOCIATES

STATUS

HARDCOPY
NO. DESCRIPTION Remarks

Available Not Available Partial

B DOCUMENT QUALITY
1 Materials Test (Quarry)
- Selected Embankment √
- Common Embankment -
- Stone for Aggregate
- Sand
2 Materials Test (Fabricant)
- Reinforcing Steel
- Precast Concrete
- Elastomeric Bearing
3 Job Mix Formula
- Aggregate Class A √
- Aggregate Class S √
- AC - Base √
- AC - Binder Course √
- AC - Wearing Course √
- Structural Concrete √ fc.30, 25, 15, 10
- Mortared √
Routine Material Quality Control Testing Reports for Every of
4
Material Produced
- Common Embankment (Every 1000 m3) -
- Selected Embankment (Every 1000 m3) -
- Stone for Aggregate (Every 1000 m3) -

Bitumen for prime of tack coat (every 6 months or 150,000

- -
liter)

5 Los Angeles Abrasion (every 5000 m3)

- Aggregate Grading in stockpiles (every 1000 m3)
- Aggregate Grading in Hot Bin (every 250 m3)
- Sand Equivalent (every 250 m3)
- Voids in Mix at Refusal Density (every 3000 tons)
- Mix Design (every change in Aggregate)
6 Trial Mix Report for :
- Aggregate Class A
- Aggregate Class B
- Aggregate Class S
- AC - Binder Course
- AC - Wearing Course
7 Non Conformity Report (NCR) internal Contractor
8 Follow up Non Conformity Report (NCR) internal Contractor
9 Non Conformity Report (NCR) issued by the Engineer √
10 Follow up Non Conformity Report (NCR) issued by the Engineer √
11 Test on Completion Report
 12 Others

Page 02/03

CHECKLIST AS BUILT DOCUMENTS CIVIL WORKS PACKAGE

ISLAMIC DEVELOPMENT BANK (IDB)
Development of Trans South - South Java Road Project (TRSS)
LOT 1 TAMBAKREJA - BANTARSARI

Package No. : LOT 1 TAMBAKREJA - BANTARSARI

Length of Road : 6.15 KM
Contract : KH.02.03/PJN.II.JATENG/PPK-PSW/IV/2019
Contractor : ISTAKA - TRIE MUKTY ( JO)
Consultant : PERENCANA DJAYA & ASSOCIATES

STATUS

HARDCOPY
NO. DESCRIPTION Remarks

Available Not Available Partial

C DOCUMENTS
1 Monthly Environmental Management Plan Report √
2 Traffic Management Report √
3 Health and Safety Plan Report √
4 Road Safety Audit Findings Report (if any) √
5 Follow up Road Safety Audit Findings Report (if any) √
6 LARAP Report (Social impact)
7 Contactor Claims (if any) -
8 Other Issues -

DSC-2 Regional Team DSC-2 Field Team

1. 2.
Co Team Leader/Ass.CSE Site Supervision Engineer

4. 5.
Quality Assurance Engineer Quality Engineer

7.
Quantity Engineer
Page 03/03
 A.01 A.02 A.03 A.04

PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK
KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG

ENGINEERING ENGINEERING ENGINEERING ENGINEERING

CONTRACT WEEKLY PROGRESS TIME

DOCUMENT MEETING REPORT SCHEDULE
 B.01 B.02 B.03 B.04

PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK
KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG

OPERATIONAL OPERATIONAL OPERATIONAL OPERATIONAL

REQUEST
OF WORKS
 C.01 C.02 C.03 C.04

PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK
KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG

ADM & KEU ADM & KEU ADM & KEU ADM & KEU

DOKUMEN PROGRESS
JAMINAN PAYMENT
 D.01 D.02 D.03 D.04

PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK
KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG

HSE HSE HSE HSE

 E.01 E.02 E.03 E.04

PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK PEMBANGUNAN FLY OVER CISAUK
KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG KABUPATEN TANGERANG

QUALITY CONTROL QUALITY CONTROL QUALITY CONTROL QUALITY CONTROL