URBAN INSTITIUTE AND INFRA-STRUCTURE DEVELOPMENT

PROGRAM(UIIDP)
Letter of Call the next least evaluated. bidder
Acceptance

Request NO
Forfeit the bid
Performance security
security

YES – Register the data on UIIDP / 007

Contract signing

Site Handover

Use – UIIDP / 008, Use – UIIDP / 001

Request complete work schedule

Use – UIIDP / 002, Use – UIIDP / 003

Use – UIIDP / 004, Use – UIIDP / 005

Use – UIIDP / 006

NO
Approve the Revise
submitted
Schedule

YES
 Examine & inspect the
construction site

Use – UIIDP / 009

Right of way
Clear the problem as
problem YES immediately as possible

NO

Supervise and inspect the work using the

formats UIIDP / 10 - 20

Assess current status of the sub project as

per the schedule – UIIDP / 021

Request material testing as per the test

schedule – UIIDP / 022

Evaluate the
test result Take appropriate
Rejected measure
UIIDP/023

Accepted
 Register Daily activity of the site

Use – UIIDP / 024

Conduct site meeting prepare

monthly progress report

Use – UIIDP / 025 & 26

Work order Prepare Payment Certificate Time Extension

Assess any variation work by
using UIIDP / 28
Get approval from concerned
bodies UIIDP / 27
For new item fix the rate using
UIIDP / 029
Use – UIIDP / 31
 Deduct payment advance
proportionally – If financial
utilization is 80%, the
advance should be deducted
100%
 Hold retention money
 Deduct previous payments
As per the detail procedure
Evaluate any time claim
requested by the contractor
use UIIDP / 030.
Extend time for approved
variation items that need
additional time to execute

NO Order the contractor to

Analyze execute remaining
contractor’s works that make the
request for work ready for
Temporary provisional acceptance
Acceptance

YES
 Conduct the Temporary Acceptance
Release
 50% of the retention money
 50% of the Performance security
 Use – UIIDP /0 32


After 365 days of provisional acceptance

call the contractor to rectify the defects
observed within this period.
Assess the defects and give in writing to
the contractor.

Maintenance will be executed

by the contractor

Is the sub
project well
rectified & NO
Order in writing to the
competent for
contractor to rectify the
Final
defects as to the satisfaction
Acceptance?
of the client

YES

Conduct Final acceptance and:

Release:-
 The 2.5% retention money
 The remaining performance bond
Use – UIIDP / 033
 FORM NO.UIIDP/001

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

HANDING OVER THE CONSTRUCTION SITE

This _________________________date of ______________ EFY 2013, the site for the construction
of_________________________________________________
_____________________________________________________________has been officially handed
over to (the contractor) _____________________________

__________________________________________________________________by the client

representative________________________________. The contractor, therefore acknowledge the taking
over of the site in accordance with clause 42(1) of the standard conditions of contract and work with all
its explanation clearly defined in the specification and drawings (sketches).

The contractor hereinafter, shall be responsible for the damages that occur as a result of his fault,
carelessness or negligence in connection with untimely commencement of the work.

The contractor in addition acknowledges that the completion of the said work shall count as from the date
mentioned above and comply with the terms and conditions of the contract to the satisfaction of the client.

IN WITNESS HERE OF THIS DOCUMENT HAD BEEN SIGNED BY ALL PRESENCE IN THREE
COPIES OF WHICH ONE COPY SHOULD BE DELIVERED TO CLIENT, CONSULTANT (RESIDENT
ENGINEER) AND TO THE CONTRACTOR.

----------------------------- ------------------------------------- ----------------------

For the Client (Employer) For the Consultant For the Contractor

WITNESSES

1. _______________________________________
2. _______________________________________
3. _______________________________________
 Form No-UIIDP/002
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
CONSTRUCTION WORK SCHEDULE

PROJECT_____________________________________________
EMPLOYER___________________________________________
CONTRACTOR________________________________________
CONSULTANT________________________________________
CONTRACT
AMOUNT__________________________________
Project Duration in Calendar Days_______________________
4.
CONTRACT
NO___________________________________________
CONTRACT
TIME__________________________________________
COMMENCEMENT
DATE___________________________________
COMPLETION
DATE________________________________________
Site Hand Over Date_______________________________________

Time required Week

Com Remark
No Work Description Unit QTY Value in Birr Start pletio
Duration 1st
2nd
3rd
4th
5th
6th
7th
Date n
Date

PREPARED BY ________________________________________ APPROVED BY ________________________________________

SIGNATURE___________________________________________ SIGNATURE___________________________________________
DATE________________________________________________ DATE________________________________________________
 Form No-UIIDP/003

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

MANPOWER MOBILIZATION SCHEDULE

PROJECT_____________________________________________ Consultant___________________________________________
EMPLOYER___________________________________________ Contractor___________________________________________

Employment Time Week

Staff & Labor Completio Remark
No No Salary Start
Force Duration n 1st 2nd 3rd 4th 5th 6th 7th
Date
Date

1. Staff
1.1

2. Labor
Force
2.1

PREPARED BY ________________________________________ APPROVED BY ________________________________________

SIGNATURE___________________________________________ SIGNATURE___________________________________________
 Form No-UIIDP/004

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

MATERIAL DELIVERY SCHEDULE

PROJECT_____________________________________________ Consultant___________________________________________
EMPLOYER___________________________________________ Contractor___________________________________________

Delivery Week
Staff & Labor Remark
No Unit Quantity
Force Mobilization 1st 2nd 3rd 4th 5th 6th 7th

1 Sand
2 Gravel
3 Stone
4 Cement
5 Reinforcement
Bars
6 HCB
7 Doors & Windows
8 Wood & Steel
9 Glazing
10 Chip wood
11 Zigba Battens
12 Paint
13 Etc
PREPARED BY ________________________________________ APPROVED BY ________________________________________
SIGNATURE___________________________________________ SIGNATURE___________________________________________

Form No-UIIDP/005
 URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

EQUIPMENT DELIVERY SCHEDULE

PROJECT_____________________________________________ Consultant___________________________________________
EMPLOYER___________________________________________ Contractor___________________________________________

Delivery Week
Staff & Labor Remark
No Unit Quantity
Force Mobilization 1st
2nd
3rd
4th
5th
6th
7th

1 Tools
2 Mixer
3 Vibrator
4 Form work- panel
5 Dozer
6 Crane
7 Water Pump
8 Water Tank
9 Others
10 Others
11 Others
12 Others
13 Others

PREPARED BY ________________________________________ APPROVED BY ________________________________________

SIGNATURE___________________________________________ SIGNATURE___________________________________________
 Form No-UIIDP/006

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

MATERIAL TEST REQUISITION SCHEDULE

PROJECT_____________________________________________ CONTRACT NO___________________________________________

EMPLOYER___________________________________________ CONTRACT TIME__________________________________________
CONTRACTOR________________________________________ COMMENCEMENT DATE___________________________________
CONSULTANT________________________________________ COMPLETION DATE________________________________________
CONTRACT AMOUNT__________________________________ TEST REQUEST NO________________________________________
No Type of Material Type of Test Requisition Time Remark
1 2 3 4 5 6 7 8 9 10 11 12

PREPARED BY ________________________________________ APPROVED BY ________________________________________

SIGNATURE___________________________________________ SIGNATURE___________________________________________
DATE________________________________________________ DATE________________________________________________
 Form No-UIIDP/007
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
PERFORMANCE & ADVANCE GUARANTEE FOLLOW UP FORM

REGION: _____________________________________________________________________

CITY ADMINSTRATION: ________________________________________________________

Guarantee Required in the Contract Document
NO SUB PROJECT PROJECT Amount Requested in the Type Requested in the Validity Date specified in the Remarks
COST (Birr) Special Conditions of Special Conditions of Contract Document
Contract (%) Contract
Performance Advance Performance Advance Performance Advance
Security Security Security Security Security Security
1
2
3

Actual Guarantee Submitted

NO SUB PROJECT PROJECT Guarantee Amount Guarantee Type Furnished Furnished Guarantee Remarks
COST (Birr) Furnished by the Contractor by the Contractor Validity Date specified
(%)
Performance Advance Performance Advance Performance Advance Accepted Rejected
Security Security Security Security Security Security
1
2
3
 Form No-UIIDP/008

Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT:__________________________ LOCATION__________________
INVESTOR:_________________________ CONTRACT No.______________
CONTRACTOR:_____________________ CONSULTANT:_______________
Site Handover Inspection Certificate

1. Site - Surface Soil _________________________

- Surface Water _________________________
- Surface slope _________________________
- Adjacent Construction _________________________
- Accessibility _________________________
2. Obstruction

- Trees and Bushes ________________________

- Water Supply Lines ________________________
- Sewer/drainage Lines ________________________
- Electricity Lines _________________________
- Telephone Lines _________________________
- Road/railway Lines __________________________
- Over ground Structures __________________________
- Underground Structures __________________________
- Others __________________________
3. Reference:

- Bench marks/Levels ___________________________

- Corner Stones
- Boarder Lines
- Water supply connection points
- Electricity connection points
- Sewer/drainage connection point
4. Additional Items/Comments:
___________________________
___________________________
____________________________
____________________________
____________________________

Following an inspection of the site as per the above listed items, the contractor is hereby to take over site
and proceed with the subsequent mobilization and site preparation works.

Supervisor: Name _______________________ Contractor: Name ___________________

Sign. _______________________ Sign._____________________________
Date _______________________ Date_____________________________
Form No-UIIDP/009
 Certificate No:
__________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT: ___________________________ LOCATION: ________________

INVESTOR: __________________________ CONTRACT No. _____________
CONTRACTOR: ______________________
CONSULTANT: ______________________
Site Preparation Inspection Certificate - For Item Location ____________

1. Layout:

- Building _____________________________
- Sewer Lines _____________________________
- Area to be cleared off _____________________________
- Others _____________________________
2. Levels

- Reference Bench Mark(S) _____________________________

- Bottom of Basement Floor (S)
- Bottom of Ground Floor (S)
- Site Works
- Others cleared off area
3. Additional Items/Comments
_____________________________
_____________________________
_____________________________
_____________________________

Following an inspection of the layout and levels of all buildings, Site works. Etc. as the above listed
items permission to proceed with the subsequent excavation/earth works is hereby granted/refused to the
contractor.

Supervisor: Name _____________________ Contractor: Name _____________________

Sign. ______________________ Sign ______________________

Date ______________________ Date ______________________

Form No-UIIDP/010
 Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT: __________________________ LOCATION: _________________

INVESTOR: ________________________ CONTRACT No. _____________
CONTRACTOR: ____________________
CONSULTANT: ____________________
Earth works Inspection Certificate For Item Location _____________________

1. Excavation
- Location of Excavation ________________________
- Method of Excavation ________________________
- Type of Excavated material (s): top Soil, root ________________________
- Thickness of Excavated materials _______________________
- Slopes & Levels of Excavated Surfaces _______________________
- Necessary temporary drains provided _______________________
- No Damage to adjacent areas _______________________
2. Placement of Excavated Materials:-

- Top soil. Roots & others to be carted away ______________________

- Materials - used for back filling/terracing _______________________
3. Filling:-

- Cleanliness of areas to be filled ______________________

- Quality of fill material (s) ______________________
- Thickness of Layers ______________________
- Type of Weight of Rollers ______________________
4. Degree of Compaction:-

- Optimum moisture content _______________________

- Maximum Dry Density _______________________
- Field Dry Density
- Comparison of Degree of Compaction _______________________
- Specified No. of passes of Rollers _______________________
- Correctness of Compaction _______________________
1. Protection of Filled areas from Vehicles Prior
To Placement of Upper Pavement Layer ______________________

2. Additional Items/Comments

Following an inspection of the quality of Earthworks as per the above listed items permission
of proceed with the subsequent construction / _______________________
__________________________________/ work is hereby granted/ refused to the contractor.

Supervisor: Name ______________________ Contractor: Name ___________

Sign. ______________________ Sign.___________
Date ______________________ Date ___________
 Form No-UIIDP/011

Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT: ________________________________ LOCATION: ________________

INVESTOR: ______________________________ CONTRACT No. _____________
CONTRACTOR: __________________________
CONSULTANT: __________________________

Foundation Excavation Inspection Certificate- For Item Location __________

1. Foundation Layout __________________________________

2. Width of Excavation __________________________________
3. Depth of Excavation __________________________________
4. Method of Excavation __________________________________
5. Type of Excavated material (S) compared
To soil report __________________________________
6. Foundation Levels __________________________________
7. Type of Soil at Foundation Level __________________________________
8. Foundation Pits & Trenches Free from
- Ground Water __________________________________
- Roots and bushes
- Back fill or made ground __________________________________
9. Sides of Pits & Trenches
- Safe from damage __________________________________
- Protected with sheeting strutting __________________________________
& shorting
10. Additional Items/ Comments __________________________________
Following an inspection of the layout, Depth and levels of Foundation Excavation as per the above listed items
permission to proceed with the subsequent foundation works is granted/refused to the contractor.

Supervisor: Name ______________________ Contractor: Name _____________

Sign. ______________________ Sign ______________
Date ______________________ Date ______________
 Form No-UIIDP/012

Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT: ______________________________ LOCATION ___________________

INVESTOR: _____________________________ CONTRACT No. _______________
CONTRACTOR: _________________________
CONSULTANT: _________________________

Masonry Work Inspection Certificate - For Item Location ________________________

1. Type of Masonry (Stone/HCB/Brick) ____________________________________
2. Hardness. Soundness & Size of Stone ____________________________________
3. Manufacturing & Curing of HCB ____________________________________
4. Cleanliness of Masonry _____________________________________
5. Storing of HCB & Bricks _____________________________________
6. Strength of HCB & Bricks ____________________________________
7. Quality of Mortar Ingredients
/Cement Lime. Sand. Water/ _____________________________________
8. Mix Proportion of Mortar _____________________________________
9. Upper/Lower of Mortar _____________________________________
10. Uprightness/Straightness of Wall surface _____________________________________
11. Correctness of Wall Corner Angles _____________________________________
12. Masonry bedding/Jointing thickness ___________________________________
13. Quality of Joint Pointing ___________________________________
14. Type. Size and Pattern of Masonry Laying __________________________________
15. Additional Items/Comments ___________________________________
Following an inspection of the quality of Masonry Work as per the above listed items permission to
proceed with the subsequent construction/
_____________________/ work is hereby Granted/Refused to the Contractor.
Supervisor: Name ____________________ Contractor: Name ____________
Sign. ____________________ Sign.
____________
Date _____________________ Date
____________
 Form No-UIIDP/013
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT: ________________________________ AOCCATION: _________________

INVESTOR: _______________________________ CONTRACT No. _______________
CONTRACTOR: ___________________________
CONSULTANT: ___________________________

Concrete Work Inspection Certificate for Item Location _________________

1. Quality & Age of Cement ________________________________
2. Quality of Sand/Fine Aggregate ________________________________
3. Quality of Coarse Aggregate ________________________________
4. Quality of Water ________________________________
5. Type of Mixing
- Hand Mixing _________________________________
- Mechanical Mixing _________________________________
- Mechanical Batch Mixing _________________________________
6. Approved Concrete Mix: Proportion of Cement:
- Sand: Coarse Aggregate _________________________________
- Water Cement Ratio _________________________________
- Workability/Slump _________________________________
- Flexural Strength _________________________________
7. Concrete Test Cubes
- Required/Not Required for
this purpose _________________________________
8. Concrete Placement
- pouring Height _________________________________
- No Segregation _________________________________
9. Concrete Vibration
- Not under/over Vibrated _________________________________
10. Construction Joints
- Location Approved _________________________________
 - Roughened _________________________________
- Vendexed _________________________________
- Cleaned & Free from Water _________________________________
11. Form Work
- Adequately Braced _________________________________
- Grout-tight _________________________________
- Correct Dimension & Levels _________________________________
- Cleaned & Oiled _________________________________
12. Steel Reinforcement
- Correct Grade _________________________________
- Correct Sizes _________________________________
- Correct Places _________________________________
- Tolerance _________________________________
- Concrete Cover/Clearance _________________________________
- Correctly bent __________________________________
- Lap Lengths ___________________________________
- Clean Steel ___________________________________
- Stability of Fixed Steel ___________________________________
- Correct Welds ___________________________________
- Spacers Location ___________________________________
13. Props ___________________________________
14. Built in Items ___________________________________
15. Additional Items/Comments ___________________________________

Following an inspection of the quality of concrete work as the above listed items permission to pour
concrete is hereby Granted /Refused to the Contractor.
Supervisor: Name __________________________ Contractor: Name ________
Sign. __________________________ Sign. _________
Date __________________________ Date _________
 Form No-UIIDP/014
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

Structural Timber Work Inspection Certification - For Item Location_________

1. Component ___________________________
2. Timber Members
 Quality ______________________
 Shape/Size ______________________
Free from
 Decay ___________________________
 Insects attack ___________________________
 Other damages ___________________________
3. Type Quality of Timber Treatment __________________________

4. Storage protection of Timber _____________________________

5. Quality/Size of

- Nail ______________________________
- Bolts/Nuts _______________________________
- Glue _______________________________
- Other Joinery _______________________________
6. Shape/Pattern of Timber Work _______________________________
7. Quality of Fabrication _______________________________
8. Quality/Location of Joinery _______________________________
9. Quality of Erection _______________________________
10. Straightness/Deflection of Timber Work _______________________________
11. Additional Items/Comments:
Following an inspection of the quality of Timber work as per the above listed items permission to proceed
with the subsequent construction/ __________________________

_________________________/ work is Granted/ Refused to the Contractor.

Supervisor: Name:____________________ Contractor: Name __________

Sign. ____________________ Sign. __________
Date. ____________________ Date. ______________
 Form No-UIIDP/015
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT: _______________________ LOCATION:_____________________

INVESTOR: ______________________ CONTRACT No. __________________
CONTRACTOR:___________________ CONSULTANT: ___________________
Carpentry & Joinery Work Inspection Certificate - For Item Location_______________

1. Ceiling Work
- Quality/Size of Ceiling Material _____________________________
- Fixing of Ceiling Material _____________________________
- Type, color. Quality of Ceiling Painting _____________________________
- Quality, procedure of Ceiling Painting _____________________________
- Cleanliness of Ceiling _____________________________
2. Doors & Windows
- Location of Doors/Windows ______________________________
- Quality of Door/Window Materials ______________________________
- Type of Door/Windows ______________________________
- Direction of Door/Window Swings ______________________________
- Straightness & Plumbing of Door/
Window frames ______________________________
- Quality/fixture of Door & Windows
- Hinges ______________________________
- Locks _______________________________
- Latches _______________________________
- Handles _______________________________
- Protection of Fixed Joinery from Damage _______________________________
3. Additional Items/Comments
Following an inspection of the quality of carpentry Joinery & Glazing work as per the above listed items
permission to proceed with the subsequent construction __________________ _________________
_________________________/ Work is Granted/Refused to the contractor

Supervisor: Name: _____________________ Contractor: Name _________

Sign. _____________________ Sign. __________

Date ______________________ Date __________

 Form No-UIIDP/016
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE
PROJECT: ______________________________ LOCATION: _____________

INVESTOR: _____________________________ CONTRACT No. ___________

CONTRACTOR: _________________________ CONSULTANT: ____________

Roofing & Cladding Work Inspection Certificate- For Item Location _________

1. Roofing work
 Type/Quality of Roof Sheet _________________________________
 Thickness of Roof Sheet _________________________________
 Size/Coating of Steel Hook Bolts/Nuts _________________________________
 Lapping of Sheets __________________________________
- End _________________________________
- Side laps length _________________________________
- Direction __________________________________
2. Gutters & Down Pipes
 Quality. Size. Thickness. Coating of
- Gutter __________________________________
- Down pipe __________________________________
 Quality .Size. Thickness. Spacing. Coating of
- Gutter hangers ________________________________
- Down Pipe Supports ________________________________
 Lapping of Down Pipes ________________________________
 Quality Coating o gutter Joints Welding ________________________________
3. Additional Items/Comment
Following an inspection of the quality of Roofing and cladding work as per the above listed items
permission to proceed with the subsequent construction /____________________________
_____________________________/ work is Granted/Refused to the Contractor.

Supervisor: Name ____________________ Contractor: Name ________________

Sign. ____________________ Sign.

_________________

Date ____________________ Date _________________

 Form No-UIIDP/017
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE
PROJECT: ______________________________ LOCATION: _______________

INVESTOR: _____________________________ CONTRACT No. ____________

CONTRACTOR: _________________________ CONSULTANT: _____________

Finishing Work Inspection Certificate -For Item Location _________________

1. Plastering work
 Location of Plastering
 Quality of Plaster
- Material
(Cement, Lime, Sand, Water) ____________________________________
- Mix Proportion
 Type of Mechanical Mixer Used
 Elapsed Time of Plaster
 Cleanliness of Wall
 Wetting of Wall Prior to Plastering
 Thickness of Plaster
 Plumbing & Leveling of Plaster
___________________________________
___________________________________
___________________________________
___________________________________
____________________________________
____________________________________
____________________________________
____________________________________

2. Wall Tiling Work

 Location of Tiling ____________________________________

 Readiness of Wall Surface ____________________________________
 Quality of Tile Bedding
- Material (Cement. Send. Water) _____________________________________
- Mix proportion _____________________________________
 Quality of Tile _____________________________________
 Soaking of Tiling _____________________________________
 Straightness of Tile Before Laying _____________________________________
 Grouting of Tile in White Cement _____________________________________
 Cleanliness of Wall Tile _____________________________________

3. Floor Tile Work

  Location of Tiling _________________________________
 Readiness of Concrete slab Surface _________________________________
 Quality of Tile Bedding _________________________________
- Material (Cement, Sand, Water) ___ ________________________________
- Mix proportion _________________________________

 Quality of Glue for PVC Tile _________________________________

 Quality of Tile
 Straightness of Tile Joints
 Setting/Wetting Time of Floor Tile
 Cleanliness of Floor Tile
4. Glazing Work
__________________________________
__________________________________
__________________________________
__________________________________

 Quality & Thickness of Glass Panes __________________________________

 Quality & proper application of Putty __________________________________
 Readiness of Frame ___________________________________
 Cleanliness of Glass ___________________________________
 Quality of Window Panels Fixing ___________________________________
5. Painting Work
 Kind & Quality of Painting ___________________________________
 Cleanliness of Will & Brushes prior to Painting
___________________________________
 Removal of Electrical Appliances Prior
To Painting ___________________________________
 Number of Coats Applied ___________________________________
 Drying of Painted Walls & Ceiling ____________________________________
6. Additional Items/Comment
Following an inspection of the quality of finishing work as per the above listed items permission to
proceed with the subsequent construction/ ___________________________

_______________________/Work is Granted/Refused to the Contractor.

Supervisor: Name ___________________ Contractor: Name ______________

Sign.____________________ Sign. ______________

Date____________________ Date ______________

 Form No-UIIDP/018
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE
PROJECT: ______________________________ LOCATION: _______________

INVESTOR: _____________________________ CONTRACT No. ____________

CONTRACTOR: _________________________ CONSULTANT: _____________

Site Work Inspection Certificate - for item Location __________

1. Paved Areas (Roads. Parking lots. Foot Paths)

 Location of Excavation __________________________________

 Slopes and Levels of Excavation Surfaces __________________________________
 Excavation Surface From Top Soil Roots and Loose or Softened Soil
__________________________________
 Quality and Degree of Compaction of
Fill Material __________________________________
 Quality and Size of Hard Core Stone
* Material ___________________________________
 Thickness. Placing. Ramming and Degree
Of Hard Core Layer __________________________________
 Quality. Thickness and Degree of
Compaction of
- Sub base Layer ____________________________________
- Base Course Layer ___________________________________
- Surface Course Layer ___________________________________
 Slopes and Levels of top Surface Layer ___________________________________
2. Drain Channels and Culverts

 Location of Channels & Culverts ____________________________________

 Sizes, Levels & Slopes of Channels
And Culverts ____________________________________

 Type and Quality of Channels` Lining ____________________________________

 Type, Thickness & Compaction of
Channels Lining-Bedding ____________________________________

 Jointing & Pointing of Channels` Lining ___________________________________

 Quality of Mortar ingredients
(Cement, Sand. Water) _____________________________________
  Mix Proportion of Mortar _____________________________________
3. Retaining Wall

 Position. Width and Depth of Foundation

Trench ______________________________________

 Cleanliness of Trench Bottom

(Cement, Sand, water) ______________________________________

 Type. Hardness. Soundness of Stone

(Cement, Sand, water) ______________________________________

 Mix Proportion of Mortar ______________________________________

 Location & Construction of Expansion
Joints

 Correctness of Batter Slope ______________________________________

4. Fencing & Gate

 Locating of Fencing & Gate _______________________________________

 Width & Depth of French & Gate
Foundation Trench/Pit ________________________________________

 Cleanliness of Trench or Pit Bottom _______________________________________

 Quality of Fence & Gate Materials
(Stone, HCB, Steel. etc.) ________________________________________

 Quality of Mortar. If used

(Ingredients, Mix Proportion) _________________________________________

 Quality of concrete if used

(Ingredients, Mix proportion _________________________________________

Strength, work ability) _________________________________________

 Quality of Foundation Works _________________________________________

 Quality of work above ground Level __________________________________________

5. Additional Items/Comments

Following an inspection of the site works as per the above listed items permission to proceed with
the subsequent work is hereby Granted /Refused to the Contractor

Supervisor: Name ___________________ Contractor: Name ________________

Sign. ___________________ Sign

_________________

Date ___________________ Date

________________
 Form No-UIIDP/019
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

DRAINAGE INSPECTION CERTIFICATE
PROJECT: ______________________________ LOCATION: _______________
INVESTOR: _____________________________ CONTRACT No. ____________
CONTRACTOR: _________________________ CONSULTANT: _____________
Site Work Inspection Certificate

1. Drain Channels and Culverts

 Location of Channels & Culverts ____________________________________

 Sizes, Levels & Slopes of Channels
And Culverts ____________________________________

 Type and Quality of Channels` Lining ____________________________________

 Type, Thickness & Compaction of
Channels Lining-Bedding ____________________________________

 Jointing & Pointing of Channels` Lining ___________________________________

 Quality of Mortar ingredients
(Cement, Sand. Water) _____________________________________

 Mix Proportion of Mortar _____________________________________

 Concrete & steel reinforcement Quality – Use form UIIDP/013
 Quality and Degree of Compaction of
Fill Material ________________________________________
 Position. Width and Depth of trench ______________________________________
 Cleanliness of Trench Bottom
(Cement, Sand, water) _________________________________________

 Type. Hardness. Soundness of Stone

(Cement, Sand, water) __________________________________________

 Correctness of Batter Slope __________________________________________

2. Right of way
 Right of way problem cleared __________________________________________
 If cleared when & how __________________________________________
 If not cleared what is recommended __________________________________________
3.Environment
 Schedule, A B C
 If schedule A, full EIA studied ______________________________________________
 If schedule B, Partial EIA studied ______________________________________________
 What are the mitigation measures proposed for schedule A & B sub projects

a. ______________________________________________________________

b. ______________________________________________________________
 c. _______________________________________________________________

d. _______________________________________________________________

 Is the mitigation measures proposed carried out? (Yes / No)

 If no what are the major reasons

a. ______________________________________________________________

b. ______________________________________________________________

c. _______________________________________________________________

5. Additional Items/Comments
 Following an inspection of the site works as per the above listed items permission to proceed with
the subsequent work is hereby Granted /Refused to the Contractor

Supervisor: Name _________________ Contractor: Name ________________

Sign ___________________ Sign
_________________
Date ___________________ Date
________________
 Form No-UIIDP/020
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

COBBLESTONE ROAD INSPECTION CERTIFICATE

PROJECT: ______________________________ LOCATION: _______________

INVESTOR: _____________________________ CONTRACT No. ____________

CONTRACTOR: _________________________ CONSULTANT: _____________

Site Work Inspection Certificate - for item Location __________

1. Cobblestone Roads

 Location of Cobblestone road (from – to--) ___________________________________

 Slopes and Levels of Excavation Surfaces
 Excavation Surface From Top Soil Roots and Loose or Softened Soil
 Quality and Degree of Compaction of
Fill Material
 Quality and Size of Hard Core Stone
Material
 Thickness. Placing. Ramming and Degree
Of Hard Core Layer
 Quality. Thickness and Degree of
Compaction of
- Sub grade
- Sub base Layer
- Base Course Layer
 Slopes and Levels of top Surface Layer
 Sub Grade classification, S1
S6
 Recommended CBR range
 CBR test result
 Quality and Degree of Compaction of
Fill Material
 Maximum dry density & OMC recommended
 Type. Hardness. Soundness of Stone
__________________________________
__________________________________
__________________________________
___________________________________
__________________________________
____________________________________
___________________________________
___________________________________
___________________________________
S2 S3 S4 S5
__________________________________
__________________________________
________________________________________
_________________________________
 (Cement, Sand, water) ___________________________________
2. Drain Channels and Culverts

 Location of Channels & Culverts ____________________________________

 Sizes, Levels & Slopes of Channels
And Culverts ____________________________________

 Type and Quality of Channels` Lining ____________________________________

 Type, Thickness & Compaction of
Channels Lining-Bedding ____________________________________

 Jointing & Pointing of Channels` Lining ___________________________________

 Quality of Mortar ingredients
(Cement, Sand. Water) _____________________________________

 Mix Proportion of Mortar _____________________________________

3. Retaining Wall

 Position. Width and Depth of Foundation

Trench ______________________________________

 Cleanliness of Trench Bottom

(Cement, Sand, water) ______________________________________

 Type. Hardness. Soundness of Stone

(Cement, Sand, water) ______________________________________

 Mix Proportion of Mortar ______________________________________

 Location & Construction of Expansion
Joints

 Correctness of Batter Slope ______________________________________

2. Right of way
 Right of way problem cleared __________________________________________
 If cleared when & how __________________________________________
 If not cleared what is recommended __________________________________________
4.Environment
 Schedule, A B C
 If schedule A, full EIA studied ______________________________________________
 If schedule B, Partial EIA studied ______________________________________________
 What are the mitigation measures proposed for schedule A & B sub projects

e. ______________________________________________________________

f. ______________________________________________________________

g. _______________________________________________________________

h. _______________________________________________________________

 Is the mitigation measures proposed carried out? (Yes / No)

 If no what are the major reasons
 d. ______________________________________________________________

e. ______________________________________________________________

f. _______________________________________________________________

5. Additional Items/Comments
 Following an inspection of the site works as per the above listed items permission to proceed with
the subsequent work is hereby Granted /Refused to the Contractor

Supervisor: Name _________________ Contractor: Name ________________

Sign ___________________ Sign _________________

Date ___________________ Date ________________

 Form No-UIIDP/021
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
CURRENT STAGES OF CONSTRUCTION AS PER THE SCHEDULE
No DESCRIPTION VALUE AS % OF TOTAL PLANNED & EXECUTED AS % OF THE TOTAL VALUE OF WORK
WORK
M.CONT ADD % THIS MONTH TOTAL TO DATE
PLANNE EXECUT % PLANNE EXECUT %
D ED D ED
1. SUB STRUCTURE
Excavation & Earth work
Concrete work
Masonry Work
2. SUPER STRUCTURE
Concrete work
Block Work
Roofing
Carpentry
Joinery
Steel Structure
Metal Work
Finishing
Glazing
Painting
Electrical Installation
Sanitary Installation
Site work
Others
TOTAL
REMARKS

A. Work Completed_____________________________________________________________________________________________________________
B. Work Under Construction______________________________________________________________________________________________________
 Form No-UIIDP/022

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

REQUISITION FOR MATERIAL TESTING

Project________________________________________________________________________
Site__________________________________________________________________________
_
Employer______________________________________________________________________
Contractor_____________________________________________________________________
Consultant_____________________________________________________________________
Supervisor
_____________________________________________________________________
TEST ORDER

To (Contractor)
_________________________________________________________________

We hereby instruct you to do the following material tests.

1. _______________________________________________________________
2. _______________________________________________________________
3. _______________________________________________________________
4. _______________________________________________________________

Test requested by__________________________________

Approved by______________________________________

Request Date_____________________________________

Note.

1. Representative sample should be taken in consultation with the laboratory personnel assigned to take over
the test. Representatives from the consultant, contractor and client should be available during testing and
sampling.
2. The contractor should distribute copies of the test result to the consultant and the contractor.
 Form No-UIIDP/023A

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

EVALUATION OF TEST RESULTS

Project________________________________________________________________________
Site__________________________________________________________________________
_
Employer______________________________________________________________________
Contractor_____________________________________________________________________
Consultant_____________________________________________________________________
Testing
Lab_____________________________________________________________________

Testing No_____________________________________________________________________

Kind of material tested__________________________________________________________

________________________________________________________________

Specified quality________________________________________________________________

_____________________________________________________________________________________

RECOMMENDATION OF DESGNER OR CONSULTANT OR SUPERVISOR

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

MATERIAL ACCEPTED MATERIAL REJFCTED

APPROVED BY:____________________________________________

CC:-

 To Site Supervisor
 To Inspection
 Form No-UIIDP/023B
Certificate No: __________________

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE INSPECTION CERTIFICATE

PROJECT: ____________________________ LOCATION _____________________

INVESTOR: __________________________ CONTRACT No. ________________
CONTRACTOR:_______________________
CONSULTANT: _______________________
Material Quality Evaluation certificate For Item Location ______________________

1. Testing Laboratory _____________________________________

2. Test No. & Method used _____________________________________
3. Date of Testing _____________________________________
4. Kind of Material Tested _____________________________________
5. Required Tests _____________________________________
_____________________________________
6. Required/specified qualities _____________________________________
7. Test Results _____________________________________
8. Recommendation of Supervisor _____________________________________
Material Accepted Rejected
9. Additional Items/Comments
Following an evaluation of the submitted __________________ test results as per the above listed items,
permission to use the material is hereby ______________ (Granted /Refused) to the Contractor.

Supervisor: Name ___________________ Approved by: Name ________________

Sign ___________________ Sign. ________________
Date ___________________ Date ________________

Acknowledge by Contractor: Name _________________________

Sign. _________________________
Date _________________________
 URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
Form No-UIIDP/024
Date: __________________

SITE DIARY

PROJECT: - ____________________________________________________________

SITE:-________________________________________________________________

EMPLOYER: -___________________________________________________________

CONTRACTOR: - ________________________________________________________

CONSULTANT: -________________________________________________________

SUPERVISOR: _ ________________________________________________________

1. Weather Conation Time, Good________ Bad ________ Lost Hrs ___________

2. Staff on Site

Project Eng.____________ Secretary_______________ Driver________________

Civil Eng.______________ Clerk__________________ Guard________________

Bldg Eng.______________ Purchaser______________ Plasterer______________

Technician_____________ Casher________________ Painter_______________

_

Gen. Forman____________ Dossier________________ Chiseller______________

Forman________________ Mason_________________ Glaser________________

Operator_______________ Carpenter______________ G.Leaders______________

Mechanic______________ Plumber_______________ D. Laborer _____________

Welder________________ Electrician_____________ Others________________

Bar Bender_____________ Helpers________________ Others________________

3. Work on progress___________________________________________________
_______________________________________________________________

4. Material on Site_____________________________________________________
5. Equipment on Site___________________________________________________

6. Instruction given on Site________________________________________________

7. Difficulties & Shortage________________________________________________
__________________________________________________________________

8. Recommendation____________________________________________________
__________________________________________________________________

____________________ (Supervisor) __________________ (Contractor)

 Form No-UIIDP/025
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

SITE MEETING PROGRAMME

PROJECT_____________________________________________ CONTRACT NO___________________________________________

EMPLOYER___________________________________________ CONTRACT TIME__________________________________________
CONTRACTOR________________________________________ COMMENCEMENT DATE___________________________________
CONSULTANT________________________________________ COMPLETION DATE________________________________________
CONTRACT AMOUNT__________________________________ TEST REQUEST NO________________________________________

No Meeting Addenda place Planned Requisition Time Remark

meeting date 1 2 3 4 5 6 7 8 9 10 11 12

NAME AND SIGNATURE PARTICIPANT

1.__________________________________________________ 3.__________________________________________________
2.__________________________________________________ 4.__________________________________________________
 Form No-UIIDP/026

URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

MONTHLY CONSTRUCTION PROGRESS REPORT

REPORT No _________________

MONTH _________________

CONT. AGR. No _________________

DATE OF REP _________________

PROJECT : ______________________________________________
LOCATION : ______________________________________________
EMPLOYER : ______________________________________________
CONSULTANT : ______________________________________________
CONTRACTIOR : _______________________________________________
1. INTRODUCTION & BACKGROUND

1.1. Background Information

1.2. Purpose of the report
1.3. Brief Summary of Project Area

2. CONTRACT DATA

2.1. Contract Summary

DATE OF SIGNATURE : _____________________________

CONTRACTVALUE OF MAN AGREEMENT BIRR : _________________
SUPPLEMENTARY AGREEMENT BIRR : __________________________
- VARIATION: ________________________________
- TOTAL AMOUNT BIRR: ________________________________
CONTRACT TIME:
MOBILIZATION TIME : ______________________________
COMMENCEMENT DATE : _____________________________
COMPLETION DATE : ______________________________
ADDITIONAL TIME GIVEN : ______________________________
EXTENSION OF TIME APPROVED : ______________________________
REVISED COMPLETION DATE : ______________________________
TIME ELAPSED IN DAYS : ______________________________
TIME ELAPSED IN % :______________________________
 PERCENTAGE OF WORK EXECUTED: ______________________________
PERCENTAGE OF WORK EXECUTED: ______________________________
PAYMENT CERTIFIED IN BIRR : ______________________________
PAYMENT CERTIFIED IN % :______________________________
2.2. Contract Securities
A. Performance Bond
Pursuant to the special conditions of contract clause ______, the contractor has furnished a performance
security from ______________________________Insurance / Bank, in the form of (bond/ bank
guarantee) which is _____% of the contract amount. The bond is valid for________ (Contract period of
the sub project) and ________(Defect liability period).

B. Advance Guarantee
Pursuant to the special conditions of contract clause ______, the contractor has furnished an advance
security from ______________________________ Bank, in the form of irrevocable unconditional
bank guarantee which is _____% of the contract amount. The guarantee will expire on
________________.

3. CURRENT STAGES OF CONSTRUCTION AS PER THE SCHEDULE (Should be modified as per

the project nature)

PLANNED & EXCUTED AS % OF THE TOTAL VALUE

OF
DESCRIPTION VALUE AS %
WORK
OF TOTAL
WORK THIS MONTH TOTAL TO DATE

PLANN EXCEUTE % PLANNE EXCUTE %

ED D D D

M.CON ADD%
T
A. Sub Structure
Excavation &
Earthwork
Concrete Work
Masonry
B. Super-Structure
Concrete Work
Block Work
Roofing
Carpentry
Joinery
Steel Structure
Metal Work
 Finishing
Glazing
Painting
Electrical installation
Sanitary Installation
Site Work
Others
Total

REMARKS

C. Work Completed________________________________________________________________

________________________________________________________________
D. Work Under
Construction_________________________________________________________

________________________________________________________________

3. QUALITY CONTROL TEST CONDUCTED DURING THE MONTH

(AS PER THE PROGRAM)

No TYPE OF MATERIALS TESTS DATE OF TEST RESULT

EXPECTED

1 SAND ORDERED SUBMITTED ACC REJ

2 COARSE AGGREGATE
3 SELECTED MATERIAL

4 CONCRETE
A)
B)
C)

D)
5 BLOCKS
A)

B)
6 BRICKS
A)

7 REINFORCEMENT BAR
 A)
B)
8 OTHERS
A)
B)

C)

REMARKS:-

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
__________________________________________________________________

3. DIFFICULTIES ENCOUNTERED ON SITE DURING THE MONTH UNDES REVIEW

MAJOR DIFFICULTIES BY TYPE YES/NO

MATERIAL SHORTAGE

EQUIPMENT SHORTAGE

CASH SHORTAGE

MAN POWER SHORTAGE

WETHER CONDITION

EMPLOYER INTERFERANCE

OTHERS
REMARKS:-

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
___________________________________________________________

4. INSTRUCTION GIVEN DURING THE MONTH UNDER REVEW

INSTRUCTION DATE REFERNCE

DESIGN CHANGE

ADDITIONAL WORK

SUSPENSION

MATERIAL CHANGE

RECTIFICATION

OTHERS

REMARKS:-
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_______________________________________________

6. EVALUTION (MARK:- POOR,FAIR,GOOD,EXCELLENT)

A. QUALITY OF WORKS ________________________________________________

B. QUALITY OF MATERIALS ____________________________________________

C. PERFORMANCE: (AS PER THE SCHDULE)

PROGRESS:- _______________________________________________________

DELVERY OF MATERIAL:- _______________________________________________

MOBILIZATON OF MANPOWER:- _________________________________________

EQUIPMENT OF MANPOWER:- ___________________________________________

EQUIPMENT DELIVERY :- _______________________________________________

REMARKS _____________________________________________________________

_____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________

7. VARITION APPROVED (STATE TYPE & AMOUNT)

_____________________________________________________________________________________
_____________________________________________________________________________________
______________________________________________

9. CLAMS SUBMITED (REASON & DURATION) IF NOT SUBMITTED

_____________________________________________________________________________________
_____________________________________________________________________________________

9. EVALUTION MEETING.

A. MEETING CONDUCTED ON: _________________________________________________

B. POINT RAISED AND ACTION TAKEN (IN SHORT)

1._____________________________________________________________________________
2 .____________________________________________________________________________
3. ____________________________________________________________________________
4. ____________________________________________________________________________
5. ____________________________________________________________________________
6. ____________________________________________________________________________
PROGRESS STATUS

MONTH % PLANNED % EXECUTED % TIME ELAPSED

PREVIOUS MONTHS

CURRENT MONTHS

TOTAL TO DATE

GENERAL REMARKS AND MEASURES TO BE TAKEN

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

____________________________________ _____________________________
 ENGINEER REPRESENTATIVE PROJECT ENGINEER

___________________________________ _____________________________

DATE DATE

Form No-UIIDP/027
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
WORK ORDER
PROJECT: _______________________________ DATE: ____________________
LOCATION:______________________________ Contract No.________________
INVESTOR: ______________________________ Adm. Region _______________
CONTRACTOR: ___________________________
CONSULTANT: ___________________________

INSTRUCTION

ROUGH SKETCH

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________

Prepared by_____________________ Checked by__________________ Approved by ___________

_____________________ __________________
___________

Form No-UIIDP/028
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
VARIATION ORDERS NO_________

Project _______________ Contract Number _______________

Employer _______________ Contract Amount _______________
Contractor _______________ Previous Cumulative
V.O _______________
Consultant _______________ Cumulative _______________
Contract Time _______________ Variation Order _______________
Time Extension _______________ Calendar Days added _______________
Time Deduction I/A _______________

Cause of the variation & Description of Works (Summarized)

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Responsible party of the Variation_______________________________________

Reference Work Order No._____________________________________________

Measures taken

________________________________________________________________
_______________________________________________________________
________________________________________________________________
_________________ _____________________

Prepared by Approved by
Copies

Contractor Client Consultant \Supervision Office

 Form No-UIIDP/029
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM

UNIT PRICE ANALYSIS SHEET

Project __________________________ Labor Hourly out put __________________________

_ _
Work item __________________________ Equipment __________________________
_ _
Total quantity of work item __________________________ Unit price __________________________
_ _
Material Cost (1:01) Labor Cost(1:02) Equipment Cost (1:03)
Type of Uni Qty * Rate Cost Labor No UF ** Hourly Type of No Hourly Hourly Cost
Material t per by Indexed Cost Equipmen Rental
unit Trade Hourly t
Cost

Total (1:-01) A Total (1:02) B C

A= Materials Unit Cost = A Birr/Unit B=Manpower Unit Cos t= B Birr/Unit C=Equipment Unit Cost = C Birr/Unit

Total of (1:02) Total of (1:03)

Hourly Output ______________ Hourly Output ______________
Direct Cost of work item = A+B+C = ………………………………………………………… ____ Birr/Unit
Over head cost…………………………………………………………………………………… ____ Birr/Unit
Profit…………………………………………………………………………………………… ____ Birr/Unit
….
Total unit ____ Birr/Unit
cost……………………………………………………………………………………..
UF : Utilization Factor, *INCLUSIVE OF WASTAGE, TRANSPORTATION, HANDLING ETC ** INCLUSIVE OF BENEFITS, TRAVEL SUBSIDES & COST OF OVER TIME RELATED TO
TARGET OUT PUT
 Form No-UIIDP/030
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
PROJECT COMPLETION TIME EXTENSION

PROJECT: ____________________________________________________________________
LOCATION: ___________________________________________________________________
CLIENT: _____________________________________________________________________
CONTRACTOR: ________________________________________________________________

CONSULTANT: ________________________________________________________________

CONTRACT NO: ________________________________________________________________

Site Hand over date ________________________________

Mobilization Time ________________________________
Contract Time ________________________________
Start date as per the contract agreement ________________________________
Completion date according to the contract
agreement ________________________________
Time granted to variation ________________________________
Delays justified previously in days ________________________________
Total Extended Time ________________________________
Requested Time extension ________________________________
Delays justified according to the evaluation table
attached ________________________________
Contract period + justified delays ________________________________
Completion date according to the justified delay ________________________________
Actual date of completion ________________________________
Number of unjustified delays ________________________________
Amount of Liquidated damage ________________________________
Percentage of liquidated damage to the contract
amount. ________________________________

______________________ _____________________________

Prepared Approved
 URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
TIME EXTENSION EVALUATION SHEET

PROJECT: ____________________________________________________________________
LOCATION: ___________________________________________________________________
CLIENT: _____________________________________________________________________
CONTRACTOR: ________________________________________________________________
CONSULTANT: ________________________________________________________________
CONTRACT NOR: _______________________________________________________________

NO Description of cases and Justification of claims Time Assessment of claims Time

Evidence by Contractor extension by consultant extension
requested recommend
by ed by
contracto Consultant -
r -Days Days

______________________ _____________________________

Prepared Approved
 Form No-UIIDP/031
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
የክፍያ ምስክር ወረቀት ቁጥር _____________________

CERTIFICATE OF PAYMENT No.

ሥራው _______________________________ የገንዘቡ ልክ ( ብር)

Project Amount (Birr)
ቦታው ________________________________ ዋናው ውል
Main Contract
Location
አሰሪው መ/ቤት__________________________ ተቀጽላ ውል
Employer Supplementary Contract
የሥራ ተቋራጭ _________________________ የለውጥ ሥራ ትእዛዞች
Contractor Variation Orders
አማካሪ ማሐንዲስ _______________________ ጠቅላላ ድምር
Consultant Total Sum

አባሪ በሆነው የክፍያ ሰነድ ጥያቄ መሠረት እስከ ዛሬ ድረስ ተቋራጩ የሰራው ሥራና/ያቀረበው ዕቃ ዋጋ

As per the attached Statement the Value of work excited end) or materials Supplied to date
is.___________________________
የገንዘቡ ልክ (ልክ)
Amount (Birr)

ቁ ቀን የገንዘብ ልክ ( ብር)
No. Date Amount (Birr)
የገንዘብ ልክ
1
ተቀናሽ (ብር)
2 Deduction Amount (Birr)
3 1. አስቀድሞ የተከፈለ
4 Previews Payment
5 2. ቅናሽ, Rebate
6
7 3. መያዣ, Reception
8 4. መቀጫ, Penalty
ድምር 5. የቀድሚያ ክፍያ
TOTAL Advice Replacement
6. ሌላ
Others
ድምር TOTAL
የተጣራ ለተቋራጭ የሚከፈል ገንዘብ
Nat Sum due to the Contractor
VAT (15%)
Nat Sum due to the Contractor + VAT

ለሥራ ተቋራጩ ብር -------------------------- ሊከፈል መቻሉን እናረጋግጣለን'

We Certify the Contractor is now controlled to use sum of Birr ________________________

-------------------------------------------------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------------------------------------------
ተረጋግጧል / Checked ፀድቋል / Approved
_________________________ ___________________

የክፍያ ጥያቄ ማጠቃለያ ቁጥር

Summary Of Payment Statement

ሥሪው / Project_________________________________________

ቦታው / Location______________________________________

የሥራው ተቋራጭ / Contractor_________________________

የተሠራው ሥራና/ወይም የቀረቡ ዕቃዎች ዝርዝር

Details of works executed and/or materials supplied

ተራ ድምር በከፊል ( ብር) ድምር ብር

ቁጥር መግለጫ Sub Tobi (Birr) Tool (Birr)
Term DESCRIPION
No. የውለታው የተሠራው የውለታው የተሠራው
Contract Executed Contract Executed

ድምር / TOTAL
p“b / Rebaate
ጠቅላላ ድምር / GRAND TOTAL

I / we ____________________hereby certify that the above figures are correct and that the total of
work executed to date is birr____________

(________________________________________________________)

_________ _______________ ______________

Contractor Consultant Client

ተ.ቁ
No መግለጫ መለኪያ ብዛት / QTY
DESCRIPTION UNIT ነጠላ ድምር ድምር ብር
የውለታው የተሠሪው ዋጋ በከፊል TOTAL
CONT. EXECUTED UNIT SUB- BIRR
PRICE TOTAL

______________ _________________ __________________

CONTRACTOR CONSULTANT CLIENT

 URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
DATE: _______________ TAKE OFF SHEET No. _______________ PAGE No. ______

PROJECTE ____________________________________________________________________

D S DESCRIPION T D S DESCRIPTION
T

Prepared by_____________________ Checked by__________________ Approved by ___________

_____________________ __________________
___________
 URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
BAR SCHEDULE

PROJECT: _______________________________ DATE: ____________________

LOCATION: ______________________________ Contract No.________________
CITY ADMIN: ______________________________ Adm. Region ____________
CONTRACTOR:___________________________
CONSULTANT: ___________________________
Drawing No __________ Page _____

Location Bar No. shape Dia. Length No. of Bars Dia. Dia. Dia. Dia. Dia.

Total Length
Weight Kg
Total Weight Kg

Prepared by_____________________ Checked by__________________ Approved by ___________

_____________________ __________________
___________
 Form No-UIIDP/032
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
TEMPORARY ACCEPTANCE

PROJECT : __________________________________________________________________

LOCATION: _________________________________________________________________

CLIENT: ____________________________________________________________________

CONTRACTOR: ______________________________________________________________

CONTRACT No DATE AMOUNT (BIRR) BASIS

A. Main Contract ______ _______ ______________ ___________

B. Sup. Agreement: ______ _______ ______________ ___________

C. Variation Order No. 1 ______ _______ ______________

D. ” ” ” 2 ______ _______ ______________

E. ” ” ” 3 ______ _______ ______________

F. ” ” ” 4 ______ _______ ______________

This ________________________ day __________________ by verbal/Written order No.

__________________ by the Contract Administration after the notification to all concerned parties we
undersigned.

1. __________________________________ Representing the ________________________

2. __________________________________ ” ” _________________________

3. __________________________________ ” ” _________________________

4. __________________________________ ” ” _________________________

5. __________________________________ ” ” _________________________

6. __________________________________ ” ” _________________________

7. _________________________________ ” ” ________________________

Have examined

a. Contracts. Drawings and Specification

b. _______________________________

c _______________________________
and have proceed with the ascertainment of the completion and Temporary Acceptance of the above
project on the basis of the following information.

A. Date when the contractor took possession of site ________________________________

B. Commencing date __________________________________________________________
C. Agree length of completion time________ _______________________________________
(Calendar Days/Working days)_________________________________________________
D. Completion date according to contract __________________________________________
E. Actual completion date ______________________________________________________
F. Total Number of delay _______________________________________________________
G. Number of justified days of delay ______________________________________________
H. Number of unjustified days of delay ____________________________________________
I. Penalty of ____________________________ day Eth.Birr __________________________
Per day Eth. Birr ____________________________________________________________

ACCOUNT

Total value of work executed and/or material supplied _______________________

DEDUCTIONS

1. Previous Payment ____________________

2. Penalty ____________________

3. Rebate ____________________

4. Others ____________________

TOTAL DEDUCTIONS ____________________

Total amount due to the contractor ___________________

Retention money ______________ % of the total value of work executed payable on the

Final acceptance

NET SUM PAYABLE TO THE CONTRACTOR

Performance Bond __________________________________________________________

Remarks ___________________________________________________________________
 CONCLUSION

The date for acceptance will be _________________________ after thorough investigation of the works
in all it’s excepting invisible and the specifications in an acceptable manner. We, Witnesses thereof we
have written and signed this temporary acceptance of which one copy is be issued to the contractor for all
practical purposes after due approval.

________________________ ________________________ _____________________

SUPERVISOR CITY ADMINSTRATION

CONTRACTOR

ATTENDING PARTIES

1. ________________________________ ______________________

2. ________________________________ ______________________

3. ________________________________ _______________________

4. ________________________________ _______________________

5. ________________________________ _______________________

6. ________________________________ _______________________

7. ________________________________ _______________________

DATE ________________________________
 Form No-UIIDP/033
URBAN INSTITUTE AND INFRA-STRUCTURE DEVELOPMENT PROGRAM
FINAL ACCEPTANCE

PROJECT: ____________________________________________________________________

LOCATION: ___________________________________________________________________

CLIENT: _____________________________________________________________________

CONTRACTOR: ________________________________________________________________

CONTRACT No DATE AMOUNT (BIRR)

BASIS

A. Main Contract _______ ________ _________________ _________

B. Supp. Agreement _______ ________ _________________ _________

C. Variation Order No. 1 ______ _______ ______________

D. ” ” ” 2 ______ _______ ______________

E. ” ” ” 3 ______ _______ ______________

F. ” ” ” 4 ______ _______ ______________

This ________________________ day __________________ by verbal/Written order No.

__________________ dated ___________________by the City Administration we the undersigned.

1. __________________________________ Representing the ________________________

2. __________________________________ ” ” _________________________

3. __________________________________ ” ” _________________________

4. __________________________________ ” ” _________________________

5. __________________________________ ” ” _________________________

6. __________________________________ ” ” _________________________

7. _________________________________ ” ” ________________________

Have examined

a. Contracts. Drawings and Specification

b. The final certificate of measurement

c The report of the temporary acceptance

d._______________________________________

e. _______________________________________

and have proceed with the ascertainment of good execution and final acceptance of the project on the
basis of the following facts:-

A. Date of temporary acceptance ________________ ________________________________

B. Proposed date of Final Acceptance _____________________________________________
C. Remarks made during the temporary acceptance of the work
1. ________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
4. ________________________________________________________________
5. ________________________________________________________________
6. ________________________________________________________________

FINAL EXAMINATION OF THE WORK

A. Signs of visible defects. The general examination of the works as well as checks and tests made at
the different parts of the project has shown.
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
B. NEW FACTS. Since the temporary acceptance of the work, the following facts have occurred.
1. _________________________________________________________________
2. _________________________________________________________________
3. _________________________________________________________________
4. _________________________________________________________________
5. _________________________________________________________________
C. NEW ORDERS. New orders have been given by us to the contractor on _________________ in
view of making good any eventual defects.
1. ________________________________________________________________
2. ________________________________________________________________
3. ________________________________________________________________
4. ________________________________________________________________
D. GENERAL REMARKS. The comparison of the report of the temporary acceptance of works with
the present conditions of the entire project, the contract and other justification documents has
brought up the following remarks.
1. ________________________________________________________________
2. ________________________________________________________________
 3. ________________________________________________________________
4. ________________________________________________________________

ACCOUNT

A. Total value of work executed and/or material supplied _______________________

DEDUCTIONS

1. Payment made until temporary acceptance ____________________

2. Payment made after temporary acceptance ____________________

3. Various Deductions

a.___________________________ ______________________

b.___________________________ ______________________

c.___________________________ ______________________

TOTAL DEDUCTIONS _______________________

Net sum due to the contractor Birr _______________________ (………….

………………………………………………………………………………………
……….)
CONCLUSION

Therefore, we do hereby declare that the work has been executed in the principle of good workmanship
and have accepted the project definitely on behalf of _________________________________________

________________________ ________________________ _____________________

SUPERVISOR CITY ADMINSTRATION

CONTRACTOR
No Description of Format Format No.

1 Site Handover Hand Over UIIDP / 001

2 Construction Work Schedule UIIDP / 002
3 Manpower Mobilization Schedule UIIDP / 003
4 Material Delivery Schedule UIIDP / 004
5 Equipment Delivery Schedule UIIDP / 005
6 Material Test Requisition Schedule UIIDP / 006
7 Performance & Advance Guarantee Follow Up Form UIIDP / 007
8 Site Handover Inspection Certificate UIIDP / 008
9 Site Preparation Inspection Certificate UIIDP / 009
10 Earth Works Inspection Certificate UIIDP / 010
11 Foundation Excavation Inspection Certificate- UIIDP / 011
12 Masonry Work Inspection Certificate UIIDP / 012
13 Concrete Work Inspection Certificate UIIDP / 013
14 Structural Timber Work Inspection Certification UIIDP / 014
15 Carpentry & Joinery Work Inspection Certificate - UIIDP / 015
16 Roofing & Cladding Work Inspection Certificate UIIDP / 016
17 Finishing Work Inspection Certificate UIIDP / 017
18 Site Work Inspection Certificate UIIDP / 018
19 Drainage Work Certificate UIIDP / 019
20 Cobble Stone Road Work Certificate UIIDP / 020
21 Current Stages Of Construction As Per The Schedule UIIDP / 021
22 Requisition For Material Testing UIIDP / 022
23A Evaluation Of Test Results UIIDP / 023A
23B Material Quality Evaluation Certificate UIIDP / 023B
24 Site Diary UIIDP / 024
25 Site Meeting Program UIIDP / 025
26 Monthly Construction Progress Report UIIDP / 026
27 Work Order UIIDP / 027
28 Variation Orders UIIDP / 028
29 Unit Price Analysis Sheet UIIDP / 029
30 Project Completion Time Extension UIIDP / 030
31 Certificate Of Payment UIIDP / 031
32 Temporary Acceptance UIIDP / 032
33 Final Acceptance UIIDP / 033