UBND THANH PHO HO CHI MINH CQNG HOA xA HQI CHiT NGHiA VI~T NAM

BAN QUAN L Y KHU CONG NGH~ CAO DQc l~p - Tl}:'do - H~nh phuc
THANH PHO HO CHi MINH

85: 205 /QD-KCNC Thanhph6 H6 Chi Minh, ngay05 thang 7 nam 2017

QUYETDINH
Ban hanh Quy trinh dAu nBi h~ tAng ky thu~t tir cac dl}:'an thanh phAn vm
h~ thBng h~ tAng ky thu~t chung cua Khu Cong ngh~ cao Thanh phB.

TRUONG BAN BAN QuAN LV KHU CONG NGH~ CAO

THANH PHO HO CHi MINH

Can eu Lu~t Xay d\ffig s6 50/2014/QHI3 ngay 18 thang 6 nam 2014 eua
Qu6e hQi;
Can eu Lu~t Bao v~ moi truemg s6 55/2014/QH13 ngay 23 thang 6 nam
2014 eua Qu6e hQi;
Can eu Nghi dinh s6 59/2015/ND-CP ngay 18 ngay 6 thang 2015 eua
Chinh phu v@quan ly dv an dAutu xay d\ffig;
Can eu Nghi dinh s6 46/2015/ND-CP ngay 12 thang 5 nam 2015 eua
Chinh phu v@quan ly ehfit lUQ11gva bao tri eong trinh xay dlJIlg;
Can eu Nghi dinh s6 80/2014/ND-CP ngay 06 thang 8 nam 2014 eua
Chinh phu v@thoat nuae va xu ly nuae thai;
Can eu Thong tu s6 18/2016/TT-BXD ngay 30 thang 6 nam 2016 eua BQ
Xay dlJIlg Quy dinh chi tiSt va huang dan mQt s6 nQi dung v@thAm dinh, phe
duy~t dv an va thiSt kS, dv toan xay dlJIlg eong trinh;
Can eu QuySt dinh s6 07/2017/QB-UBND ngay 17 thang 02 nam 2017
eua Uy ban nhan dan Thanh ph6 H6 Chi Minh v@Ban hanh Quy ehS t6 ehue va
ho~t dQng eua Ban Quan ly Khu Cong ngh~ eao Thanh ph6 H6 Chi Minh;
Can eu QUYStdinh s6 173/QB-KCNC ngay 31 thang 5 nam 2017 eua Ban
Quan ly Khu Cong ngh~ eao Thanh ph6 v@giao nhi~m V\l tiSp nh~n, quan ly cae
eong trinh, co So' h~ tAng ngan saeh Nha nuae dAu tu. trong Khu Cong ngh~ eao
va t6 ehue v~n hanh, khai thae, su d\lng cae eong trinh co So' h~ tAng ky thu~t;
th\le hi~n bao tri eong trinh; thve hi~n cae dieh Y\l eong eQng, cae ho~t dQng dieh
V\l co thu phi trong Khu Cong ngh~ eao va cae ho~t dQng dieh V\l khae theo yeu
eAu nha dAu tu;
X6t d@nghi eua Truang Phong Quan ly Quy ho~eh, Xay d\ffig va Moi
truemg t~i To trinh s6 18/TTr -QHXDMT ngay 03 thang 7 nam 2017,
 QUYET DINH:
Di~u 1. Nay ban hanh kern theo QuySt dinh nay Quy trinh d~u n6i h~ tfulg
kY thu~t til cac dlJ an thanh ph~n v6i h~ th6ng h~ t~ng kY thu~t chung cua Khu
Cong ngh~ cao Thanh ph6.
Di~u 2. QuySt dinh nay co hi~u h,rc k@til ngay ky va thay thS QuySt dinh
86 22/QD-KCNC ngay 26/01/2011 cua Ban Quan ly Khu Cong ngh~ cao Thanh
ph6H6 .Chi Minh.
Di~u 3. Chaph Van phong, TruOng Phong Qwin ly Quy 'ho~ch, Xay dlJng
va Moi truOng, TruOng cac Phong chuyen rnon/Giarn d6c cac don vi tflJCthuQc
Ban Quan ly Khu Cong ngh~ cao Thanh ph6 va cac ca nhan, t6 chuc co lien
quan chiu trach nhi~rn thi hanh QuySt dinh nay.!. ~
-
Nui nhlj.n:
- NhuDi~u 3;
- TruOng ban Le ROlli Qu6c (d~ bao cao);
- Cae Ph6 Truangban (d~ bi6t);
- Luu: VT, P.QHXDMT.TP.18.~

2
 UBND THANH PHD HO CHI MINH CQNG HOA xA HQI CHU NGHiA VI~T NAM
BANQuANLYKHUC6NGNGH~CAO f)qc l~p - Tl}' do - H~nh phuc
THANH P!l:: CHi MINH
.<S\. .' 4-
~ .' ()
~ • .;A
~ '_ ~~J~/ ".• ~
.:.: ".J 0~ ::.. :t-
'.".. .I'.~ ~.l'. Q)

:: ~to~"""":~')~' (").
;z:
QUY TRI'NH
~ ~~ ,,~":i.C~.:..;:
\~~1rv:~:-:-" 000' .~ ••••• Ai h~ tAng ky thu~t til' cac dl}'an thanh phAn
vOi 11.. ~ ~ tAng ky thu~t chung cua Khu Cong ngh~ cao Thanh phA.
(Ban himh kern theo Quyit atnh s6209QD-KCNC ngayObthang 7 narn 2017 cua
Truimg ban Ban Quan If;Khu C6ng ngh? cao Thanh ph6)

ChU'O'ngI
NHUNG QUY DJNH CHUNG
f)i~u 1. Ph~m vi va (fAitlfgng ap d1}ng
1. Ph~m vi ap d\mg:
Quy trinh nay quy dinh vS cong tac dfiu n6i h~ tfulg ky thu~t g6m: cfip nuac,
thoat nuac m~t, thoat nuac thai va dfiu n6i giao thong til d\l an cua cac d6i tUQ1lg
dAu tu (Nha dAu tu) vao h~ th6ng h~ tAng ky thu~t chung cua Khu Cong ngh~ cao
Thanhph6.
2. D6i tUQ11gap dVng: Quy trinh nay ap dvng cho cac d6i tUQ11gho~t dQng
trong Khu Cong ngh~ cao g6m:
- Ban Quan ly Khu Cong ngh~ cao Thanh ph6 (Ban Quan ly) th\lc hi~n nhi~m
V\l huang d~n, kiSm tra dfiu n6i h~ tAng ky thu~t til cac d\l an thanh phAn vai h~
th6ng h~ tAng ky thu~t chung;
- Ban Quan ly Cac d\l an DAu tu - Xay dvng Khu Cong ngh~ cao Thanh ph6
H6 Chi Minh (ViSt t~t la Ban Quan ly Cac d\l an).
- Cac doanh nghi~p dugc cfip phep dAu tu d\l an, cong trinh xay dvng trong
Khu Cong ngh~ cab;
- Cac dan vi dAu tu d\l an va tham gia ho~t dQng xay dvng trong Khu Cong
ngh~ cao.
f)i~u 2. Trinh tl}', cach thrrc thl}'c hi~n
1. Chu dAu tu nQp h6 sa tr\lc tiSp t~i BQ ph~n tiSp nh~n va tra kSt qua cua Ban
Quan lYe
2. BQ ph~n tiSp nh~n va tra kSt qua cua Ban Quan ly tiSp nh~n h6 sa, kiSm tra
tinh hQ'Pl~ va dAy du cua cac gifiy t6' co trong h6 sa:
- Truang hQ'Ph6 sa hQ'Pl~ va dAy du theo quy dinh thi cfip Bien nh~n h6 sa; 1/11'.
~

3
 - TruOng hqp h6 sa chua d~y du ho~c chua hqp l~, congchuc dugc phan cong
tiSp nh~n hUOng dftn cho nguai nQp h6 sa va hoan thi~n h6 sa th~o q:uydinh.
, '\, .' . ~ '.~:~-::'4.".'
3. Tra ket qua: Chu dautu nh~n ketqua t~i Van phong'~anQuan"ly trong gia
hanh chinh. ..:--' '
.....•.., "-,.'~ ".
Chu<1ng II
QUYTRlNH THVC HI~N ','
.). 3C'
Dleu . ac Io~u-h). ~J.
0 S<1
uau J._
nm
1. H6 sa dfiu n6i h~ th6ng cfip nuac.
2. H6 sa dfiu n6i h~ th6ng thmlt nuac m~t.
3. H6 sa dfiu n6i h~ th6ng thmit nuac thai.
4. H6 sa dfiu n6i h~ ili6ng giao thong.
Di~u 4. Thanh phftn h8 so", s8 lUQ'ngh8 S<1,thOi gian giiii quy~t, l~ phi
1.Thanh phftn h8 S<1g8m:
- Van ban dS nghi dfiu n6i theo mftu Ml, M2, M3, M4.
- Ban ve thiSt kS theo quy ho~ch 1/500 ho~c Ban ve chfip 'thu~ t6ng m~t bkg
- Phuang an kiSn trUc cong trinh va giai phap h~ t~ng ky thu~t dugc Ban Quan ly
duy~t va chi tiSt ky thuat diSm dfiu n6i.
- Phuang an thi cong, trong do bao g6m ca phuang an dam bao ho~t dQng cua
cac nha d~u tu trong- Khu Cong ngh~ cao khong bi gian do~ (Giao thong, cfip di~n,
cfip nuac ... ) (03 ban).
- Phuang an tai l~p m~t bkg theo hi~n tr~g ban d~u.
- Bang tiSn dQ thi congo
- Van ban cam kSt gift v~ sinh trong qua trinh thi cong va tai l~p m~t bkg sau
khi thi congo
2. S8 lUQ'ngh8 sO": 03 (ba) bQ

3. ThOi gian giiii quy~t: Khong qua 05 (nam) ngay lam vi~c 'kS til ngay nh~n
h6 sa d~y du h6 sO',hqp l~
4. L~ phi: Khong.
Di~u 5. Quy trinh th\fc hi~n
Sau khi nh~n h6 sO',BQ ph~ tiSp nh~ va tra kSt qua chuySn Phong Quan ly
Quy hQ~ch, Xay d\l'ng va Moi truOng (Phong QHXDMT) dS kiSm tra th\l ly xac
nh~n S\l'phil hqp quy ho~ch, tham mrm trinh Lanh d~o Ban Quan ly cong van chfip
thu~n phu(yng an dfiu n6i h~ t~ng ky thu~t dS chu d~u tu triSn khai buac tiSp theo.
- TruOng hqp h6 sa dfiu n6i h~ t~ng ky thu~t chua phil hqp vS quy ho~ch, xay
d\fllg, Phong QHXDMT d\l' thao Cong van huang dftn chu d~u tu. ~

4
 - TruOng hgp h~ th6ng hl;ttcing ky thu~t chua duQ'c Ban Qmin 1y Cac d\1 an,
Phong QHXDMT co cong van huang d~n theo 3 huang: (1)chu dftu tu t\1 b6 kinh
phi dftu tu xay d\Illg tl;tmh~ th6ng hl;ttftng ky thu~t truac; (2)th6a thu~n su d\lllg d\1
an 1iSnkS; (3)cha dftu tu chung cua Ban Quan 1y.
- TruOng hgp h6 sa dftu n6i hl;ttftng phil hQ'PvS quy hOl;tch,xay d\Illg, Phong
QHXDMT chuySn kSt qua gui BQ ph~n tiSp nh~n va tra kSt qua chu dftu tu 01 bQ h6
sa, chuYSn Ban Quan 1y Cac d\1 an 01 bQ h6 sa, Phong QHXDMT lUll 01 bQ.
J)i~u 6. J)i~u ki~n chu~n bi thi cong va thi cong
Dan vi thi cong do chu dftu tu t\1 quySt dinh ho~c giao dan vi quan ly hl;ttftng
Khu Cong ngh~ cao th\l'C hi~n (Theo dan gia dugc cong b6 va dugc th6ng nhftt).
Truac khi thi cong 03 (ba) ngay chu dftu tu ho~c dan vi thi cong phai th\l'c hi~n:
1. Dang kY lam thu t\lC dong tiSn kY quy theo quy dinh cua Ban Quan 1y vai
Ban Quan ly Cac d\l' an (Ban Quem If Cac dv an co Giciy xac nhq,n a011vi ali aong
ti~n kY quf!).
2. Ban Quan ly Cac d\l' an huang d~ chu dftu tu th\l'c hi~n vi~c dftu n6i, th6ng
nhftt huang tuySn, vi tri diSm dftu n6i th\l'c dia, l~p bien ban ban giao m~t b~ng va
diSm dftu n6i tl;tihi~n truOng theo m~u M5 (Thanh phdn g6m Phong QHXDMI', Ban
Quan If Cac dvan, a011vi thi cong, chu adu t14).Bien ban a14(1cIq,p03 ban.
3. Trang qua frinh thi cong: Cac a011vi phai aam baa tuy~t d6i an toan (Co
bi?n phap raa chan, baa V? khi lap h6 ga, ...) va dam bao v~ sinh m6i truOng xung
quanh. NSu g~p S\l'c6, phai bao cho Ban Quan ly, Ban Quan ly Cac dv an dS ph6i
hgp xu 1y.
4. LUll Y d6i vai dftu n6i h~ th6ng xu 1y nuac thai: Yeu cftu cac doanh nghi~p,
dan vi co quy mo xa thai tren 100m3 /ngay dem, phai th\l'c hi~n l~p d~t h~ th6ng
quan tr~c tv dQng chftt 1ugng nuac thai sau xu ly truac khi tiSn hanh dftu n6i vao h~
th6ng thu gom nuac thai chung cua Khu Cong ngh~ cao (Thea Cong van s6
1856/KCNC-QHXDMTngay 30/12/2016 cua Ban Quan If).
J)i~u 7. Giai do~n nghi~m thu, ban giao
1. Chu dftu tu thong bao dSn Ban Quan 1y, Ban Quan ly Cac d\1 an mai chUng
kiSn nghi~m thu va xac nh~n phftn dftu n6i theo ky thu~t da th6a thu~. Thai gian d\l'
kiSn nghi~m thu phai duQ'c thong bao truac 03 (ba) ngay.
2. Thanh phcin tham gia nghi~m thu, ban giao: Chu dftu tu, dan vi thi eong,
Ban Quan 1y Cae d\1 an, Phong QHXDMT va dan vi khac (NSu eftn).
3. H6 sa nghi~m thu, ban giao:
- Bien ban nghi~m thu (Theo m~u M6 dinh kern): 03 ban.
- Ban ve ky thu~t hoan cong diSm dftu n6i: 03 ban. \IIU
J ~

."~

5
 ....
;.

- Bien bfm xac nh~n hoan tat cong tac tai l~p m~f b~ng theo hi~n tn;mg ban dllu
va v~ sinh moi truOng (Theo mau M7 dinh kern): 03 bfm.
4. Cac ben co lien quan phai hoan tat h6 sa nghi~m thu truac ngay t6 chuc
nghi~m thu, ban giao. H6 sa nghi~m thu, ban giao duQ'c l~p 03 bQ: Phong
QHXDMT 01 bQ, Ban Quan 1yCac d\I an 01 bQ va chl.idllu t~ 01 bQ.
5. Sau khi h6 .8g IJ,ghi~m!hu, bap gia9 ...4ugc. c;ac;ben xacnb~n,chl.i dllu tu
(Ho~c dan vi thi cong nSu 1a dan vi dong tiSn kY quy) lien h~ dan vi thu tiSn kY quy
dS th\Ic hi~n thli tl,lcnh~n l~i tiSn kY dii kY quy.
ChuO'ngIII
TO CHUC THlfC HIE:N
Di~u 8. Trach nhi~m hmyng d~n, thi himh
1. Phong QHXDMT
a) Ph6i hQ'Pch~t che vai cac dan vi co lien quan trong qua trinh th\Ic hi~n cong
tac va dam bao thai gian giai quySt hB sa.
b) C~p nh~t thong tin cac cong trinh xay dlJllg duQ'c dau n6i h~ tllng ky thu~t dS
ph\lc Vl;lcong tac quan 1y.
2. Ban Quan lyCac d1J' an
a) Ph6i hQ'Pch~t che vai cac don vi co1ien,quan trong qua trinh th\IC hi~n cong
tac va dam bao thai gian giai quySt h6 sa.
b) C~p nh~t thong tin cac cong trinh xay dlJllg duQ'c dau n6i h~ tllng ky thu~t dS
ph\lc Vl;lcong tac quan 1yva cung cap cho Ban Quan 1y (Phong QHXDMT).
c) L~p d\I toan chi phi va dan gia ap d\lng cho timg Quy giri vS Ban Quan 1y dS
cong b6 vS:
- Tu van dich V\l h6 sa dau n6i h~ tllng cap nuac, thoat nuac mua, thoat nuac
thai, dau n6i giao thong.
- Chi phi v~t tu, thiSt bi, nhan cong dS th\Ic hi~n vi~c dau n6i hoan thi~n, tai
l~p m~t b~ng theo tung tuySn dUOngC\lthS trong Khu Cong ngh~ cao.
Trong qua trinh th\IC hi~n, nSu co cac phat sinh vu6ng ril~c clln diSu chinh, b6
sung Quy trinh, Phong QHXDMT bao cao b~ng van ban d@TruOng ban xem xet,
quySt dinh.!. ~
- KT. TRUONG BAN
, TRUONG BAN

Le Thanh D~i
6
 MauMl
CQNG HOA xA HQI CHU NGHiA VI:t::T NAM
DocHip - Ttl' do - Hanhphuc

Tp.H6Chi Minh, ngay ..... thimg ..... niim 20

VAN BAN DE NGHJ DAu NOI H:t::THONG cAp Nuac

Xay dl,l'ngmai
Ci~iti;lo,sfra chfra

Kinhgifi: Ban Quan Ly Khu Cong ngh~ cao Thanh ph6 Hfl Chi Minh

1. Ten Chll d~u tu:

- 'Dja chi lien h~:
S6 di~n tho~i:
2. Dja diSm xay dl,l'ng:
T~i 10 dAt: , .
........................................................................................................................................
3. NQi dung d8 nghj: BAu n6i M th6ng dp nuac mua til cong trinh .
.............................................................................................................................................
.............................................................................................................................................
sang h~ th6ng cAp nuac chung CllaKhu Cong ngM cao Thanh ph6 He, Chi Minh.
Luu luc;mgnuac dung: m3/ngay demo .
.. , d'"':' A 1...
V! tn tern dau not: .
.......................................................................................................................................
SoA I.ugng d tern
. .:t I.. 1...
dau not: .
.......................................................................................................................................
, h h ' I.. I.. 1...
Ktc t UO'Cong dau not: .
Thai gian
,
thl,l'Chi~n: .
4. Cac yeu cau khac : .
.........................................................................................................
.........................................................................................................
Toi xin cam k~t thl,l'chi~n dung theo Quy trinh dfiu n6i h~ t~ng ky thu~t til cac dlJ an
thanh ph~n vao h~ th6ng h~ t~ng ky thu~t chung CllaKhu Cong ngh~ cao duQ'cban hanh
t~iQuy~t dinhs6 .lQD-KCNC ngay thang natrl .
DAI DIEN DON VI PHAp NHAN
(Ky, d6~g dAuva ghi ro hQten)
 M~uM2
CONG HOA xA HOI CHU NGHiA VIJ1:TNAM
Doe lap - Tlf do - Hanh phue

Tp.H6 Chi Minh, ngay ..... thang ..... nam 20

VAN BAN DE NGHI DAu NOI HJ1:THONG THOAT NUOC M~T

Xay dv'ng mai

CAit~o, sua chua

Kinh giri: Ban Qmin Ly Khu Cong ngh~ eao TP.H6 Chi Minh

1. Ten chu dftu tu:

Dja chi lien M:
S6 di~n tho~i:
2. Dja diSm xay dlJng:
T~i 10 dih: .

3. NQi dung d~ nghj: D~u n6i h~ th6ng thoat nuac mua tlr cong trinh .

sang h~ th6ng thoat nuac m~t ~hung cua Khu Cong ngh~ cao Thanh ph6 H6 Chi Minh.
• , •A :.. :...
VI tn dIem dau nOI: .
.......................................................................................................................................
:. 1 .A :.. :..
So uQ'ng dIem dau nOI: , .
, , ,
Kich thuac 6ng dau n6i: .
Thai gian thlJChi~n: .
' .... cau
4 . Cac yeu A kh'ac .

T6i xin cam kSt thlJc hi~n dung theo Quy trinh d~u n6i h~ tftng ky thu~t ill cac dg an
thanh phftn vao M th6ng h~ tAng ky thu~t chung cua Khu Cong ngh~ cao duQ'cban hanh
t~i QUYStdinh s6 .IQD-KCNC ngay thang nam .

DAI DIEN DON VI PHAP NHAN

(Ky, d6~g d~u va ghi ro hQten)
 M~uM3
CQNG HOA XA HQI CHU NGHiA VI~T NAM
DocHip - TO'do - Hanhphuc

Tp.H6 Chi Minh, ngay ..... thang ..... nam 20

VAN BAN DE NGHJ DAu NOI H~ THONG THOAT NUOC THAI

Cai t~o,sua chua

KinhgiH: Ban Qm'in Ly Khu Cong ngh~ cao Thanh ph8 HB Chi Minh

1. Ten chu dau tu:

:E>iachi lien h~: .
s6 di~n tho~i:
2. :E>iadi~m xay d\fng:
T~i 16d~t: .

3. NQi dung d~ nghi: :E>~un6i M th6ng thoM nuac thai tu c6ng trinh .

sang h~ th6ng thoat nuac thai chung cua Khu C6ng ngh~ cao Thanhph6
• , • ..t. J.. /... '.
He, Chi Minh.
V t tn diem dau nOI: .

Sl.o Iuqng diem

.
.%. J.. 1...
dau nOI: .

i , h th UO'C
' ong
/.. dau
I.. Ao
KlC nOI: .
. 1
I
Thai gian th\fc hi~n: , ~ .
Luu luqng nuac thai: ~ ~ .
4. Cac yeu cau khac : .

T6i xin cam k~t th\fc hi~n dung theo Quy trinh d~u n6i h~ tAng ky thu?t til' cac d\f an
thanh phan vao M th6ng h~ tang ky thu?t chung cua Khu C6ng ngh~ cao duqc ban hanh
t~i Quy~t dinh s6 .IQ:E>-KCNC ngay thang nam .

DAI DIEN DON VI PHAp NHAN

(Ky, d6~g d~u Va ghi ro hQ,ten)
 MiiuM4
CQNG HOA XA HQI CHU NGHiA VI~T NAM
DocHip - Ttl' do - Hanhphuc

Tp.H6 Chi Minh, ngay ..... thimg ..... nam 20

VAN BAN DE NGHI DAu NOI NOI GIAO THONG

Xay d\fl1grnai
Cfli t~o,sua chua

Kinhgifi: Ban Quan Ly Khu Cong ngh~ cao Thanh ph8 H6 Chi Minh

1. Ten chu dAutu:

Bja chi lien M:
S<3di~n tho~i:
2. Bja di~rn xay d\rng:
T~i 10d~t: ,..........•..................................................................................................

3. N9i dung d€ nghj: B~u n<3ih~ th<3nggiao thOng til cong trinh .

sang h~ th<3nggiao thong chung cua Khu Cong ngh~ caoThimh ph<3H6 Chi Minh.
V.1 trl'd',t.
lern d,( ,(.
au nOl: ; ; .

So,( IuQ'ng d',t.

lern d,( ,(.
au nOl: .

Thai gian thlJChi~n: ~ .

4. Cac yeu cau khac .

Toi xin cam k€t thlJc hi~n dung theo Quy trinh d~u n<3ih~ tAng ky thu~t til cac dlJ an
thanh phAn vao h~ th<3ngh~ tAng ky thu~t chung cua Khu Cong ngh~ cao duQ'cban hanh
t~i Quy€t djnh s6 : .. .lQB-KCNC ngay thang narn .

DAI Dr EN DON VI PHAp NHAN

(Ky, d6~g d~u va ghi ro hQten)

~i
 UBND THANH PHO HO CHi MINH CQNG HOA xA HQI cHiJ NGHiA VI~T NAM
BAN QuAN LY KHU CONG NGH~ CAO DQc I~p - TV do - H~nh phuc
THANH PHD HO cHi MINH .

Thanh phJ Hi> Chi Minh, ngay thimg nam 20

A ? "\ __;:. .:t_.c..c. :1-

BIEN BAN BAN GIAO M~T BANG, DIEM DAU NOI H~ TANG

A. H~ng m\lc:
B. Thanh phful tham gia:
C. Thanh phAn tham dl;rg6m co:
. I. D~i di~n ben giao: .
D~i di~n Ban Quan Iy Khu C6ng ngh~ cao Thanh ph5 H6 Chi Minh
.1.................................... Chilc V\l: .
2 .................................... Chilc vu: .
D~i di~n Ban Quan Iy Cac d\f an DAu tu' - Xay d\IDg Khu C6ng ngh~ cao
1 ................................. Chilc V\l: .
2.................................... Chilc V\l: .
D~i di~n ben nh~n:
1 .. .............................. ... . Chilc V\l: ; .
2. ............................... .... Chilc V\l: .
'" dung. b'an glao:
N91 . .- ~ .

" .- va'd' !a d'1em

Th0'1glan " b'an glao:
. .

Cac y kiSn khac:

..........' .
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D~i di~n BQL Kbn CNC D~i di~n BQLCDA DTXD KCNC

D~i di~n DO'n vi tbi cong . .

Dai dH~nCbu DAn tll'
 MiuM6

UBND THANH PHO HO CHI MINH CONG HOA XX HOI cHiJ NGHiA VIlj:T NAM
BAN QuLiN LY KHU CONG NGH~ CAO D{)cl,p - TV do - H~nh phuc
THANH PHO HO CHi MINH

Thanhphb H6 Chi Minh, ngay tha:ng nam 20

,,? _ x..c. '1

BIEN BAN NGHIEM

"
THU BAU NOI HA". TANG
A. H~ng ffi\lC:
B. Thanh phAn tham gia:
C. Thanh phftn tham dg g6m co: .
I. D~i di~n Ban Quim Iy Khu Cong ngh~ cao Thanh ph6 H6 Chi Minh
1.................................... Chuc V\l: : .
2.................................... Chuc V\l: .................................•..............................
II. D~i di~n Ban Qulm Iy Cac dg an DAu tu - Xay d\lllg Khu Cong ngh~ cao'
1 '....... Chuc V\l: .
2 ,.................. Chuc V\l: .
III. D~i di~n Chti DAu tu:
1.................................... Chuc V\l: .
2.................................... Chuc V\l: : .
III. D~i di~n Don vi thi cong:
1.................................... Chuc V\l: .
2.................................... Chuc V\l: , ' .
D. N9i dung kiSm tra nghi~m thu:
1. Vi tri d~u n6i: .
................................................. .
2. Thai gian: ~ ; .
D '00 .,,, , t. t... .
3. a gla cong tac dau nOl: : .
................................................ .
................................................ .
, I
I
4. Cac y kiSn khac:
I

..................................................................................................................................
...................................................................................................................................
,5. KSt lu~n: .
...................................................................................................................................
D~i di~n BQL Khu CNC D~i di~n BQLCDA DTXD KCNC

D~i di~'nDO'n vi thi cong D~i di~n Chii D~u to'

 M~uM7

UBNDTHANH PHO HO cHi MINH CQNG HOA xA HQI CHU NGHiA VI$T NAM
BAN QuAN LY KHU CONG NGH~ CAO D{)cl~p - T\f do - H,nh phuc
THANH PHO HO CHi MINH

Thanh ph6 H6 Chi Minh, ngay thang nam 20

" ? " -

BIEN BAN LAM VI~C

V/v: .

" nay, vao

Hom , 1ue
,. .,
gIO' ,
ngay t h'ang ~
nam .
Dia diSm t~i: .
Thanh phAn tham dl)' g6m co:
1 Chue V\l: .
2 Chile V\l: .
3 Chue V\l: .
4 Chue V\l: .
5 Chue V\l: .
6 Chile V\l: .
7 ; ;.. Chue V\l: .
Co' bUOI
"'1'am VH;eVO'I
." ,. 0 ng /B'.a: .

. DUNG LAM VIEC

NOI .
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Bien ban kSt thilc vao lilc .... gia ... ngay ..... thang .... nam 20 ... , duQ'c dQc l~i
cho cac ben cung nghe va d6ng kY ten.!.

D~i di~n BQL Khn CNC D~i di~n BQLCDA DTXD KCNC

D~i di~n Don vi thi cong D~i di~n Chu DAn tU'

2
 M~u8

UBND THANH PHO HO CHi MINH . HOA XX HOI. CHU NGHiA VIET
CONG . NAM
BAN QUAN LY KHU CONG NGHt CAO DQc l~p - T1}' do - H~nh phuc
THANH PHO HO CHi MINH

S6 h6 sa: Thanhphb H6 Chi Minh, ngay thang nam 20

. HO
BIEN NHAN _ .c
sa DE NGHI . DAu V Ao
.
HE THO NG .

Ban Q~an}y Khu Cong ngh~ cao Thanh ph6 H6 Chi Minh co nh~n h6 sa dS
ng h!'dAau nOIA' ,
cua:
Dan vi: .
l:'\'. h'
LI!a c I: .
SAo d'~ h .
l~n t O~l1: .

H6 sa dau n6i g6m cae giay to' sau:

1 .
2 .
3 .
4 .
5 .
6 .
7 .
8 , .
9 ; .
S6 bi) h6 sa da:nh~n:
MQi thong tin huang dan vui long lien h~ Ban Qmin ly Khu Cong ngh~ cao
Thanh ph6 H6 Chi Minh s6 di~n tho~i: 028.37360290 -115- Phong Quan ly
Quy ho~ch, Xay d\ffig va M6i truang.

NhaD vieD ti~p Dh~D

Ghi ehu: Vui lOng mang theo bien nh{in khi lien hf