PROJECT NAME: EMPLOYER: NCR No.

Vision 1793 Vision 1793 sal DATE :

PROJECT MANAGEMENT: TECHNICAL CONSULTANT: CONTRACTOR:

Charles Hadife Architects NATCON

STATUMEN FOR CONTRACTING

NON-CONFORMITY REPORT (NCR)

SUBJECT:
DESCRIPTION OF DEFICIENCIES

Name: Signature: Date:

PROPOSED CORRECTIVE ACTION TO BE TAKEN BY THE CONTRACTOR

Contractor's
Signature: Date:
Representative

Consultant's Response / Comments

WE HEREBY AGREE WITH THE PROPOSED CORRECTIVE ACTION AS STATED BELOW:

ACTION HAS BEEN CHECKED BY THE CONSULTANT AND

Name: Signature: Date:

Engineer's Response / Comments

WE HEREBY AGREE WITH THE PROPOSED CORRECTIVE ACTION AS STATED BELOW:

ACTION HAS BEEN CHECKED BY THE ENGINEER AND

STAT 07- F11

Rev : 00
Name: Signature: Date:

STAT 07- F11

Rev : 00