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    242 22 DSF LC 0004 00

    Uploaded by

    abdulrasheed howsawi
    good mts

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    242 22 DSF LC 0004 00

    Uploaded by

    abdulrasheed howsawi
    4 views2 pages
    good mts

    Original Title

    242-22-DSF-LC-0004-00

    Copyright

    © © All Rights Reserved

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    good mts

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    4 views2 pages

    242 22 DSF LC 0004 00

    Uploaded by

    abdulrasheed howsawi
    good mts

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Client PMC Contractor Name

    CAPEX PROJECT
    Document Submittal Form (DSF)
    Project Details
    Document
    No:
    242-22-DSF-LC-0004 Rev. No.: 00
    Upgrading the network system of the
    Project Title: Date: 18-05-2024
    security CCTV (Phase II) at KAIA
    Project No: 242-22 Discipline:
    To Consultant
    This submittal has been reviewed, checked, and approved by an authorized person. The
    document(s) has been coordinated with the requirements of the works and the project documents.
    The content has been verified prior to the submittal.

    Document Submitted

    Project Quality Plan ☐ Non-Conformance/ Audit Report ☐


    Health and safety Plan ☐ Commissioning Plan ☐
    Inspection and Test Plan ☐ Mobilization Plan ☐
    Method Statement  Logistic Plan ☐
    Key Performance Indicator ☐ Traffic Management Plan/ ☐
    Diversion Plan
    Handover & Closed out Plan ☐ Construction Management Plan ☐
    Programme of Works/ ☐ Drawings and Data ☐
    Programming Date
    Quality Organizational Chart ☐ Construction Staff ☐
    Organizational Chart
    Monthly Progress Report ☐ Health and Safety ☐
    Organizational Chart
    Material List ☐ Procurement Status Report ☐
    As Built Record Drawing ☐ As built Survey Drawing ☐
    Quality Monthly Report ☐ Other 

    Details of Document(s) Submitted (Document Title: Revision No.)

    Method Statement for Cabling Installation.

    Contractor Declaration
    We certify that the document(s) submitted are complete and have been reviewed in detail and meet
    the requirements of the General Condition of Contract

    Name : Eng Ahmed Positio Project Signatur Date 18-05-


    : Alshrqawi n Manager e : 2024

    Disclaimer:
    Approval by the JEDCO-PMT shall not relieve the Contractor of its obligations and liabilities under the contract
    or constitute authorization of any change to Contract Documents, and therefore, shall not imply any recognition
    whatsoever of additional time or cost to the contract.
    SJ-JEDCO-CON-FM-014 Rev.00 Page 1 of 2
    Date: 18-2-2024
    Client PMC Contractor Name

    CAPEX PROJECT
    Document Submittal Form (DSF)

    PMT Response

    To Contractor: Refer to attached comment review sheet

    Action Code 1: ☐ Approved- Work May Proceed

    ☐ Approved with comments, revise, and resubmit - Work may proceed


    subject to incorporation of comments as indicated.
    Action Code 2:
    Contractor to incorporate comments and resubmit for upgrading to
    code1 within 21 days, otherwise code will be downgraded to code 3.
    Action Code 3: ☐ Revise and resubmit. Work may not proceed
    Action Code 4: ☐ Rejected - Work may not proceed

    PMT- Manager Name: Signature: Date:

    JEDCO-PM Name: Signature: Date:

    JEDCO-
    Department Name: Signature: Date:
    Manager

    Received by JEDCO Returned to Contractor

    (JEDCO Receipt of MTS – Stamp, Date & Sign) (Contractor Receipt of MTS – Stamp, Date & Sign)

    Disclaimer:
    Approval by the JEDCO-PMT shall not relieve the Contractor of its obligations and liabilities under the contract
    or constitute authorization of any change to Contract Documents, and therefore, shall not imply any recognition
    whatsoever of additional time or cost to the contract.
    SJ-JEDCO-CON-FM-014 Rev.00 Page 2 of 2
    Date: 18-2-2024

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