石油化工行业监理用表(SH-T3903--2004监理表格) 35页

'SH/T3903--2004附录AAttachmentA（规范性附录）(RegulatoryAttachment)承包单位用表FormsforConstructionContractorA.1表SH/T3903—A.1~A.14给出了施工阶段监理工作承包单位用表格式，表号与名称：------SH/T3903－A.1工程开工/复工报审表------SH/T3903－A.2施工组织设计（方案）报审表------SH/T3903－A.3包单位资格报审表------SH/T3903－A.4报验申请表------SH/T3903－A.5工程款支付申请表------SH/T3903－A.6监理工程师通知回复单------SH/T3903－A.7工程临时延期申请表------SH/T3903－A.8费用索赔申请表------SH/T3903－A.9工程材料/构配件/设备报审表------SH/T3903－A.10工程竣工报验单------SH/T3903－A.11施工进度计划报审表------SH/T3903－A.12工程质量事故处理方案报审表------SH/T3903－A.13主要施工设备进场报审表------SH/T3903－A.14单机试车申请表A.2表SH/T3903—A.15~A.16给出了勘察/设计阶段监理工作承包单位用表格式，表号与名称：------SH/T3903－A.15勘察/设计费用支付报审表------SH/T3903－A.16勘察/设计进度调整报审表 SH/T3903--2004SH/T3903-A.1工程开工/复工报审表工程名称：中石化平顶山分公司鲁山第五加油站油气回收工程编号：致：中石化中原监理有限公司我单位承担的鲁山第五加油站油气回收工程，已完成了以下各项工作，具备了开工/复工条件，特此申请施工，请核查并签发开工/复工指令。附：开工报告承包单位（章）项目经理日期审查意见：项目监理机构总监理工程师日期 SH/T3903--2004SH/T3903-A.2施工组织设计（方案）报审表ConstructionOrganizationDesignApprovalRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）我方已根据施工承包合同的有关规定完成了     工程施工组织设计（方案）的编制，并经我单位技术负责人审查批准，请予以审查。Accordingtotherelatedregulationsoftheconstructioncontract,wehavecompletedthepreparationoftheconstructionorganizationdesign     ,andithasbeenreviewedandapprovedbythetechnicalresponsiblepeopleofourcompany,pleasereviewit.附Attached：施工组织设计/施工方案。ConstructionOrganizationDesign/ConstructionPlan。承包单位（章）Contractor（Chop）     项目经理ProjectManager     日期Date     专业监理工程师审查意见Reviewcommentsfromdisciplinesupervisionengineer：     专业监理工程师DisciplineSupervisionEngineer     日期Date     总监理工程师审核意见Reviewcommentsfromchiefsupervisionengineer：     项目监理机构CS/CMC     总监理工程师ChiefSupervisionEngineer     日期Date      SH/T3903--2004SH/T3903-A.3分包单位资格报审表SubcontractorQualificationApprovalRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）经考察，我方认为拟选择的     （分包单位）具有承担下列工程的施工资质和施工能力，可以保证本工程项目按合同的规定进行施工。分包后，我方仍承担承包合同的全部责任。请予以审查和批准。Afterinvestigation,wethinktheproposed     (subcontractor)hasthequalificationandcapabilityforcontractingthefollowingworks,andcanassurethatthisworkswillbeconstructedasperthecontractregulations.Aftersubcontractingthisworks,westillholdthewholeresponsibilitiesofthelumpsumcontractor.Pleasereviewandapproveit.附Attached：1分包单位资质材料SubcontractorQualificationDocuments；2分包单位业绩材料SubcontractorPerformanceDocuments。分包工程名称（部位）Subcontractedworks（Location）工程数量WorksQuantity拟分包工程合同额Contractpriceofproposedsubcontractedworks分包工程占全部工程Percentageofsubcontractedworks                                        合计Totals               承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     专业监理工程师审查意见Reviewcommentsfromdisciplinesupervisionengineer：     专业监理工程师DisciplineSupervisionEngineer     日期Date     总监理工程师审核意见Reviewcommentsfromchiefsupervisionengineer：     项目监理机构CS/CMC     总监理工程师ChiefSupervisionEngineer     日期Date      SH/T3903--2004SH/T3903-A.4     报验申请表     InspectionRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）我单位已完成了     工作，经自检合格,现报上该工程报验申请表，请予以审查和验收。Wehavecompletedthe     works,aftertheselfinspection,theworksisonspec,nowwesubmittheinspectionrequestforthisworks,pleaseinspectandaccept.附Attached：     承包单位（章）Contractor（Chop）     项目经理ProjectManager     日期Date     审查意见Reviewcomments：     项目监理机构CS/CMC     总/专业监理工程师Chief/disciplinesupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.5工程款支付申请表WorksPaymentRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）我方已完成了     工作，按施工承包合同的规定，建设单位应在    年  月  日前支付该项工程款共（大写）     （小写     ），现报上     工程付款申请表，请予以审查并开具工程款支付证书。Wehavecompletedthe     Works,accordingtothecontractregulations,theownershouldmakethepaymentoftotalof     （amountinwords）,(say     )forthisworksbefore     .NowwesubmittheWorksPaymentRequest,pleasereviewandissuetheworkspaymentcertificate.附件Attached：1工程量清单QuantityList；2计算方法CalculationMethods。     承包单位（章）Contractor（Chop）     项目经理ProjectManager     日期Date      SH/T3903--2004SH/T3903-A.6监理工程师通知回复单CorrespondencetoSupervisionEngineerNotice工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）我方接到编号为     的监理工程师通知后，已按要求完成了     工作，现报上，请予以复查。Afterwereceivedthesupervisionengineernoticeof     ,wehavecompletedthe     jobs，nowwesubmitit,pleaserecheck.详细内容Detailedcontents：     承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     复查意见Recheckcomments：     项目监理机构CS/CMC     总/专业监理工程师Chief/disciplinesupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.7工程临时延期申请表WorksTemporaryDelayRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     (CS/CMC)根据承包合同条款     条的规定，由于     原因，我方申请工程延期，请予以批准。Accordingtoclausesoftheconstructioncontractclauses,duetothe     reasons,werequesttheworksdelay,pleaseapproveit.合同交工日期ContractAsBuildDate：     申请延长交工日期DelayedAsBuildDate：     附件Attached：1工程延期的依据及工期计算Worksdelaybasisandworkingperiodcalculation：     2证明材料Supportingdocuments。     承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date      SH/T3903--2004SH/T3903-A.8费用索赔申请表CostClaimRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）根据承包合同条款     条的规定，由于     的原因，我方要求索赔金额（大写）     ，请予以批准。Accordingtoclauses     oftheconstructioncontract,duetothe     reasons,werequestthecostclaimof(amountinwords)     ，pleaseapproveit.索赔的详细理由及经过Detailedcauseandcourseoftheclaim：     索赔金额的计算Calculationofclaimedamount：     附Attached：证明材料Supportingdocuments     承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date      SH/T3903--2004SH/T3903-A.9工程材料/构配件/设备报审表WorksMaterials/Components/EquipmentInspectionRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     (CS/CMC)我方于    年  月  日进场的工程材料/构配件/设备数量如下（见附件）。现将质量证明文件及自检结果报上，拟用于下述部位：     ，请予以审核。Wehavemobilizedthefollowingmaterials/components/equipmentfortheworkson     itsquantityislistedbelow（seetheattachments）.Now,wesubmitthequalitydocumentsandourselfinspectionresults,Theproposedlocationsforuseasfollows：     ，Pleasereviewit.附件Attached：1数量清单QuantityList；2质量证明文件QualityDocuments；3自检结果SelfInspectionResults。     承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     审查意见Reviewcomments：经检查上述工程材料/构配件/设备，符合/不符合设计文件和规范的要求，准许/不准许进场，同意/不同意使用于拟定部位。Aftertheinspection,theabovematerials/components/equipment，meet/donotmeettherequirementsofthedesigndocumentsandspecifications.sitemobilizationisallowed/sitemobilizationisnotallowed,usefortheproposedlocationsisallowed/notallowed.项目监理机构CS/CMC     总/专业监理工程师Chief/disciplinesupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.10工程竣工报验单WorksCompletionInspectionRequest工程名称WorksTitle：J10-32四联合油浆拔头系统消缺完善编号ItemNo：     致洛阳炼化工程建设监理有限责任公司（监理单位）To     (CS/CMC)我方已按合同要求完成了四联合油浆拔头系统消缺完善(管道安装) 工程，经自检合格，请予以检查和验收。Wehavecompletedthe     worksaccordingtotherequirementsofthecontract，aftertheselfcheck,itisonspec,pleaseinspectandaccept.附Attached：工程交工证书1份承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     审查意见Reviewcomments：经初步验收，该工程：afterthepreliminaryinspectionandacceptance,thisworks:1符合/不符合我国现行法律、法规要求；meet/notmeettherequirementsofthecurrentstatelawsandregulations.2符合/不符合我国现行工程建设标准；meet/notmeettherequirementsofthecurrentnationalstandards.3符合/不符合设计文件要求；meet/notmeettherequirementsofthedesigndocuments.4符合/不符合施工合同要求。Meet/notmeettherequirementsoftheconstructioncontract.综上所述，该工程初步验收合格/不合格，可以/不可以组织正式验收。Basedontheabovepoints,thepreliminaryinspectionandacceptanceofthisworksisonspec/offspec,formalinspectionandacceptancecanbe/cannotbeorganized.     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.11施工进度计划报审表ConstructionScheduleApprovalRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）我方已根据承包合同的有关规定编制完成了    年  月  日至    年  月  日的：Wehavecompletedthepreparationsofthefollowingschedulesfrom     to     accordingtotherelatedregulationsoftheconstructioncontract：1工程施工总进度计划ProjectConstructionOverallSchedule；2工程施工月进度计划ProjectConstructionMonthlySchedule；3工程施工周进度计划ProjectConstructionWeeklySchedule；4     计划     schedule。并经我单位技术负责人审查批准，现报上，请予以审查。我们将严格按审查通过的进度计划组织施工。Ithasbeenreviewedandapprovedbyourtechnicalresponsiblepeople.Nowwesubmitittoyou,pleasereview.Wewillorganizetheconstructionbystrictlyfollowingtheapprovedschedule.附Attached：图表、说明书共     页。Drawingsandcharts,instructionbooks,totallyin     pages.承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     审查意见Reviewcomments：同意此进度计划。Approvedthisschedule.不同意此进度计划，请按以下要求修改再报：Notapprovedthisschedule,pleasemodifyitaccordingtothefollowingrequirements,andresubmitit：专业监理工程师Disciplinesupervisionengineer     日期Date     审核意见Reviewcomments：     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.12工程质量事故处理方案报审表WorksQualityIncidentSolutionApprovalRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     (CS/CMC)    年  月  日     在     （工程部位）发生     工程质量事故，已于  月  日发出工程质量事故报告（编号：     ），经我方组织对该质量事故进行详细调查、分析和研究，现将详情及处理方案报上，请审查。On     ,at     (workslocation),therewas     worksqualtityincident,theworksqualityincidentreport(itemNo     )hasbeenissuedon     ,afterweinvestigated,analyzedandstudiedit,nowwesubmitthedetailsandsolutiontoyou,pleasereview.附Attached：事故详情及处理方案IncidentDetailsandSolution。     承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     审核意见Reviewcomments：同意此事故处理方案。Approvedthesolutionforthisincident.不同意此事故处理方案，修改后再报。Notapprovedthesolutionforthisincident,pleasemodifyitandresubmit.按以下意见修改后执行：Toimplementitaftermodifiedasperthefollowingcomments.     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.13主要施工设备进场报审表MajorConstructionEquipmentMobilizationApprovalRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）我方承担的     工程，按合同规定的主要施工设备、机具及检测设备、工具拟进场，并经自检合格，请查验。Wecontractedthe     works,wearegoingtomobilizethemajorconstructionequipmentandtoolsaswellastheinspectionequipmentandtoolsspecifiedbythecontract,aftertheselfinspection,theyareonspec,pleaseinspect.附Attached：     承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     审查意见Reviewcomments：经检查上述施工设备、机具及检测设备、工具，符合/不符合施工组织设计文件和相关要求，准许/不准许进场。Accordingtoourinspection,theaboveequipment,toolsandtheinspectionequipmentandtoolsmeet/donotmeettherequirementsoftheconstructionorganizationdesigndocumentsandotherrules,sitemobilizationallowed/sitemobilizationnotallowed.不准许进场原因如下：Thereasonsfornotallowingsitemobilizationarelistedbelow：     项目监理机构CS/CMC     总/专业监理工程师Chief/disciplinesupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.14单机试车申请表Pre-commissioningRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）我方已按合同要求完成了     试车准备工作，经自检合格，请予以检查，并准予试车。Wehavecompletedthe     commissionigpreparationsaccordingtothecontractrequiremetns,aftertheselfcheck,thepreparationsareonspec,pleasecheckandapprovethePre-commissioningtest.附Attached：     承包单位（章）Contractor（Chop）     项目经理Projectmanager     日期Date     审核意见Reviewcomments：     项目监理机构CS/CMC     总/专业监理工程师Chief/disciplinesupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.15勘察/设计费用支付报审表Geotech/DesignPaymentApprovalRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     (CS/CMC)根据委托设计合同第     条款，我单位已于    年  月  日交付     设计文件，建设单位应支付该项勘察／设计费共（大写）     （小写：     ），请予以审核。Accordingtoclauses     oftheEntrustedDesignContract,wehavesubmittedthe     designdocumentson     ,Ownershouldmakethepaymentof（amountinwords）     （say：     ）forgeotech／design,pleasereview.附Attached：     勘察／设计单位（章）Geotech/DesignUnit（Chop）     项目经理Projectmanager     日期Date     审核意见Reviewcomments：经审核同意按合同第     条款支付勘察／设计费共（大写）     （小写：     ）。Afterreviewed,thetotalpaymentof（amountinwords）     （say：     ）forgeotech／designfeesareapprovedtobemadeasperclause     ofthecontract.     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-A.16勘察／设计进度调整报审表Geotech/DesignScheduleChangeApprovalRequest工程名称WorksTitle：     编号ItemNo：     致     （监理单位）To     (CS/CMC)我单位承担的     工程的勘察/基础工程设计/详细工程设计原定     完成，现拟调整到     完成，请予以审批。Geotech/BED/DEDof     theworkscontractedbyuswasscheduledtobecompletedon     ，Nowisrescheduledtocompletedon     ,Pleasereviewandapproveit.调整原因Changereasons：     勘察／设计单位（章）Geotech/DesignUnit（Chop）     计划工程师Planningengineer     项目经理Projectmanager     日期Date     审查意见Reviewcomments：同意调整。Changeapproved.不同意调整.Changenotapproved.根据下列要求调整：Tobechangedasperthefollowingrequirements：     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004附录BAttachmentB（规范性附录）(RegulatoryAttachment)监理单位用表FormsforCS/CMCB.1表SH/T3903—B.1~B.8给出了段监理单位用表格式，表号与名称：-----SH/T3903－B.1监理工程师通知单；-----SH/T3903－B.2工程暂停令；-----SH/T3903－B.3工程款支付证书；-----SH/T3903－B.4工程临时延期审批表；-----SH/T3903－B.5工程最终延期审批表；-----SH/T3903－B.6费用索赔审批表；-----SH/T3903－B.7监理备忘录；-----SH/T3903－B.8监理日志。B.2表SH/T3903—B.9.1~B.9.6给出了段监理月报用表格式，编号与名称-----SH/T3903－B.9.1监理月报封面；-----SH/T3903－B.9.2月工程情况概要；-----SH/T3903－B.9.3月工程质量控制情况评析；-----SH/T3903－B.9.4月工程进度控制情况评析；-----SH/T3903－B.9.5月HSE管理情况评析；-----SH/T3903－B.9.6月工程费用控制情况评析。 SH/T3903--2004SH/T3903-B.1监理工程师通知单SupervisionEngineerNotice工程名称WorksTitle：     编号ItemNo：     致     （承包单位）To     （Contractor）事由Subject：     内容Contents：     项目监理机构CS/CMC     总/专业监理工程师Chief/disciplinesupervisionengineer     日期Date      SH/T3903--2004SH/T3903-B.2工程暂停令WorksSuspensionOrder工程名称WorksTitle：     编号ItemNo：     致     （承包单位）To     (CS/CMC)由于     原因，现通知你方必须于    年  月  日     时起，对本工程     的部位（工作）实施暂停施工，并按下述要求做好各项工作：Dueto     ,wenotifyyounowtostoptheconstructiononthelocations(jobs)of     forthisworks,pleasedothejobsasperthefollowingrequirements.     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-B.3工程款支付证书WorksPaymentCertificate工程名称WorksTitle：编号ItemNo：致     （建设单位）To     (CS/CMC)根据承包合同的规定，经审核承包单位的付款申请和报表，并扣除有关款项，同意本期支付工程款共（大写）     （小写：     ）。请按合同规定及时付款。Accordingtothecontractregulations,afterreviewedthepaymentrequestandreportingtablesanddeductedtherelatedcosts,weagreewiththepaymentof（amountinwords）     （say：     ）。Pleasemakethepaymentperthecontractinatimelymanner.其中Amongwhich：1承包单位申报款为：     Therequestedpaymentofcontractor：     2经审核承包单位应得款为：     Thereviewedpaymentofcontractor：     3本期应扣款为：     Thedeductedpayment：     4本期应付款为：     Theduepayment：     附件Attached：1承包单位的工程付款申请表及附件ContractorWorksPaymentRequestandAttachments；2项目监理机构审查记录CS/CMCReviewRecords。     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-B.4工程临时延期审批表WorksDelayTemporaryApproval工程名称WorksTitle：     编号ItemNo：     致     （承包单位）To     (Contractor)根据承包合同条款     条的规定，我方对你方提出的     工程延期申请（第     号）要求延长工期     日历天的要求，经过审核评估：Accordingtoclauses     ofthecontract,wereviewedyourWorksDelayRequest（No.     ）of     forthedurationsof     calendardays:暂时同意工期延长     日历天。使交工日期（包括已指令延长的工期）从原来的    年  月  日延迟到    年  月  日。请你方执行。Delayof     calendardaysapprovedtemporarily,whichwilldelaytheasbuilddate(includedtheinstructeddelayedworkingperiod)from     to     Pleasefollowit.不同意延长工期，请按约定交工日期组织施工。Delaynotapproved,pleaseorganizetheconstructionaspertheagreedasbuiltdate.说明Notes：     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-B.5工程最终延期审批表WorksDelayFinalApproval工程名称WorksTitle：     编号ItemNo：     致     （承包单位）To     （Contractor）根据施工合同条款     条的规定，我方对你方提出的     工程延期申请（第     号）要求延长工期     日历天的要求，经过审核评估：Accordingtoclauses     ofthecontract,wereviewedyourWorksDelayRequest(No.     )of     forthedurationsof     calendardays：最终同意工期延长     日历天。使交工日期（包括已指令延长的工期）从原来的     年     月     日延迟到     年     月     日。请你方执行。Delayof     calendardaysapprovedfinally,whichwilldelaytheasbuilddate(includedtheinstructeddelayedworkingperiod)from     to     Pleasefollowit.不同意延长工期，请按约定交工日期组织施工。Delaynotapproved,pleaseorganizetheconstructionaspertheagreedasbuiltdate.说明Notes：     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-B.6费用索赔审批表CostClaimApproval工程名称WorksTitle：     编号ItemNo：     致     （承包单位）To     （Contractor）根据承包合同条款     条的规定，你方提出的     费用索赔申请（第     号），索赔（大写）     ，经我方审核评估：Accordingtoclauses     ofthecontract,wehavereviewedandassessedyourcostclaimrequest(No.     )withsumof     （amountinwords）：不同意此项索赔。Thisclaimnotapproved同意此项索赔，金额为（大写）     。Thisclaimapproved,thesum（amountinwords）     理由Reasons：     索赔金额的计算Calculationoftheclaimsum：     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-B.7监理备忘录SupervisionMemorandum工程名称WorksTitle：     编号ItemNo：     致     To          抄报Reportedto：     抄送CC：     项目监理机构CS/CMC     总监理工程师Chiefsupervisionengineer     日期Date      SH/T3903--2004SH/T3903-B.8监理日志SupervisionDailyLog工程名称WorksTitle         年  月  日    Year  Month  Date天气Weather     气温Temperature最高thehighest  ℃最低thelowest  ℃施工承包方当天施工内容Constructioncontentofthecontractor：     监理人员当天工作内容、发现问题及处理结果：Supervisor’sworkingcontents,issuesidentifiedandsolutions：     其他事宜：Otherissues：     监理工程师/监理员Supervisionengineer/supervisor      SH/T3903--2004SH/T3903-B.9.1封面Cover工程名称WorksTitle：     编号ItemNo：     监理月报SupervisionMonthlyReport第     期EditionNo：         年Year  月Month项目监理机构     CS/CMC总监理工程师     Chiefsupervisionengineer编制人     Preparedby日期     Date SH/T3903--2004SH/T3903-B.9.2  月工程情况概要MonthlyWorksConditionSummary  工程名称Workstitle：     编号ItemNo：     相关情况登记Registerofrelatedinformation合同编号ContractNo.     本月日历天Calendardaysofthismonth  天days工程变更Changeorder    份copy实际工作日Actualworkingdays  天days监理通知单Supervisionnotice    份copy建设单位指令Ownerorder    份copy监理备忘录Supervisionmemorandum    份copy监理联系单Supervisionliaisonsheet    份copy专题会议纪要Memosofsubjectmeetings    份copy例会会议纪要Routinemeetingmemos    份copy本月工程情况综述Overviewoftheworksconditionsofthismonth：      SH/T3903--2004SH/T3903-B.9.3  月工程质量控制情况评析MonthlyWorksQualityControlAssessment  工程名称Workstitle：     编号ItemNo：     本月质量控制情况登记Registerofmonthlyqualitycontrol本月共检项目项数Totalmonthlyinspectionitems   项item共检项目不合格项数Offspecitems   项item本月抽查试验次数Totalmonthlyrandomtests   次time试验结果不合格次数Offspectests   次time本月检查分项工程Itemworksinspectedmonthly    项item,其中amongwhich合格onspec    项item本月焊接质量Monthlyweldingquality拍片总数Totalfilms     ，合格片数Onspec     ，一次合格率Onetimequalityrate     ％工程质量情况简析（文字或图表）Briefofworksqualitycondition（descriptionsorcharts）     下月工程质量重点和目标Nextmonthworkskeypointsandtarget      SH/T3903--2004SH/T3903-B.9.4  月工程进度控制情况评析MonthlyWorksScheduleControlAssessment  工程名称Workstitle：     编号ItemNo：     本月工程进度情况简析（文字、图表）Briefofmonthlyschedulecondition（descriptions,charts）     下月工程进度情况预计和目标Nextmonthworksschedulepredictandtarget      SH/T3903--2004SH/T3903-B.9.5  月HSE管理情况评析MonthlyHSEManagementAssessment  工程名称Workstitle：     编号ItemNo：     本月HSE管理情况MonthlyHSEManagement至本月底安全生产连续    天Continuoussafeproductiondaysuptotheendofthismonth     本月发生安全事故    起Safetyaccidentsofthismonth     其他：Others     本月HSE管理情况简析（文字、图表）BriefofmonthlyHSEmanagement（description,charts）     下月HSE管理情况预计和目标NextmonthHSEmanagementpredictandtarget      SH/T3903--2004SH/T3903-B.9.6  月工程费用控制情况评析MonthlyWorksCostControlAssessment  工程名称Workstitle：     编号ItemNo：     本月工程费用情况Monthlyworkscoststatus本月实际完成金额Actuallycompletedsum     万元累计完成金额占总预算金额     ％Accumulatedcompletedsumaccountingfor     %ofthetotalbudgets本月扣除预付款Deducteddownpayment     万元累计扣除预付款占总预付款     ％Accumulateddeducteddownpaymentaccountingfor     %ofthetotaldownpayment本月监理批准付款PaymentapprovedbyCS/CMC     万元累计批准付款额Accumulatedpaymentapproved     万元本月发生批准索赔ClaimapprovedbyCS/CMC     万元累计发生索赔额Accumulatedoccurredclaims     万元本月工程费用控制情况简析（文字或图表）Briefofmonthlyworkscostcontrol（descriptionorcharts）     预计下月工程发生费用Nextmonthestimatedworksexpenditure      SH/T3903--2004附录CAttachmentC（规范性附录）(RegulatoryAttachment)监理单位用表GeneralFormsforEachParty表SH/T3903—C.1、表SH/T3903—C.2给出了监理工作各方用表格式，表号与名称：------SH/T3903－C.1监理工作联系单------SH/T3903－C.2工程变更单 SH/T3903--2004SH/T3903-C.1监理工作联系单工程名称：501、502、503单元桩基工程编号：     致:天津石化第十五项目分部事由：关于现场预制方桩与设计要求不符的几点问题内容：1、设计图纸要求预制方桩混凝土强度为C40，而现场提供的桩强度仅为C35；2、设计图纸要求的桩型为JZHb-240-1010BG，而现场的桩型为JZHb-240-0911BG；3、现场提供的预制方桩桩帽与设计所用图籍《预制钢筋混凝土方桩》（04G361）不符，也未见到相关设计变更和图纸；建议：1、业主尽快给予明确答复，避免因此造成质量隐患。监理单位：专业监理工程师总监理工程师：日期： SH/T3903--2004SH/T3903-C.2工程变更单WorksChangeOrder工程名称Workstitle：     编号ItemNo：     致     （监理单位）To     （CS/CMC）由于     原因，兹提出     工程变更（内容见附件），请予以审批。Duetothereasons     ，WerequestherebytheWorksChangeOrder（foritscontents,seetheattachments）,pleaseapproveit.附Attached：     提出单位Requestedby     代表人Representative     日期Date     一致意见consistentcomments：     建设单位代表（签字）Ownerrepresentative（Signature）     设计单位代表（签字）Designunitrepresentative（Signature）     项目监理机构代表（签字）ProjectCS/CMC（Signature）     承包单位代表（签字）CCrepresentative（Signature）     日期Date     日期Date     日期Date     日期Date                                                                                                                                                                         '