石油化工建设工程项目监理工作用表(Ⅳ类)(共33页).doc

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1、精选优质文档-倾情为你奉上石油化工建设工程项目监理工作用表（类）JL-0201-06序号表格编号表格名称使用单位备注1SH/T 3903A.1工程开工/复工报审表承包单位施工阶段2SH/T 3903A.2施工组织设计（方案）报审表承包单位施工阶段3SH/T 3903A.3包单位资格报审表承包单位施工阶段4SH/T 3903A.4报验申请表承包单位施工阶段5SH/T 3903A.5工程款支付申请表承包单位施工阶段6SH/T 3903A.6监理工程师通知回复单承包单位施工阶段7SH/T 3903A.7工程临时延期申请表承包单位施工阶段8SH/T 3903A.8费用索赔申请表承包单位施工阶段9SH/

2、T 3903A.9工程材料/构配件/设备报审表承包单位施工阶段10SH/T 3903A.10工程竣工报验单承包单位施工阶段11SH/T 3903A.11施工进度计划报审表承包单位施工阶段12SH/T 3903A.12工程质量事故处理方案报审表承包单位施工阶段13SH/T 3903A.13主要施工设备进场报审表承包单位施工阶段14SH/T 3903A.14单机试车申请表承包单位施工阶段15SH/T 3903A.15勘察/设计费用支付报审表承包单位勘察/设计阶段16SH/T 3903A.16勘察/设计进度调整报审表承包单位勘察/设计阶段17SH/T 3903B.1监理工程师通知单监理单位施工阶段1

3、8SH/T 3903B.2工程暂停令监理单位施工阶段19SH/T 3903B.3工程款支付证书监理单位施工阶段20SH/T 3903B.4工程临时延期审批表监理单位施工阶段21SH/T 3903B.5工程最终延期审批表监理单位施工阶段22SH/T 3903B.6费用索赔审批表监理单位施工阶段23SH/T 3903B.7监理备忘录监理单位施工阶段24SH/T 3903B.8监理日志监理单位施工阶段25SH/T 3903B.9.1监理月报封面监理单位施工阶段26SH/T 3903B.9.2月工程情况概要监理单位施工阶段27SH/T 3903B.9.3月工程质量控制情况评析监理单位施工阶段28SH/

4、T 3903B.9.4月工程进度控制情况评析监理单位施工阶段29SH/T 3903B.9.5月HSE管理情况评析监理单位施工阶段30SH/T 3903B.9.6月工程费用控制情况评析监理单位施工阶段31SH/T 3903C.1监理工作联系单各单位施工阶段32SH/T 3903C.2工程变更单各单位施工阶段SH/T 3903-A.1工程开工/复工报审表Works Commencement/Resumption Approval Request工程名称 Works Title：编号 Item No： 致 （监理单位） To （CS/CMC）我单位承担的工程，已完成了以下各项工作，具备了开工/复工条

5、件，特此申请施工，请核查并签发开工/复工指令。 We have fulfilled the following activities for the work contracted by us, the works commencement/works resumption conditions are available，therefore the construction is applied hereby, please review and issue works commencement/works resumption orders.附Attached：1 开工报告 commenc

6、ement Report；2 证明文件 Supporting documents。承包单位（章）Contractor（Chop）项目经理Project Manage 日 期Date 审查意见Review Comments：项目监理机构CS/CMC 总监理工程师Chief Supervision Engineer 日 期Date SH/T 3903-A.2施工组织设计（方案）报审表Construction Organization Design Approval Request工程名称 Works Title：编号 Item No：致 （监理单位）To （CS/CMC）我方已根据施工承包合同的有

7、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。According to the related regulations of the construction contract, we have completed the preparation of the construction organization design , and it has been reviewed and approved by the technical responsible people of our company, please review it.附Attach

8、ed：施工组织设计/施工方案。Construction Organization Design /Construction Plan。承包单位（章）Contractor（Chop）项目经理Project Manager 日 期Date 专业监理工程师审查意见 Review comments from discipline supervision engineer：专业监理工程师Discipline Supervision Engineer 日 期Date 总监理工程师审核意见 Review comments from chief supervision engineer：项目监理机构CS/CM

9、C 总监理工程师Chief Supervision Engineer 日 期Date SH/T 3903-A.3分包单位资格报审表Subcontractor Qualification Approval Request工程名称 Works Title： 编号 Item No：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。After investigation, we think the proposed (subcontractor)

10、 has the qualification and capability for contracting the following works, and can assure that this works will be constructed as per the contract regulations. After subcontracting this works, we still hold the whole responsibilities of the lump sum contractor. Please review and approve it.附Attached：

11、1 分包单位资质材料 Subcontractor Qualification Documents；2 分包单位业绩材料 Subcontractor Performance Documents。分包工程名称（部位）Subcontracted works（Location）工程数量Works Quantity拟分包工程合同额Contract price of proposed subcontracted works分包工程占全部工程Percentage of subcontracted works合 计 Totals承包单位（章）Contractor （Chop）项目经理Project manag

12、er 日 期Date 专业监理工程师审查意见 Review comments from discipline supervision engineer：专业监理工程师Discipline Supervision Engineer 日 期 Date 总监理工程师审核意见 Review comments from chief supervision engineer： 项目监理机构CS/CMC 总监理工程师Chief Supervision Engineer 日 期Date SH/T 3903-A.4报验申请表Inspection Request工程名称 Works Title： 编号 Item

13、No： 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。We have completed the works, after the self inspection, the works is on spec, now we submit the inspection request for this works, please inspect and accept.附Attached：承包单位（章）Contractor （Chop）项目经理Project Manager 日 期Date 审查意见 Review comments：

14、项目监理机构CS/CMC 总/专业监理工程师 Chief/discipline supervision engineer 日 期Date SH/T 3903-A.5工程款支付申请表Works Payment Request工程名称 Works Title：编号 Item No： 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。We have completed the Works, according to the contract regulations,

15、 the owner should make the payment of total of （amount in words）, (say ) for this works before . Now we submit the Works Payment Request, please review and issue the works payment certificate.附件Attached：1 工程量清单 Quantity List；2 计算方法 Calculation Methods。 承包单位（章）Contractor（Chop）项目经理Project Manager 日 期D

16、ate SH/T 3903-A.6监理工程师通知回复单Correspondence to Supervision Engineer Notice工程名称 Works Title： 编号 Item No： 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。After we received the supervision engineer notice of , we have completed the jobs，now we submit it , please recheck.详细内容 Detailed contents：承包单

17、位（章）Contractor（Chop）项目经理Project manager 日 期Date 复查意见 Recheck comments：项目监理机构CS/CMC 总/专业监理工程师Chief/discipline supervision engineer 日 期Date SH/T 3903-A.7工程临时延期申请表Works Temporary Delay Request工程名称 Works Title：编号 Item No： 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。According to clauses of the co

18、nstruction contract clauses , due to the reasons, we request the works delay, please approve it.合同交工日期Contract As Build Date：申请延长交工日期Delayed As Build Date：附件Attached：1 工程延期的依据及工期计算 Works delay basis and working period calculation：2 证明材料 Supporting documents。承包单位（章）Contractor（Chop）项目经理Project manager

19、 日 期Date SH/T 3903-A.8费用索赔申请表Cost Claim Request工程名称 Works Title： 编号 Item No： 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。According to clauses of the construction contract ,due to the reasons, we request the cost claim of (amount in words) ，please approve it.索赔的详细理由及经过 Detailed cause and

20、 course of the claim：索赔金额的计算 Calculation of claimed amount：附Attached：证明材料 Supporting documents承包单位（章）Contractor（Chop）项目经理Project manager 日 期Date SH/T 3903-A.9工程材料/构配件/设备报审表Works Materials/Components/Equipment Inspection Request工程名称 Works Title：编号 Item No：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

21、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。We have mobilized the following materials/components/equipment for the works on its quantity is listed below（see the attachments）.Now, we submit the quality documents and our self inspection results, The proposed locations for use as follows： ，Please review it. 附件A

22、ttached：1 数量清单 Quantity List；2 质量证明文件 Quality Documents；3 自检结果 Self Inspection Results。承包单位（章）Contractor（Chop）项目经理Project manager 日 期Date 审查意见Review comments：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。After the inspection, the above materials /components/equipment，meet/do not meet the

23、requirements of the design documents and specifications. site mobilization is allowed/site mobilization is not allowed, use for the proposed locations is allowed /not allowed.项目监理机构CS/CMC 总/专业监理工程师Chief/discipline supervision engineer 日 期Date SH/T 3903-A.10工程竣工报验单Works Completion Inspection Request工

24、程名称 Works Title： 编号 Item No： 致 （监理单位）To (CS/CMC)我方已按合同要求完成了工程，经自检合格，请予以检查和验收。We have completed the works according to the requirements of the contract，after the self check, it is on spec, please inspect and accept.附Attached：承包单位（章）Contractor（Chop）项目经理Project manager 日 期Date 审查意见Review comments：经初步验收

25、，该工程：after the preliminary inspection and acceptance, this works:1 符合/不符合我国现行法律、法规要求；meet/not meet the requirements of the current state laws and regulations.2 符合/不符合我国现行工程建设标准；meet/not meet the requirements of the current national standards.3 符合/不符合设计文件要求；meet/not meet the requirements of the desig

26、n documents.4 符合/不符合施工合同要求。Meet/not meet the requirements of the construction contract.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。Based on the above points, the preliminary inspection and acceptance of this works is on spec/off spec, formal inspection and acceptance can be/can not be organized .项目监理机构CS/CMC 总监

27、理工程师Chief supervision engineer 日 期Date SH/T 3903-A.11施工进度计划报审表Construction Schedule Approval Request工程名称 Works Title：编号 Item No：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：We have completed the preparations of the following schedules from to according to the related regulations of the constructi

28、on contract：1 工程施工总进度计划 Project Construction Overall Schedule；2 工程施工月进度计划 Project Construction Monthly Schedule；3 工程施工周进度计划 Project Construction Weekly Schedule；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。It has been reviewed and approved by our technical responsible people. Now we su

29、bmit it to you, please review. We will organize the construction by strictly following the approved schedule.附Attached：图表、说明书共页。Drawings and charts, instruction books, totally in pages.承包单位（章）Contractor（Chop）项目经理Project manager 日 期Date 审查意见 Review comments：同意此进度计划。Approved this schedule.不同意此进度计划，请按以

30、下要求修改再报：Not approved this schedule, please modify it according to the following requirements, and resubmit it：专业监理工程师Discipline supervision engineer 日 期Date 审核意见 Review comments：项目监理机构CS/CMC 总监理工程师Chief supervision engineer 日 期Date SH/T 3903-A.12工程质量事故处理方案报审表Works Quality Incident Solution Approval

31、Request工程名称 Works Title： 编号 Item No： 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 (works location), there was works qualtity incident, the works quality incident report (item No ) has been issued on , after we investigated, analyzed and s

32、tudied it, now we submit the details and solution to you, please review.附Attached： 事故详情及处理方案 Incident Details and Solution。承包单位（章）Contractor（Chop）项目经理Project manager 日 期Date 审核意见 Review comments：同意此事故处理方案。Approved the solution for this incident.不同意此事故处理方案，修改后再报。Not approved the solution for this inc

33、ident,please modify it and resubmit.按以下意见修改后执行：To implement it after modified as per the following comments.项目监理机构CS/CMC 总监理工程师Chief supervision engineer 日 期Date SH/T 3903-A.13主要施工设备进场报审表Major Construction Equipment Mobilization Approval Request工程名称 Works Title： 编号 Item No： 致 （监理单位）To （CS/CMC）我方承担的工

34、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。We contracted the works, we are going to mobilize the major construction equipment and tools as well as the inspection equipment and tools specified by the contract, after the self inspection, they are on spec, please inspect.附Attached：承包单位（章）Contractor（Chop）项

35、目经理Project manager 日 期Date 审查意见 Review comments：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。According to our inspection, the above equipment, tools and the inspection equipment and tools meet/do not meet the requirements of the construction organization design documents and other rules, site m

36、obilization allowed /site mobilization not allowed.不准许进场原因如下：The reasons for not allowing site mobilization are listed below：项目监理机构CS/CMC 总/专业监理工程师Chief/discipline supervision engineer 日 期Date SH/T 3903-A.14单机试车申请表Pre-commissioning Request工程名称 Works Title：编号 Item No： 致 （监理单位）To （CS/CMC）我方已按合同要求完成了试车

37、准备工作，经自检合格，请予以检查，并准予试车。We have completed the commissionig preparations according to the contract requiremetns, after the self check, the preparations are on spec, please check and approve the Pre-commissioning test.附Attached：承包单位（章）Contractor（Chop）项目经理Project manager 日 期Date 审核意见 Review comments：项目监

38、理机构CS/CMC 总/专业监理工程师Chief/discipline supervision engineer 日 期Date SH/T 3903-A.15勘察/设计费用支付报审表Geotech/Design Payment Approval Request工程名称 Works Title：编号 Item No：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。According to clauses of the Entrusted Design Contract, we have su

39、bmitted the design documents on ,Owner should make the payment of （amount in words）（say：）for geotechdesign, please review.附Attached：勘察设计单位（章）Geotech/Design Unit（Chop）项 目 经 理Project manager 日 期Date 审核意见 Review comments：经审核同意按合同第条款支付勘察设计费共（大写）（小写：）。After reviewed, the total payment of （amount in words

40、）（say：）for geotechdesign fees are approved to be made as per clause of the contract.项目监理机构CS/CMC 总监理工程师Chief supervision engineer 日 期Date SH/T 3903-A.16勘察设计进度调整报审表Geotech/Design Schedule Change Approval Request工程名称 Works Title：编号 Item No：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

41、批。Geotech/BED/DED of the works contracted by us was scheduled to be completed on ，Now is rescheduled to completed on ,Please review and approve it.调整原因 Change reasons：勘察设计单位（章）Geotech/Design Unit（Chop）计 划 工 程 师Planning engineer 项 目 经 理Project manager 日 期Date 审查意见 Review comments：同意调整。Change approved

42、.不同意调整.Change not approved.根据下列要求调整：To be changed as per the following requirements：项目监理机构CS/CMC 总监理工程师Chief supervision engineer 日 期Date SH/T 3903-B.1监理工程师通知单Supervision Engineer Notice工程名称 Works Title： 编号 Item No：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/discipline supervision engineer 日 期Date SH/T 3903-B.2工程暂停令Works Suspension Order工程名称 Works Title：编号 Item No：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：Due to ,we notify you now to stop the construction on the locations (jobs) of for this works, please do th