SH-T3903--2004监理表格(可编辑版)

1、实用标准文案附录 AAttachment A（规范性附录）(Regulatory Attachment)承包单位用表Forms for Construction ContractorA.1 表 SH/T3903 A.1A.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/T 3903 A.1工程开工 / 复工报审表-SH/T 3903 A.2施工组织设计（方案）报审表-SH/T 3903 A.3包单位资格报审表-SH/T 3903 A.4报验申请表-SH/T 3903 A.5工程款支付申请表-SH/T 3903 A.6监理工程师通知回复单-SH/T 3903 A.7工程临时延期

2、申请表-SH/T 3903 A.8费用索赔申请表-SH/T 3903 A.9工程材料 / 构配件 / 设备报审表-SH/T 3903 A.10工程竣工报验单-SH/T 3903 A.11施工进度计划报审表-SH/T 3903 A.12工程质量事故处理方案报审表-SH/T 3903 A.13主要施工设备进场报审表-SH/T 3903 A.14单机试车申请表A.2表 SH/T3903 A.15A.16给出了勘察 / 设计阶段监理工作承包单位用表格式，表号文档大全实用标准文案与名称：-SH/T 3903 A.15勘察 / 设计费用支付报审表-SH/T 3903 A.16勘察 / 设计进度调整报审表文

3、档大全实用标准文案工程开工 / 复工报审表工程名称Works Title：SH/T 3903-A.1Works Commencement/ResumptionApproval Request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 workcontracted by us, theworkscommencement/worksresumptionconditionsar

4、eavailable， thereforetheconstruction is applied hereby, please review and issueworks commencement/worksresumption orders.附 Attached ：1开工报告commencement Report；2证明文件Supporting documents。项目经理Project Manage承包单位（章）日期Contractor（ Chop ）Date审查意见 Review Comments：总监理工程师Chief Supervision Engineer项目监理机构日期CS/CMC

5、Date文档大全实用标准文案施工组织设计（方案）报审表SH/T 3903-A.2Construction Organization DesignApproval 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 thepreparation of the co

6、nstruction organization design , and it has been reviewed and approved by the technical responsible people of our company, please review it.附 Attached ：施工组织设计 /施工方案。Construction Organization Design /Construction Plan。项目经理Project Manager承包单位（章）日期Contractor（ Chop ）Date专业监理工程师审查意见Review comments from d

7、iscipline 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：总监理工程师Chief Supervision Engineer项目监理机构日期CS/CMCDate文档大全实用标准文案工程名称 Works Title：分包单位资格报审表SH/T 3903-A.3Subcontractor Qualification ApprovalRequest编号 Item No：致（监理单位）To（ CS/

8、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,wethinkthe proposed(subcontractor)hasthequalificationand capability for contractingthefollowing works,and can assurethat thisworkswill beconstructed as per the contract regulations. After sub

9、contracting this works, we still hold thewhole responsibilities of the lump sum contractor. Please review and approve it.附 Attached ：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）工程数量拟分包工程合同额分包工程占全部工程Subcontracted worksWorksContract price ofPer

10、centage of subcontracted（Location）Quantityproposedworks合计Totals项目经理Project manager承包单位（章）日期Contractor（Chop ）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：总监理工程师Chief Supervisio

11、n Engineer项目监理机构日期CS/CMCDate文档大全实用标准文案工程名称Works Title：报验申请表SH/T 3903-A.4Inspection Request编号Item 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 theworks, after the self inspection, the works is on spec, nowwe submit the inspection request for this works, please inspect

12、and accept.附 Attached：项目经理Project Manager承包单位（章）日期Contractor（Chop ）Date审查意见Review comments：总 / 专业监理工程师Chief/discipline supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案工程名称Works Title：工程款支付申请表SH/T 3903-A.5Works Payment Request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）

13、，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 theWorks, according to the contract regulations, the ownershould make the payment of total of（ amount in words） , (say) for this worksbefore. Now we submit the Works PaymentRequest, please review and issue the works payment certificate.附件 Attached：1工程量清单

14、Quantity List；2计算方法Calculation Methods。项目经理Project Manager承包单位（章）日期Contractor（ Chop ）Date文档大全实用标准文案监理工程师通知回复单工程名称Works Title：SH/T 3903-A.6Correspondence to Supervision EngineerNotice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

15、, we have completed thejobs ， now we submit it , please recheck.详细内容Detailed contents：项目经理Project manager承包单位（章）日期Contractor（ Chop ）Date复查意见Recheck comments：总 / 专业监理工程师Chief/discipline supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案工程名称Works Title：工程临时延期申请表SH/T 3903-A.7Works Temporary Delay Request

16、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 construction contract clauses , due to thereasons, werequest 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 pe

17、riod calculation：2证明材料Supporting documents。项目经理Project manager承包单位（章）日期Contractor（ Chop ）Date文档大全实用标准文案工程名称Works Title：费用索赔申请表SH/T 3903-A.8Cost Claim Request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 clausesof the construction contract ,due to thereasons, wereque

18、st the cost claim of (amount in words)， please approve it.索赔的详细理由及经过Detailed cause and course of the claim：索赔金额的计算Calculation of claimed amount：附 Attached ：证明材料Supporting documents项目经理Project manager承包单位（章）日期Contractor（ Chop ）Date文档大全实用标准文案工程材料 / 构配件 / 设备报审表SH/T 3903-A.9Works致（监理单位）To(CS/CMC)工程名称Wor

19、ks Title：编号Item No：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/equipmentfortheworks onits quantity is listed below（ see the attachments）.Now, we submit the qualitydocuments and our self inspection results, The proposed locations for

20、 use as follows：，Please review it.附件 Attached：1数量清单Quantity List；2质量证明文件Quality Documents；3自检结果Self Inspection Results。项目经理Project manager承包单位（章）日期Contractor（Chop ）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 abovematerials /compone

21、nts/equipment，meet/donotmeettherequirementsofthedesigndocumentsandspecifications.sitemobilizationisallowed/sitemobilizationisnotallowed,usefortheproposedlocations is allowed /not allowed.总 / 专业监理工程师Chief/discipline supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案工程竣工报验单工程名称 Works Title：J10-32四联合油浆拔头

22、系统SH/T 3903-A.10消缺完善Works Completion Inspection Request编号Item No：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。We have completed theworks according to the requirements of the contract，afterthe self check, it is on spec, please inspect and accept.附 Attached ：工程交工

23、证书1 份项目经理Project manager承包单位（章）日期Contractor（ Chop ）Date审查意见 Review comments：经初步验收，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 curr

24、ent national standards.3符合 /不符合设计文件要求；meet/not meet the requirements of the design 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 ison spec/off s

25、pec, formal inspection and acceptancecan be/can not be organized .总监理工程师Chief supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案工程名称Works Title：施工进度计划报审表SH/T 3903-A.11Construction Schedule Approval Request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 th

26、e following schedules fromtoaccording to the related regulations of the construction 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

27、 has been reviewed and approved by our technical responsible people. Now we submit 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 inpages.项目经理Project manager承包单位（章）日期Contract

28、or（ Chop ）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 ：总监理工程师Chief supervision engineer项目监理机构日期CS/CMCDa

29、te文档大全实用标准文案工程质量事故处理方案报审表SH/T 3903-A.12Works Quality Incident Solution Approval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 wasworks qualtity incident, the worksqualityincidentreport(itemNo) ha

30、sbeenissuedon, afterweinvestigated,analyzed and studied 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。项目经理Project manager承包单位（章）日期Contractor（ Chop ）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

31、方案，修改后再报。Not approved the solution for this incident,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.总监理工程师Chief supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案主要施工设备进场报审表SH/T 3903-A.13Major Construction Equipment工程名称Works Title：编号Item No：致（监理单位

32、）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。Wecontractedtheworks,wearegoingtomobilizethemajorconstructionequipment 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：项目经理Project mana

33、ger承包单位（章）日期Contractor（ Chop ）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 equipmentandtoolsmeet/donotmeettherequirementsoftheconstructionorganizationdesigndocumentsandotherrules,sitemobilizati

34、onallowed/sitemobilizationnotallowed.不准许进场原因如下：The reasons for not allowing site mobilization are listed below：总 / 专业监理工程师Chief/discipline supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案工程名称Works Title：单机试车申请表SH/T 3903-A.14Pre-commissioning Request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准备工作，经自检合

35、格，请予以检查，并准予试车。Wehavecompletedthecommissionigpreparationsaccordingtothecontractrequiremetns, after the self check, the preparations are on spec, please check and approve thePre-commissioningtest.附 Attached：项目经理Project manager承包单位（章）日期Contractor（ Chop ）Date审核意见Review comments：总 / 专业监理工程师Chief/discipli

36、ne supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案勘察 / 设计费用支付报审表SH/T 3903-A.15Geotech/Design Payment Approval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 clausesof the Entrusted Design Contract, we have submitted thedesign docume

37、nts on,Owner should make the payment of（ amount in words）（say ：） forgeotechdesign, please review.附 Attached：项目经理Project manager勘察设计单位（章）日期Geotech/Design Unit（ Chop ）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：）。Afterreviewed,thetotalpaymentof（amountin words ）（ say ：） forgeotechdesign fees are

38、 approved to be made as per clauseof the contract.总监理工程师Chief supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案勘察设计进度调整报审表SH/T 3903-A.16Geotech/Design Schedule Change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，请予以审批。Geotech/BED/DED ofthe works contracted by us wa

39、s scheduled to becompleted on，Now is rescheduled to completed on,Please review and approveit.调整原因Change reasons：计划工程师Planning engineer项目 经 理Project manager勘察设计单位（章）日期Geotech/Design Unit（ Chop ）Date审查意见 Review comments：同意调整。Change approved.不同意调整 .Change not approved.根据下列要求调整：To be changed as per the

40、following requirements：总监理工程师Chief supervision engineer项目监理机构日期CS/CMCDate文档大全实用标准文案附录 BAttachment B（规范性附录）(Regulatory Attachment)监理单位用表Forms for CS/CMCB.1表 SH/T3903 B.1B.8 给出了段监理单位用表格式，表号与名称：-SH/T 3903 B.1监理工程师通知单；-SH/T 3903 B.2工程暂停令；-SH/T 3903 B.3工程款支付证书；-SH/T 3903 B.4工程临时延期审批表；-SH/T 3903 B.5工程最终延期

41、审批表；-SH/T 3903 B.6费用索赔审批表；-SH/T 3903 B.7监理备忘录；-SH/T 3903 B.8监理日志。B.2表 SH/T3903 B.9.1B.9.6 给出了段监理月报用表格式，编号与名称-SH/T 3903 B.9.1监理月报封面；-SH/T 3903 B.9.2月工程情况概要；-SH/T 3903 B.9.3月工程质量控制情况评析；-SH/T 3903 B.9.4月工程进度控制情况评析；-SH/T 3903 B.9.5月 HSE 管理情况评析；-SH/T 3903 B.9.6月工程费用控制情况评析。文档大全实用标准文案工程名称Works Title：监理工程师通知单SH/T 3903-B.1Supervision Engineer Notice编号Item No：致（承包单位）To（Contractor）事由 Subject