TEMPORARY ACCEPTANCE FORM
Region: ___________________ Project Site name: ________________________
Zone: _____________________ Client: __________________________________
Woreda: __________________ Contractor: ______________________________
Keble: ___________________ Consultant: _____________________________
Contracts No Date Amount Basic
A. Main Contract ________ __________ ______________ _____
B. Suppl. Agreement ________ __________ ______________ _____
C. Variation Order;
V. O. No. 1 ________ __________ ______________ _____
V. O. No. 2 ________ __________ ______________ _____
V. O. No. 3 ________ __________ ______________ _____
This______ day of________ (month) ________ (year) by the verbal (written) order no
_____________of the contract administration after the notification to all concerned parties, we
the undersigned. Signature
1 __________________________ Representing the ________________________ _________
2 __________________________ Representing the ________________________ _________
3 __________________________ Representing the ________________________ _________
4 __________________________ Representing the ________________________ _________
5 __________________________ Representing the ________________________ _________
6 __________________________ Representing the ________________________ _________
7 __________________________ Representing the ________________________ _________
8 __________________________ Representing the ________________________ _________
9 __________________________ Representing the ________________________ _________
10 __________________________ Representing the ________________________ _________
Have examined
A. Contracts, Drawings and Specification ________________________________________
and have proceed with the ascertainment of the completion and temporary acceptance of
the above project on the basis of the following information.
B. Date when the contractor took possession of the site _______________________
C. Commencement date__________________________
D. Agreed length of completion date______________(calendar days/ working days)
E. Completion date according to the contract_______________________
F. Actual completion date_________________
G. Total completion date__________________
H. Total number of delay__________________
I. Number of justified days_____________ as per letter no____________________
J. Number of unjustified days of delay_____________________
K. Penalty of ____________day birr___________per day___________birr
Summary of Account
Total value of work executed and/or material supplied_________________________birr
Deductions
1. Precious payment__________________________
2. Penalty______________________
3. Rebate______________________
4. Retention money ______% _____________
5. Advance payments______________________
Total Deduction_____________________ Birr
Total amount due to the contractor__________________Birr
Retention money ______ % __________________
Total value of work executed payable up on the Final Acceptance___________________
Net sum payable to the contractor_________________________
Performance Bond _____________________________
Bank Guarantee_______________________________
Conclusion
The date for final acceptance ___________________
After a thorough investigation of the works in all its parts except invisible latent defects, we
declare that it was executed in accordance with the drawings and the specifications in an
acceptable manner. We, witness thereof, we have written and signed this temporary acceptance.
______________________ _____________________ ______________________
Construction supervisor Owner Contractor
ATTACHENTS
1.__________________________________________
2. __________________________________________
3. __________________________________________
REMARKS (Comments)
1.____________________________________________________________________________
2.____________________________________________________________________________
3.____________________________________________________________________________
4.____________________________________________________________________________
5.____________________________________________________________________________
6. ____________________________________________________________________________
7.____________________________________________________________________________
8. ____________________________________________________________________________
Attending Parties Signature
1. ______________________________ ______________
2. _____________________________ ______________
3. ______________________________ ______________
4. ______________________________ ______________
5.______________________________ ______________
Site Handover Form
Ministry of works and urban development handing over the construction site
The ____date of _________month __________year the work for the construction of the
__________________has been officially handed over to the contractor
Mr/Ato_____________________the contractor therefore acknowledged the taking over of the
and immediately the work with all its explanation clearly defined in the specification and
drawing (sketches). The contractor, hereinafter, shall be responsible for the damages that occurs
as a result of his fault carelessness or negligence in connection with untimely commencement of
the work the contractor. In addition acknowledge the completion of the said work shall count as
from the date mentioned above and comply with the terms and condition of the contractor of the
employer.
The attached check list section is to the completed and signed by the contractor and owner or
Consultant. We the under signed do here by undertake that the dwelling. To constructed on the
check list addressed will be built and strictly – in accordance with the Approved agreements.
In witness here of this document has been signed by all presence in six cores of which the
employers one the supervisor one the contractor on and the building design enterprise three
FOR THE EMPLOYER THE CONTRACTOR
______________________ _______________________
______________________ ________________________
Witness
1. ______________________ 1. _______________________
2. ______________________ 2. _______________________
3. ______________________ 3.________________________
