CHILLERS (DAIKIN).pdf

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CONSTRUCTION OF JAKARTA MASS RAPID TRANSIT PROJECT

UNDERGROUND SECTION CONTRACT PACKAGE CP106

FORM - 02

(*) To delete as necessary

S M CC - H K J O

REQUEST FOR MATERIAL SAMPLE APPROVAL (MSA)

CONTRACT NO. : 001/SMCC-HKJO/SUBCONT/05/2015

SAMPLE NO : MRTCP106-SI-MSA-15-021-r0

DATE : 07 November 2015

DATE : 05 May 2013 THE CONTRACTOR : SMCC-HK THE ENGINEER : JMCMC

PACKAGE : CP106 COST CENTER NO :

MATERIAL DESCRIPTION: CHILLERS

PROPOSED LOCATION : SEE ATTACHED SCHEMATIC DRAWING

NAME AND ADDRESS OF MANUFACTURER/SUPPLIER:

Name: PT. Neksusindo Cahaya Gemilang Address: Jl. Petojo Melintang No.3A-B

Jakarta PusatPhone: +62 21 3458287Fax: +62 21 3859234

SPECIFICATION OR STANDARD TO WHICH THE MATERIAL CONFORMS :- AHRI Certified No. 6993569- ISO 9001 : 2008- ISO 14001 : 2004- JIS G3115 SPV235- Class NK OTH12ZG06023

DOCUMENT ATTACHED, e.g., test data, broshures, etc

1. Outline Design Specification (ODS)2. Manufacturer Specification / Catalog / Brochure3. Company Profile, Project Reference and Certification (International Standard)4. Design Drawing (Plan Layout/ Single Line Diagram/ Schematic Drawing)5. Material Traceability List, Installation, Operation, Testing & Commisioning Manual

6. Manufacturer Shop Drawing, Test Report/ Test Form (Acceptable Tolerance)7. Delivery, Storage and Handling Procedure8. Supporting Letters

CONTRACTOR’S SUBMISSION ENGINEER’S COMMENTS:

 Approval for the above-mentioned subcontractor is requested tocarry out the specified works.

The material/supplier is accepted/rejected (*)

Contractor’s Representativ

(The Contractor)

Name :Position:<Related Engineer>

(JMCMC)

Date : Date:

ENGINEER’S COMMENTS: CONFIRMED BY THE EMPLOYER

The material/supplier is accepted/rejected (*)With the following reason (s):

The material/Supplier is/is not confirmed (*)With the following reason (s).

Name :Position: Project Manager 

(JMCMC)

Name :Position: Project Manager ……section

(MRTJ)

Date : Date:

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CONSTRUCTION OF JAKARTA MASS RAPID TRANSIT PROJECT

UNDERGROUND SECTION CONTRACT PACKAGE CP106

FORM - 02

(*) To delete as necessary

S M CC - H K J O

TABLE OF CONTENTS

I. Part 1. DESCRIPTION

1. Outline Design Specification (ODS)

2. Manufacturer Specification/ Catalogs/ Brochure

3. Company Profile

4. Project Reference

5. Certification (International Standard)

II. Part 2. MATERIAL AND PRODUCT

1. Design Drawing (Plan Layout/ Single Line Diagram/ Schematic layout)

2. Material Traceability List

3. Installation, Operation, Testing & Commissioning Manual

III. Part 3. EXECUTION

1. Manufacturer Shop Drawing

2. Test Report/ Test Form (Acceptable Tolerance) – To Follow

3. Delivery, Storage and Handling Procedure

IV. Part 4. OTHERS

1. Supporting Letters

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