DPM-CONST03 - Superintendent's Instruction Form

• Audit Title

• Superintendent's Instruction #

• Project Site

• Project Number

• Stage

• Location
  Address

• Client

• Prepared By - Superintendent Representative

• Contractor

• Contractor's Representative

• Conducted on

  Date

1.0 - Type of Direction

• This Direction is -

• a Confirmation of a Verbal Instruction (Provide Details Below)

• a New Direction as Set Out in Details Below

• for Defective Material or Work (Clause 30.3 modified AS2124-1992)

• to Suspend Whole or Part of the Works as Set Out in Details Below (Clause 34 modified AS2124-1992)

• for Protection of People & Property (Clause 15 modified AS2124-1992)

• Other -

2.0 Variation

• A Contract Variation WILL NOT be Considered as a Result of this Notice

• A Contract Variation WILL be Considered as a Result of this Notice (valued and assessed under Clause 40 modified AS2124-1992)

• Further comments -

3.0 Extension of Time

• An EOT WILL NOT be considered as a Result of this Notice

• An EOT WILL be considered as a Result of this Notice (determined and reviewed under Clause 35.5 modified AS2124-1992)

• Further comments -

4.0 Details

• Details of Instruction

• Supporting photo(s) -

  Media

• Additional Information Attached?

  Yes

  No

  N/A

5.0 Acknowledgement

• Superintendent's Representative

  Sign

• (Print Name)

• Contractor's Representative

  Sign

• (Print Name)