Impact report Copy

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• IMPACT REPORT
  

Information

• Project:

• Job No:

• Date:

• Impact Number:

• Trade:

• Area:

• Foreman:

• Deviations from scheduled work?

  Yes

  No

  N/A

• Delay?

  Yes

  No

  N/A

• Acceleration?

  Yes

  No

  N/A

• Re-sequencing of:

  Select Manpower Equipment Material deliveries Engineering Inspection Schedule Completion

  • Manpower
  • Equipment
  • Material deliveries
  • Engineering
  • Inspection
  • Schedule
  • Completion

Cause of impact

• Access

• Change order

• Field direction

• Weather

• Detailing

• Co-ordination

• Safety hazard/accident

• Directed overtime

• Design problem

• Subcontractor performance

• Scheduling problems

• Pictures attached?

  Yes

  No

  N/A

• Add media

  Media

• Add media

  Media

Impact description

• Impact Description

Documentation/witnesses

• Documentation/Witnesses

Field Impact

• Manpower "lost time":

• Material:

• Equipment:

• Engineering:

• Subcontractor:

• Overtime:

Office Impact

• Extended warranties:

• Extended overhead:

• (See Itemized Cost Summary): M.C.E.

Sign and date

• Add signature

  Sign

• Select date

  Date