Provisional Sum Variation Form

Provisional Sum Variation Form

• Date

  Date

• FSAM

• FDA

  Select Distribution 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

  • Distribution
  • 1
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  • 20
• Location
  Address

• Area supervisor

• Project Manager

  Jonathan Cogan

  Alan Bassett

  Sunil Nair

CERTIFICATION

• Subcontractor

• Subcontractor Certification I certify that the information provided is an accurate reflection of the additional works requirements.

  Sign

• Silcar Certification I certify that the information provided is an accurate reflection of the additional works required.

  Sign

• NBN Co. Verification I authorise the additional works required.

  Sign

VARIATION DETAILS

Provisional Sum Items

• HINT! Power Make Ready Construction Activities (Construction) supporting documentation:
  
  -Copy of Construction Drawings
  -Quotes/Invoices from accredited Aerial Contractor

• NBN Sequence Number

• 10-01-01-04 Power Make Ready Construction Activities - Construction

Item #

• Attach Supporting Documentation

  Media

• 'A' end Identifier (eg 2ARM-0101-PIT-001)

• 'Z' end Identifier (eg 2ARM-0101-PIT-002)

• Description of Work

• HINT! Telecommunications Utility Charges supporting documentation:
  
  -Copy of Design Reports
  -Construction Plan
  -Quotes/Invoices from Telco Utility Company

• 10-01-01-02 Telecommunication Utility Charges

Item #

• Attach Supporting Documentation

  Media

• 'A' end Identifier (eg 2ARM-0101-PIT-001)

• 'Z' end Identifier (eg 2ARM-0101-PIT-002)

• Description of Work

• HINT! Power Make Ready Construction Activities (Design) supporting documentation:
  
  -Copy of Design Reports
  -Utility Infrastructure Investigation Reports
  -Access Licence application
  -Quotes/Invoices from accredited Aerial Design service provider

• 10-01-01-03 Power Make Ready Construction Activities - Design

Item #

• Attach Supporting Documentation

  Media

• 'A' end Identifier (eg 2ARM-0101-PIT-001)

• 'Z' end Identifier (eg 2ARM-0101-PIT-002)

• Description of Work

• HINT! Exceptional Environmental and Heritage assessments supporting documentation:
  
  -Copy of Environmental and Heritage Assessment Reports
  -Approvals from relevant Authority
  -Quotes/Invoices from NBN accredited Surveyor

• 10-01-01-07 Exceptional Environmental and Heritage assessments/studies or approvals

Item #

• Attach Supporting Documentation

  Media

• 'A' end Identifier (eg 2ARM-0101-PIT-001)

• 'Z' end Identifier (eg 2ARM-0101-PIT-002)

• Description of Work

• HINT! Registered Surveyor Works supporting documentation:
  
  -Copy of Survey Reports
  -Quotes/Invoices from NBN Surveyor

• 10-01-01-09 Registered Surveyor Works

Item #

• Attach Supporting Documentation

  Media

• 'A' end Identifier (eg 2ARM-0101-PIT-001)

• 'Z' end Identifier (eg 2ARM-0101-PIT-002)

• Description of Work

• HINT! Other Third Party Mandatory Requirements supporting documentation:
  
  -Quotes/Invoices from third party authority

• 10-01-01-10 Other Third Party Mandatory Requirements

Item #

• Attach Supporting Documentation

  Media

• 'A' end Identifier (eg 2ARM-0101-PIT-001)

• 'Z' end Identifier (eg 2ARM-0101-PIT-002)

• Description of Work

• Additional Comments