Form A APPLICATION TO CARRY OUT FITOUT WORKS

Transcription

1 APPLICATION TO CARRY OUT FITOUT WORKS Location of Shop/Premises: I hereby appoint As Tenant's Site Representative Title: As our Designer/Consultant As our Contractor As our Safety Page 1 of 4 and submit herewith the documents listed overleaf for approval. I agree to pay the insurance premium and Work Permit processing fee and be bound by the conditions of the Work Permit issued for the fitout works. APPLICATION FOR WORK PERMIT I hereby apply for access to the premises from (date & time), to commence the following fitout works (brief description) :, with completion targeted on (date & time). The maintenance (defects liability) period is months. The estimated value of the fitout contract is HK$. I hereby apply for a Work Permit to be issued for the above-mentioned fitout works which involve: yes(method statement Office use required) / no WP- Hot work Electrical hazard Handling of toxic and/or hazardous materials Entry into confined space Working at height (falling from a height of more than 2m) The Tenant and his agent (or agents) agree to jointly and severally indemnify the Airport Authority, its employees and agents against liability in connection with the death or illness of or injury to any person and the loss of or damage to any property arising out of or in connection with the work performed under the Work Permit provided that the scope of such indemnity shall be reduced proportionately to the extent that the act or default of the Authority, its employees or agents caused or contributed to the death, illness, injury, loss or damage. The Authority will suspend or cancel the Work Permit if any conditions of the Work Permit or the Tenant's method statement are found to have been violated.

2 Page 2 of 4 APPLICATION TO CARRY OUT FITOUT WORKS DESIGN PROPOSAL (Office use) Drawing Title Copies Drawing no Architectural / Structural & Calculations / Sample Board Electrical / Fire Services / HVAC / Plumbing & Drainage Method Statement / Hoarding / Signage / Perspectives APPLICATION FOR WORK BY AUTHORITY'S CONTRACTORS Fire Services [Please attach reflected ceiling plan showing works required] Other Services Utility and Building Services Requirements Fill in when energization is required; fax this Maintenance Services Control Centre (MSCC) tel Electricity kva page with WR1/WR1A to MSCC at Office use [EEA no] Supply required Date Time Switchboard Panel MCCB/MCB Circuit no Load Temporary Permanent Telecommunication / Data Lines TDF no [if available]: MATV / BBIF Others pairs authorised signatory: Job Title: Signature and chop:

3 COMMENCEMENT AND COMPLETION OF FITOUT WORKS Page 3 of 4 Location of Shop /Premises: HANDOVER It is hereby certified that the premises have been handed over by the Authority to the Tenant with the following outstanding issues to be rectified/resolved, if any: ITEM Cleanliness Fire Shutters / Security Shutters Door leaf / frame Ironmongery (hinge / closer / lock / key) Floor Wall Ceiling Glazing Electrical Installation HVAC (chilled water pipe / condensate pipe) Ventilation (kitchen exhaust / toilet exhaust) Fire Dampers Fire Services Installation Telecommunication & Data Plumbing Drainage (soil pipe / grey water pipe / manhole) Key / Digital Key Code REMARKS number(s)

4 COMMENCEMENT AND COMPLETION OF FITOUT WORKS Page 4 of 4 COMPLETION I hereby certify that the fitout works in the premises stated overleaf have been completed and reflected in the following record documentation and that the building works comply with all statutory requirements. Two (2) sets of as-built drawings Original of signed and chopped Electronic copy of CADD record drawings Copy of BD103 Copy of Fire Services Certificate FS314a/F251/F501 Copy of Food License/General Restaurant License Copy of Dangerous Goods Store License Copy of WR1/WR1A Temporary electricity meter reading CLP meter number(s) [available on first statement] CLP account number Water meter reading Tick/state as required Checker's signature (0ffice use) DEFECTS The following defective work or non-compliance with approved design are noted and will be rectified by the Tenant. Office use Item Description Re-inspection date Checker's signature The above defects are hereby acknowledged.

5 Form B COST ESTIMATE OR QUOTATION FOR WORK BY AUTHORITY'S CONTRACTOR Location of Shop/Premises: Further to your request dated: for works to be carried out by Authority's Contractor(s), I confirm that the same can be carried out as below: Tenant's Site Tenant's Tenant's Estimated duration of works: [ ] ESTIMATE [ ] LUMP SUM QUOTATION You will be invoiced for a 50% down payment (25% where the Prepayment invoice for the full amount will estimate is over $150,000 with monthly interim instalments). be issued to you according to the Adjustments will be made according to final costs. quoted price. [ Description of works ] Add AA's administrative fee 16.5% TOTAL This Estimate or Quotation is valid for one month from the date of issue. Please confirm your acceptance of the above by fax ( ) and by post. I confirm acceptance of the above Estimate / Quotation. Signature & company chop: