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UNITATEA

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SANTIER __________________________ PUNCT DE LUCRU
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OBIECTUL
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PROCES-VERBAL DE PREDARE-PRIMIRE
A AMPLASAMENTULUI SI A BORNELOR DE REPER
Nr: ________, data _______________
1. Delimitarea terenului cf. plan nr. __________________________________________avand
coordonatele (axele):
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Plansa
nr:_____________________________,
proiect
nr.:
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cu reperele de identificare a terenului si trasare a lucrarilor (bornele, constructiile, etc.)
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Indicativul
bornei
de
referinta
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Cota
_____________________________
Cota absoluta____________________________
Borna 1
Borna 2
Borna 3
Borna 4
Coordonata
X ____________
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____________
(axa)
Y ____________
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Z ____________
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2. Constructii-instalatii existente pe amplasament sau in subsol:
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3. Alte mentiuni:
CONSTRUCTORUL se oblige:
BENEFICIARUL se oblige:
a) sa transporte cantiatea de _______mc a) sa plateasca constructorului costul
moluz existenta pe amplasament
incarcarii si transporturilor comandate

b) sa demoleze volumul de fundatii b) sa plateasca constructorului valoarea


existent pe amplasament pentru a fi lucrarilor comandate
transportate ____mc.
4. PREDAT:
Numele
Prenumele
Functia
Semnatura
BENEFICIAR:
_____________ _____________ _____________ _____________
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_
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PROIECTANT:
_____________ _____________ _____________ _____________
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PRIMIT:
CONSTRUCTO
R:

Numele
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Prenumele
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Functia
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Semnatura
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