UNITATEA ___________ ______________________________

ANTIER ____ ____

OBIECTUL ______ ______________
PROCES-VERBAL DE RECEPIE LA TERMINAREA LUCRRILOR
Nr. _____ Data _________
Beneficiar: ______ ________________________________________________________________
privind lucrarea: ____ _____________________________________________________________
executat n cadrul contractului nr. ________ data ________
1.
2.

Lucrrile au fost executate n baza autorizaiei nr. _______ eliberat de ________Primaria ___________ la data
________________ cu valabilitate _______________
Comisia de recepie i-a desfurat activitatea n data __________ fiind format din:
Nr.
crt.

Numele i prenumele

Calitatea

Denumirea unitii de
care aparine

1.
2.
3.
4.
5.
3.

Au mai participat la recepie:

Nr.
Numele i prenumele
crt.

Calitatea

1.
2.
4.

Constatrile comisiei:
4.1. Din documentaia scris i desenat necesar a fi prezentat, au lipsit sau sunt incomplete urmtoarele piese:
_____________________________________________________________________________________
______________________________________________________________________________________________
4.2. Urmtorarele cantiti de lucrri nu au fost executate sau urmeaza a fi remediate:
______________________________________ __________________________________________
______________________________________________________________________________________________
4.3. Urmtoarele lucrri nu respect prevederile proiectului:
____________________________________________________________________________________
______________________________________________________________________________________________
4.4. Situatia financiara conform contract:
______________________________________ __________________________________________
4.5. Valoarea lucrarilor executate la data incheierii procesului verbal:
______________________________________ __________________________________________

5.

n urma constatrilor fcute, comisia propune:

__________________________________________________________________________________________
______________________________________________________________________________________________
Comisia motiveaz propunerea fcut prin:
_________________ _____________________________________________________________________________

6.

Prezentul proces-verbal, coninnd _1__file si ..... anexe fost ncheiat astzi _______ la locul: _____Santier______
n _____ exemplare.
MEMBRI COMISIE:
Numele i prenumele

Calitatea

Semntur