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.:
___________________________________
cu reperele de identificare a terenului si trasare a lucrarilor (bornele, constructiile,
etc.)
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Indicativul
bornei
de
referinta
_________________________
Cota
_____________________________
Cota absoluta____________________________
Borna 1
Borna 2
Borna 3
Borna 4
Coordonata
X ____________
____________
____________
____________
(axa)
Y ____________
____________
____________
____________
Z ____________
____________
____________
____________
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 a) sa plateasca constructorului
_______mc moluz existenta pe costul incarcarii si transporturilor
amplasament
comandate
b) sa demoleze volumul de fundatii b) sa plateasca constructorului
existent pe amplasament pentru a valoarea lucrarilor comandate
fi transportate ____mc.
4. PREDAT:
Numele
Prenumele
Functia
Semnatura
BENEFICIAR:
______________
______________
______________
______________
PROIECTANT:
______________
______________
______________
______________

PRIMIT:
CONSTRUCTOR
:

Numele
______________

Prenumele
______________

Functia
______________

Semnatura
______________