Client: (PMC): Contractor:

REQUEST FOR INSPECTION (RFI)

Project : Project No.
SUBJECT WORK REQUESTED FOR INSPECTION LOCATION RFI No.

REVISION

DATE IN

DATE OUT
Approved Drawing Ref.

PMC REMARKS

INSPECTION RESULTS
Code Status Date Signature
A  Work is accepted
Revise & Submit: Work may be accepted subject to incorporation
B 
of changes indicated.
C  Work not accepted. Rework, adjust, and, resubmit.
D  Not ready. Resubmit when ready.

CONTRACTOR PMC

This review does not relieve the contractor of his Above subject works have been visually inspected by
Responsibility under the terms & Conditions of the the Consultant and found acceptable/ Not acceptable as
contract nor Authorized additional compensation with per the code given above.
respect to time & cost.

We hereby submit/ resubmit for inspection of above

subject works and confirm herewith that above works are
completed and ready for inspection as stated above all in
accordance with the specification, drawings, and
consultant instruction. Contractor to complete the
information below.

Name: Name:

Position: Position:

Signatur Signature:
e

Date: Date: