Ph lc 2

BN V HON CNG
(Ban hnh km theo Thng t s 10/2013/TT-BXD
ngy 25 thng 7 nm 2013 ca B Xy dng)
1. Lp bn v hon cng:
a) Nu cc kch thc thc t ca cng trnh, hng mc cng trnh khng
vt qu sai s cho php so vi kch thc thit k, bn v thi cng c chp
(photocopy) li v c cc bn c lin quan ng du v k xc nhn ln bn
v lm bn v hon cng;
b) Trong trng hp cn thit, nh thu thi cng xy dng c th v li
bn v hon cng mi, c khung tn bn v hon cng vi thng tin tng t
nh mu du bn v hon cng quy nh ti Ph lc ny.
2. Mu du bn v hon cng
TN NH THU THI CNG XY DNG
BN V HON CNG
Ngy.. thng.. nm..
Ngi lp
(Ghi r h tn, chc v,
ch k)

Ngi i din theo php

lut ca nh thu thi cng
xy dng

Ngi gim st thi cng xy

dng cng trnh ca ch u
t

(Ghi r h tn, ch k, chc v,

du php nhn)

(Ghi r h tn, chc v, ch k )

Hnh 1- Mu du bn v hon cng khi khng p dng hnh thc hp ng tng thu
thi cng xy dng. Kch thc du ty thuc kch c ch.

TN NH THU THI CNG XY DNG

BN V HON CNG
Ngy.. thng.. nm..
Ngi lp
(Ghi r h tn,
chc v, ch k)

Ngi i din theo

php lut ca nh
thu ph thi cng
xy dng

Ngi i din theo

php lut ca nh thu
tng thu thi cng xy
dng

(Ghi r h tn, ch k,
chc v, du php nhn)

(Ghi r h tn, ch k,
chc v, du php nhn)

Ngi gim st thi

cng xy dng cng
trnh ca ch u t
(Ghi r h tn, chc v,
ch k )

Hnh 2 - Mu du bn v hon cng khi p dng hnh thc hp ng tng thu thi
cng xy dng. Kch thc du ty thuc vo kch c ch.
60

Ph lc 3
(Ban hnh km theo Thng t s 10/2013/TT-BXD
ngy 25 thng 7 nm 2013 ca B Xy dng)
.......(Tn Ch u t) .........
S: /

CNG HO X HI CH NGHA VIT NAM

c lp-T do-Hnh phc

, ngy......... thng......... nm..........

BO CO HON THNH THI CNG XY DNG

CNG TRNH/HNG MC CNG TRNH
Knh gi : . (1).
Ch u t cng trnh/hng mc cng trnh ............. bo co hon thnh
thi cng xy dng cng trnh/hng mc cng trnh vi cc ni dung sau :
1. Tn cng trnh/hng mc cng trnh:.
2. a im xy dng ...
3. Quy m cng trnh: (nu tm tt v cc thng s k thut ch yu ca
cng trnh).
4. Danh sch cc nh thu (tng thu, nh thu chnh: kho st xy dng,
thit k xy dng cng trnh, thi cng xy dng, gim st thi cng xy dng).
5. Ngy khi cng v ngy hon thnh (d kin).
6. Khi lng ca cc loi cng vic xy dng ch yu c thc hin.
7. nh gi v cht lng hng mc cng trnh hoc cng trnh xy dng
so vi yu cu ca thit k.
8. Bo co v vic iu kin tin hnh nghim thu a cng trnh
vo s dng (ghi r cc iu kin c nghim thu a cng trnh vo s
dng theo quy nh ca php lut).
ngh .(1).t chc kim tra cng tc nghim thu a cng trnh vo
s dng theo thm quyn./.
Ni nhn :
- Nh trn;
- .. (2) .( bit);
- Lu ...

NGI I DIN THEO QUY NH

PHP LUT CA CH U T
(K, ghi r h tn, chc v v ng du php nhn)

(1). C quan chuyn mn v xy dng kim tra cng tc nghim thu ca ch u t theo thm
quyn quy nh ti iu 25 Thng t ny.
(2). S Xy dng hoc S qun l cng trnh xy dng chuyn ngnh i vi cc trng hp
quy nh ti Khon 1, Khon 2, Khon 3 v Khon 4 iu 25 Thng t ny.

61

Ph lc 4
(Ban hnh km theo Thng t s 10/2013/TT-BXD
ngy 25 thng 7 nm 2013 ca B Xy dng)
(1) ..
________
S: /

CNG HO X HI CH NGHA VIT NAM

c lp - T do - Hnh phc
______________________
.........., ngy......... thng......... nm..........

KT QA KIM TRA CNG TC NGHIM THU A

CNG TRNH VO S DNG
Knh gi : .......(tn ch u t)...............
- Cn c Ngh nh s 15/2013/N-CP ngy 06 thng 02 nm 2013 ca
Chnh ph v qun l cht lng cng trnh xy dng;
- Cn c Thng t s 10 /2013/TT-BXD ngy 25 thng 07 nm 2013 ca
B trng B Xy dng;
- Cn c bo co hon thnh thi cng xy dng cng trnh/hng mc cng
trnh ti vn bn s . Ngy thng .. nm..;
- Cn c bin bn kim tra cng tc nghim thu a cng trnh vo s
dng ti hin trng (2) ngy ...thng...nm...
(1) . thng bo kt qu kim tra cng tc nghim thu a
cng trnh vo s dng nh sau:
1. Nhn xt v hin trng cht lng ca cng trnh/ hng mc cng trnh.
2. Nhn xt v s tun th cc quy nh ca php lut thng qua kim tra
h s hon thnh cng trnh theo quy nh ti im b v im c Khon 3 iu
24 Thng t s 10/2013/TT-BXD.
3. Kt lun:
ng / Khng ng cho ch u t t chc nghim thu a cng trnh
vo s dng.
4. Cc kin khc (nu c)./.
Ni nhn:
. (1) ..
- Nh trn;
- Lu:

(K, ghi r h tn, chc v v ng du php nhn)

(1). C quan chuyn mn v xy dng kim tra cng tc nghim thu ca ch u t c quy
nh ti iu 25 Thng t ny.
(2). i din cc bn tham gia kim tra bao gm: c quan chuyn mn v xy dng, ch u
t v cc nh thu xy dng cng trnh c lin quan k tn trong bin bn kim tra.

62

Ph lc 5
DANH MC H S HON THNH CNG TRNH
(Ban hnh km theo Thng t s 10 /2013/TT-BXD
ngy 25 thng 7 nm 2013 ca B Xy dng)
A.

H S CHUN B U T XY DNG V HP NG

1.

Quyt nh v ch trng u t km theo Bo co u t xy dng cng

trnh (bo co nghin cu tin kh thi) hoc quyt nh ph duyt ch
trng u t.

2.

Quyt nh ph duyt d n u t xy dng cng trnh hoc d n thnh

phn ca cp c thm quyn km theo D n u t xy dng cng trnh
(bo co nghin cu kh thi).

3.

Cc vn bn thm nh, tham gia kin ca cc c quan c lin quan trong

vic thm nh d n u t xy dng v thit k c s.

4.

Phng n n b gii phng mt bng v xy dng ti nh c.

5.

Vn bn ca cc t chc, c quan nh nc c thm quyn (nu c) v: tha

thun quy hoch, tha thun hoc chp thun s dng hoc u ni vi cng
trnh k thut bn ngoi hng ro; nh gi tc ng mi trng, m bo
an ton (an ton giao thng, an ton cc cng trnh ln cn) v cc vn bn
khc c lin quan.

6.

Quyt nh cp t, cho thu t ca c quan c thm quyn hoc hp ng

thu t i vi trng hp khng c cp t.

7.

Giy php xy dng, tr nhng trng hp c min giy php xy dng.

8.

Quyt nh ch nh thu, ph duyt kt qu la chn cc nh thu v cc

hp ng gia ch u t vi cc nh thu.

9.

Cc ti liu chng minh iu kin nng lc ca cc nh thu theo quy nh.

10. Cc h s, ti liu khc c lin quan trong giai on chun b u t.

B.
H S KHO ST XY DNG, THIT K XY DNG CNG
TRNH
1.

Phng n k thut kho st, bo co kho st xy dng cng trnh.

2.

Bin bn nghim thu kt qu kho st xy dng.

3.

Kt qu thm tra, thm nh thit k; quyt nh ph duyt thit k k thut,

km theo: h s thit k k thut c ph duyt (c danh mc bn v
km theo); ch dn k thut; vn bn thng bo kt qu thm tra thit k ca
63

c quan chuyn mn v xy dng (nu c).

4.

H s thit k bn v thi cng c ch u t xc nhn (c danh mc

bn v km theo).

5.

Bin bn nghim thu thit k xy dng cng trnh.

6.

Cc vn bn, ti liu, h s khc c lin quan n giai on kho st, thit

k xy dng cng trnh.

C.

H S THI CNG V NGHIM THU CNG TRNH XY DNG

1.

Cc thay i thit k trong qu trnh thi cng v cc vn bn thm nh, ph

duyt ca cp c thm quyn.

2.

Bn v hon cng (c danh mc bn v km theo).

3.

Cc k hoch, bin php kim tra, kim sot cht lng thi cng xy dng
cng trnh.

4.

Cc chng ch xut x, nhn mc hng ha, cng b s ph hp v cht

lng ca nh sn xut, chng nhn hp quy, chng nhn hp chun (nu
c) theo quy nh ca Lut cht lng sn phm hng ha, Lut Thng
mi v cc quy nh php lut khc c lin quan.

5.

Cc kt qu quan trc, o c, th nghim trong qu trnh thi cng v quan

trc trong qu trnh vn hnh.

6.

Cc bin bn nghim thu cng vic xy dng, nghim thu giai on (nu
c) trong qu trnh thi cng xy dng.

7.

Cc kt qu th nghim i chng, kim nh cht lng cng trnh, th

nghim kh nng chu lc kt cu xy dng (nu c).

8.

L lch thit b lp t trong cng trnh.

9.

Quy trnh vn hnh, khai thc cng trnh; quy trnh bo tr cng trnh.

10. Vn bn tha thun,chp thun, xc nhn ca cc t chc, c quan Nh

nc c thm quyn (nu c) v:
a) Di dn vng lng h, kho st cc di tch lch s, vn ha;
b) An ton phng chy, cha chy;
c) An ton mi trng;
d) An ton lao ng, an ton vn hnh h thng thit b cng trnh, thit b
64

cng ngh;
) Thc hin Giy php xy dng (i vi trng hp phi c giy php
xy dng);
e) Cho php u ni vi cng trnh h tng k thut v cc cng trnh khc
c lin quan;
g) Cc vn bn khc theo quy nh ca php lut c lin quan.
11. H s gii quyt s c cng trnh (nu c).
12. Kt qu kim tra cng tc nghim thu a cng trnh vo s dng ca c
quan chuyn mn v xy dng.
13. Bin bn nghim thu hon thnh hng mc/ cng trnh a vo s dng ca
Ch u t.
14. Cc ph lc tn ti cn sa cha, khc phc sau khi a cng trnh vo s
dng.
15. Cc h s/ vn bn/ ti liu khc c lin quan trong giai on thi cng xy
dng v nghim thu cng trnh xy dng.
D. QUY CCH V S LNG H S HON THNH CNG TRNH
1. Cc bn v thit k phi c lp theo quy nh v phi c ch u
t hoc i din c u quyn ca ch u t xc nhn.
2. Cc bn v hon cng phi c lp theo hng dn ti Ph lc 2 ca
Thng t ny.
3. H s hon thnh cng trnh c bo qun trong hp theo kh A4
hoc bng cc phng php khc ph hp, ba hp ghi cc thng tin lin quan
ti ni dung h s lu tr trong hp.
4. Thuyt minh v bn v thit k, bn v hon cng cng trnh xy dng
c th c lu tr di dng bng t, a t hoc vt mang tin ph hp.
5. Cc vn bn quan trng trong h s hon thnh cng trnh nh quyt
nh ph duyt d n u t xy dng, quyt nh ph duyt bo co kinh t-k
thut (trng hp ch phi lp bo co kinh t-k thut), quyt nh ph duyt
thit k, bin bn nghim thu cng trnh a vo s dng, bin bn bn giao
cng trnh ... c lu tr bng bn chnh. Trng hp khng cn bn chnh th
c thay th bng bn sao hp php;

65

6. S lng b h s hon thnh cng trnh do ch u t v cc nh thu

tha thun nu trong hp ng.

66

Ph lc 6
(Km theo Thng t s 10/2013/TT-BXD ngy 25 thng 7 nm 2013 ca B Xy
dng-p dng cho Bo co ca UBND cp tnh)

UBND TNH/ THNH PH

CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc

S: ................./BC-UBND
.................., ngy ...... thng ....... nm
BO CO

v tnh hnh cht lng v cng tc qun l

cht lng cng trnh xy dng trn a bn tnh/thnh ph ...
Nm ................
Knh gi: B trng B Xy dng

I. Tng s cng trnh xy dng/ d n u t xy dng (trng hp d n c

nhiu cng trnh xy dng) ang c thi cng xy dng trn a bn
1. Tng s cng trnh xy dng (tt c cc ngun vn tr nh ring l) trong k bo co:

Loi cng
trnh chnh

ang thi cng

Cp cng trnh chnh
c
bit

II

III

hon thnh
Cp cng trnh chnh
IV

c
bit

II

III

IV

Dn dng
Cng
nghip
Giao thng
Nng
nghip
v PTNT
H tng
k thut
Tng s
2. S cng trnh xy dng s dng vn ngn sch Trung ng:
3. S cng trnh xy dng s dng vn ngn sch a phng:
4. S cng trnh xy dng s dng cc ngun vn khc:

II. S c trong thi cng xy dng v khai thc, s dng cng trnh xy dng:
1. S lng s c:
67

Loi cng
trnh chnh

S c cp c bit
nghim trng
ang
ang
thi cng
s dng

S c cp I

S c cp II

S c cp III

ang
ang
ang
ang
ang
ang
thi cng s dng thi cng s dng thi cng s dng

Dn dng
Cng
nghip
Giao
thng
Nng
nghip
v PTNT
H tng
k thut
Tng s
2. M t loi s c, thit hi v cng trnh, vt cht v v ngi; nh gi nguyn nhn v
gii quyt s c.

III. TNH HNH CHT LNG V QUN L CHT LNG CNG

TRNH XY DNG:
1. Cht lng kho st, thit k (thng qua cng tc thm tra thit k theo iu 21 Ngh
nh 15/2013/N-CP):
a) S lng h s thit k cng trnh c thm tra theo quy nh ti iu 21 Ngh nh
15/2013/N-CP;
b) Cht lng thit k (1);
c) Ct gim chi ph u t (s tin, t l % trc v sau thm tra) (2);
d) Cc nh gi khc.
Trng hp vic thm tra thit k cng trnh theo quy nh ti iu 21 Ngh nh
15/2013/N-CP c thc hin bi t chc t vn do c quan chuyn mn v xy dng ch
nh th cc thng tin nu trn cn c kt qu thm tra ca t chc t vn.
2. Cht lng thi cng xy dng (thng qua cng tc kim tra trong thi cng v nghim
thu):
a) S lng cc cng trnh c kim tra theo quy nh ti iu 32 Ngh nh
15/2013/N-CP;
b) Cht lng thi cng xy dng v cng tc qun l cht lng (3);
c) nh gi tng th cht lng cng trnh xy dng sau khi nghim thu (Tt, Kh,
Trung bnh)(4) .
3. Cc gii thng v cht lng cng trnh:
a) S lng cng trnh t gii thng quc gia v cht lng;
b) S lng cng trnh t gii thng cht lng cao;
c) S lng cc nh thu c tn vinh thng qua cc gii thng.
68

4. S lng cc t chc, c nhn hot ng xy dng vi phm v qun l cht lng b x

l vi phm hnh chnh v c ng ti trn trang thng tin in t ca c quan qun l nh nc
v xy dng ti a phng.
5. S lng cc cng trnh b nh ch thi cng xy dng; nh ch khc thc, s dng.

IV. Cc ni dung bo co khc v kin ngh:

1. Kt qu kim tra cht lng cng trnh nh k v t xut theo quy nh ti iu 32
ca Thng t ny.
2. Cc kin, kin ngh (nu c).
TM. UBND TNH/THNH PH ......
CH TCH
(Ch k, ghi r h tn v ng du)

Ni nhn:
- Nh trn;
- Cc Gim nh Nh nc v Cht lng
cng trnh xy dng - B Xy dng;
- Lu: VP UBND, S Xy dng tnh.

(1) Bo co v s lng h s thit k xy dng cng trnh khng m bo cht lng hoc
khng tun th quy nh ca php lut do vi phm mt trong cc li sau:
- Sai st trong vic tnh ton kt cu, thit k cng trnh hoc th hin sai trn bn v
dn ti khng m bo an ton ca cng trnh dn n phi chnh sa thit k.
- Vi phm Quy chun k thut quc gia, tiu chun ch yu p dng cho cng trnh.
- Vi phm quy nh ca php lut v iu kin nng lc ca t chc, c nhn thc hin
thit k hoc c nhiu sai st khc i hi phi tnh ton, chnh sa li ton b h s thit k.
(2) Ct gim chi ph c tnh da trn d ton do ch u t trnh:
- S tin ct gim = Gi tr d ton do ch u t trnh Gi tr d ton sau khi thm
tra ca c quan qun l nh nc v xy dng.
S tin ct gim
- T l ct gim (%) =
x 100.
Gi tr d ton do ch u t trnh
(3) Bo co v s lng cng trnh c c cht lng thi cng xy dng khng t yu cu khi
c vi phm sau:
- xy ra s c cng trnh hoc cc sai st ln v cht lng cng trnh nh hng
n an ton, cng nng s dng ca cng trnh.
- Vi phm cc quy nh v qun l cht lng cng trnh xy dng, khng c s
c chp thun nghim thu a vo s dng.
(4) nh gi tng th v cht lng cng trnh theo cc mc : Trung bnh/ Kh/Tt c th:
- Cht lng cng trnh t Tt nu c nh gi t 85 im tr ln.
- Cht lng cng trnh t Kh nu c nh gi t 70 n 84 im.
- Cht lng cng trnh t Trung bnh nu im nh gi < 70 im nhng vn
iu kin nghim thu a vo s dng.
Vic chm im c vn dng theo Thng t Ban hnh Quy nh T chc gii
thng v cht lng cng trnh xy dng ca B Xy dng.

69

Ph lc 7
(Km theo Thng t s 10 /2013/TT-BXD ngy 25 thng 7 nm 2013ca B Xy
dng- p dng cho Bo co ca B qun l cng trnh chuyn ngnh, B Cng an,
B Quc phng)
B QUN L CNG TRNH
XY DNG CHUYN NGNH

CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc

S: ......./BC-B

.................., ngy ...... thng ....... nm

BO CO
v tnh hnh cht lng v qun l cht lng cng trnh xy dng
do B ..... qun l
Nm ................
Knh gi: B trng B Xy dng

I. Cc cng trnh xy dng do B qun l (1)

1. Tng s cng trnh xy dng :
ang thi cng
Loi cng
Cp cng trnh chnh
trnh
c bit
I
II
III
Cng trnh
chuyn
ngnh

IV

hon thnh
Cp cng trnh chnh
c bit
I
II
III

IV

Cng trnh
khc
Tng s
2. S cng trnh xy dng s dng vn ngn sch nh nc:
3. S cng trnh xy dng s dng cc ngun vn khc:

II. S c trong thi cng xy dng v khai thc, s dng cng trnh xy dng
1. S lng s c:

Loi cng
trnh

S c cp c bit
nghim trng
ang
ang
thi cng
s dng

S c cp I

S c cp II

S c cp III

ang
ang
ang
ang
ang
ang
thi cng s dng thi cng s dng thi cng s dng

Chuyn
ngnh
Cng trnh
khc
Tng s
2. M t loi s c, thit hi v cng trnh, vt cht v v ngi; nh gi nguyn nhn v
gii quyt s c.
70

III. Tnh hnh cht lng v qun l cht lng cng trnh xy dng:
1. Cht lng kho st, thit k (thng qua cng tc thm tra thit k theo iu 21 Ngh
nh 15/2013/N-CP):
a) S lng h s thit k cng trnh c thm tra theo quy nh ti iu 21 Ngh nh
15/2013/N-CP;
b) Cht lng thit k (2);
c) Ct gim chi ph u t (s tin, t l % trc v sau thm tra) (3);
d) Cc nh gi khc.
Trng hp vic thm tra thit k cng trnh theo quy nh ti iu 21 Ngh nh
15/2013/N-CP c thc hin bi t chc t vn do c quan chuyn mn v xy dng ch
nh th cc thng tin nu trn cn c kt qu thm tra ca t chc t vn.
2. Cht lng thi cng xy dng (thng qua cng tc kim tra trong thi cng v nghim
thu):
a) S lng cc cng trnh c kim tra theo quy nh ti iu 32 Ngh nh
15/2013/N-CP;
b) Cht lng thi cng xy dng v cng tc qun l cht lng (4);
c) nh gi tng th cht lng cng trnh xy dng sau khi nghim thu (Tt, Kh,
Trung bnh)(5) .
3. Cc gii thng v cht lng cng trnh:
a) S lng cng trnh t gii thng quc gia v cht lng;
b) S lng cng trnh t gii thng cht lng cao;
c) S lng cc nh thu c tn vinh thng qua cc gii thng.
4. S lng cc t chc, c nhn hot ng xy dng vi phm v qun l cht lng b x
l vi phm hnh chnh v c ng ti trn trang thng tin in t ca c quan qun l nh nc
v xy dng ti a phng.
5. S lng cc cng trnh b nh ch thi cng xy dng; nh ch khc thc, s dng.

IV. Cc ni dung bo co khc v kin ngh:

1. Kt qu kim tra cht lng cng trnh nh k v t xut theo quy nh ti iu 32
ca Thng t ny.
2. Cc kin, kin ngh (nu c).
Ni nhn:
- Nh trn;
- Cc Gim nh Nh nc v Cht lng
cng trnh xy dng - B Xy dng;
- Lu: B bo co.

B TRNG
(Ch k, ghi r h tn v ng du php nhn)

(1) Cc cng trnh do B qun l bao gm:

- Cc cng trnh xy dng do B quyt nh u t hoc l ch u t;
- Cc cng trnh xy dng khc c B thm tra thit k v kim tra cng tc nghim
thu a cng trnh vo s dng theo quy nh ti Ngh nh 15/2013/N-CP.
71

(2) Bo co v s lng h s thit k xy dng cng trnh khng m bo cht lng hoc
khng tun th quy nh ca php lut do vi phm mt trong cc li sau:
- Sai st trong vic tnh ton kt cu, thit k cng trnh hoc th hin sai trn bn v
dn ti khng m bo an ton ca cng trnh dn n phi chnh sa thit k.
- Vi phm Quy chun k thut quc gia, tiu chun ch yu p dng cho cng trnh.
- Vi phm quy nh ca php lut v iu kin nng lc ca t chc, c nhn thc hin
thit k hoc c nhiu sai st khc i hi phi tnh ton, chnh sa li ton b h s thit k.
(3) Ct gim chi ph c tnh da trn d ton do ch u t trnh:
- S tin ct gim = Gi tr d ton do ch u t trnh Gi tr d ton sau khi thm
tra ca c quan qun l nh nc v xy dng.
S tin ct gim
- T l ct gim (%) =
x 100.
Gi tr d ton do ch u t trnh
(4) Bo co v s lng cng trnh c c cht lng thi cng xy dng khng t yu cu khi
c vi phm sau:
- xy ra s c cng trnh hoc cc sai st ln v cht lng cng trnh nh hng
n an ton, cng nng s dng ca cng trnh.
- Vi phm cc quy nh v qun l cht lng cng trnh xy dng, khng c s
c chp thun nghim thu a vo s dng.
(5) nh gi tng th v cht lng cng trnh theo cc mc : Trung bnh/ Kh/Tt c th:
- Cht lng cng trnh t Tt nu c nh gi t 85 im tr ln.
- Cht lng cng trnh t Kh nu c nh gi t 70 n 84 im.
- Cht lng cng trnh t Trung bnh nu im nh gi < 70 im nhng vn
iu kin nghim thu a vo s dng.
Vic chm im c vn dng theo Thng t Ban hnh Quy nh T chc gii
thng v cht lng cng trnh xy dng ca B Xy dng.

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Ph lc 8
(Km theo Thng t s 10 /2013/TT-BXD ngy 25 thng 7 nm 2013 ca
B Xy dng- p dng cho cc B, C quan ngang B khng phi l B qun l
cng trnh chuyn ngnh)
B / C QUAN NGANG B

CNG HA X HI CH NGHA VIT NAM

c lp T do Hnh phc

S: ......./BC-B/C quan ngang b

.................., ngy ...... thng ....... nm

BO CO
v tnh hnh cht lng v qun l cht lng cng trnh xy dng
do B l ngi quyt nh u t hoc l ch u t
Nm ................
Knh gi: B trng B Xy dng

I. Cc cng trnh xy dng

1. Tng s cng trnh xy dng (do B l ngi quyt nh u t hoc/ v l ch u t):
ang thi cng
hon thnh
Loi cng trnh
Cp cng trnh chnh
Cp cng trnh chnh
c bit
I
II
III IV c bit I
II
III IV
Dn dng
Cng nghip
Giao thng
Nng nghip v PTNT
H tng k thut
Tng s
2. S cng trnh xy dng s dng vn ngn sch nh nc:

II. S lng s c trong thi cng xy dng v khai thc, s dng cng trnh
xy dng:
1. S lng s c:
2. M t s c, thit hi v ngi, ti sn; nguyn nhn, nh gi v gii quyt s c.

III. Cc ni dung bo co khc v kin ngh:

Ni nhn:
- Nh trn;
- Cc Gim nh Nh nc v Cht lng
cng trnh xy dng - B Xy dng;
- Lu: B bo co.

B TRNG
(Ch k, ghi r h tn v ng du php nhn)

73