Issue No.
01
CONS/CVI/22 FORMS/RECORDS
Rev. No 00
FORM22: CONFIRMATION OF VERBAL INSTRUCTION
Date: CVI No.
Project Name
Confirmation required by
Name Designation
Company Date Confirmation required
DETAILS OF INSTRUCTION
Instruction Given to: Date Instruction was Given:
Related Drawing Ref. Location of tasks:
Details of Instruction:
Related Cost Implication? Yes No Variation Order No……..
Related Time Implication? Yes No Extension of Time……….
Related change in Drawing/Design? Yes No New Drawing No. ………..
CONFIRMATION REQUESTED BY
NAME DESIGNATION
SIGNATURE DATE
CONSULTANT TO COMPLETE
NAME DESIGNATION
CONFIRMATION APPROVED CONFIRMATION NOT APPROVED
REMARKS:
SIGNATURE: DATE:
CC to Client M&E Engineer QS
Architect Structural Engineer Other: ………….
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IC: PAD/CONS/01