COMMISSIONING STAGE COMPLIANCE CERTIFICATE CSCC

System Reference / Description: Discipline Code: Location:

Certificate of Installation Completion

Verification that Installation Activities are Completed sufficiently for PreFunctional and Operational Check Out Procedures to commence.

Certificate of Readiness
Verification that Pre-Functional and Operational Check Out Activities are Completed and prior to the Functional Testing being commenced.

Certificate of Commissioning Completion

Verification that Functional Testing Activities are Completed and prior to the Integrated Commissioning being commenced.
Item Completed Comment Signed by Date 1 QANs Reviewed. Refer to Checklist 2 CTIs Reviewed. Refer to Checklist 3 NCRs Refer to Checklist 4 Commissioning Issues Log Items reviewed. 5 Construction/Installation Completed. 6 Sub-Contractors works Complete. 7 Pre-Functional Check Out Signed. 8 Operational Check Out Signed. 9 Functional Check Out Signed. Note: All outstanding issues that can be carried forward and do not prevent commissioning from continuing must be added to the commissioning issues log. Signed by: Signature: On Behalf of: Sub-Contractor Date: Signed by: Signature: On Behalf of: SOJV Construction Date: Signed by: Signature: On Behalf of: SOJV Cx Date: Signed by: Signature:

On Behalf of: OBI Date: Upon sign off of this document, the following procedures / test activities may be conducted. TABTP/CTP/TPP Ref.

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COMMISSIONING STAGE COMPLIENCE CERTIFICATE CHECKLIST

SYSTEM/EQUIPMENT REF: Date: AREA LOCATION: WORKS DESCRIPTION: ITEM DOCUMENT/DRAWING No CODE 1. Method Statements 2. Test Procedures 3. Shop Drawings 4. QANs 5. NCRs 6.CTIs