L&W-CONS-FM-24 Rev 1

L&W Construction (Private) Limited Subcontract Violation Form

CORRECTIVE ACTION REQUEST
#N/A
Project : MCCIN_Phase-01 Date : 31-10-2022

To : Khegan Mondel SV Register No.: LW1905/MCCIN/SV-003

(Name of Sub-contractor & representative)

From : Nagendra - Sr. Project Manager Originator :

Arun M - Sr. Engineer-QA/QC
(Name & Signature of L&W Snr / Site Manager)

Dear Sir,
The following violation of our subcontract agreement was noted during a review / formal inspection of your services / works.
Please complete part 2 of this form and return to L&W by 02-11-2022
Please note that we are WITHHOLDING INR. - & Fine INR. ₹ 10,000 from your account.

The withholding amount will be released upon satisfactory completion of rectification works. However, if you failed to
response within the time frame stipulated or non-compliance to agreed actions, the withholding amount will be forfeited.

1. Reason for Subcontract Violation

(Clearly identify / establish non compliance including location / grid ref etc. Attach relevant documents / photos / sketches)

GF_Column_C17
Column found twisted around 35mm at NW corner

2. Proposed Corrective & Preventive Action (by Sub-contractor)

(Describe the effective corrective / preventive actions to be taken to rectify current problem & preventive measures).
Please attach sketches / photos/ method statements as necessary (do not proceed until you receive approval of your proposal).

Proposed by :

Name / Signature of Sub-Contractor Date

3. Acceptance of Proposed Corrective / Preventive Action (by Woh Hup's Snr / Site Manager )

Comments :

Approved by :
Name / Signature of L&W Snr / Site Manager Date

4. Verification of Completion of Rectification Works / Corrective / Preventive Actions

Comments :

Submitted by : Verified by :
Name / Signature of Sub-Contractor Date Name / Signature of L&W Staff Date

We (Sub-Contractor) have completed the above rectification works. Approved by :

The affected areas / works are ready for re-inspection. Name / Signature of L&W Snr / Site Manager Date
Note: Any direct or consequential costs associated with this violation will be reviewed by WOH HUP and shall be charged to your account where
deemed necessary. This corrective action request will be analyzed and the results will be added to your sub-contractor performance record
maintained by our contract administration department for future reference.

Distribution:
Originator / Subcontractor / Snr / Site Manager / QA/QC Manager / Q.S. / Others : ___________________
OBSERVATION PHOTO
01-10-2022