Ref. No.

P20028-CP01-NCN-087-22

NON-COMPLIANCE NOTICE (NCN)

Project Name Bloom Residences Phase I Date April 11, 2022
Contract Vision Properties Development
CP-01 – Civil, Structural & Masonry Works Contractor
Package Corp.
Work Area Road Network along Towers C & E

Structural Architectural Electrical Mechanical Sanitary / Plumbing

Civil Fire Pro FDAS Survey Others

Test Inspection

 Description of Non-Conformance:

 Cracks on Road Network

(SEE ATTACHED PHOTO)

 Category of NCN (Severity Range 1 (low) to 5

4
(highest):

 Deviation to SMDC-ENGG-QAQC-IOM-09 Occurred cracks

 References (Codes/Standards/Specs/Drawings)
on pavement

Inspected by: Noted by:

Engr. Jayson Arguelles / April 11, 2022/ Engr. Mark Loie Villanueva/ April 11, 2022/
GMCPMI QA/QC (Name/Date/Signature) GMCPMI PM (Name/Date/Signature)
Acknowledge by:

______________________________________
Contractor’s Rep (Name/Date/Signature) Contractor’s PM (Name/Date/Signature)

CORRECTIVE ACTION BY CONTRACTOR

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 Ref. No. P20028-CP01-NCN-087-22

1. Description of Corrective Actions and Proposed Preventive Actions:

Corrective Actions Proposed Preventive Actions

(Description here) (Description here)

2. Reference Codes/Standard on which Corrective

(attached here)
action has been Proposed:

3. Proposed Date for Completion of Corrective

From _______________ To _______________
Action:
(Date) (Date)

4. Estimated Cost Impact Php __________________________________

5. Estimated Schedule Impact No. of Days ____________________________

6. Comments & Approval of GMCPMI:

Agreed Agreed with Comments _____________________________ Disagreed

Approved by:

______________________________________ ______________________________________
GMCPMI QA/QC (Name/Date/Signature) GMCPMI PM (Name/Date/Signature)

CORRECTION REPORT BY CONTRACTOR - TO BE SIGNED BY CONTRACTOR AFTER COMPLETION OF

CORRECTIVE ACTIONS

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1. Actual Date of Completion of Corrective Action: ______________________________________

(Date)
Submitted by:

___________________________________________
Contractor’s Representative (Name/Date/Signature)

2. Actual Photo of Completed Corrective Action:

(attached photo here) (attached photo here)

3. Supporting Documents:

Accepted by:

______________________________________ ______________________________________
GMCPMI QA/QC (Name/Date/Signature) GMCPMI PM (Name/Date/Signature)

Noted by:

______________________________________ ______________________________________
SMDC PO (Name/Date/Signature) SMDC PM (Name/Date/Signature)

Non-complying work may be required to be removed and replaced at no cost to the Owner. It shall be your
responsibility to determine the corrective action necessary, and to determine whether you wish to discontinue
operations until additional investigations by the Owner or Project Manager confirm or refute the initial findings.

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