Material Submittal

Program:
Project: Rosewood Resort Triple Bay
Package: Fuel Transfer System

[Contract No.]

Program: XX
Project: XXXX
Package:

Material
Document Number
Revision
Revision Date
RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Discipline
Rev.00, Oct. 01,2022 Page | 1
Material Submittal Template
RSG-CN-TMP-0007

Material
Fuel Transfer System
Document Number

Revision
0
Revision Date
11th September 2023
Discipline
Mechanical
Submitting Contractor
Gas Solutions

Revision History

Rev. Date Details of Revision Prepared By Reviewed By Approved By

0 11/09/2023 Sayed Pallikal Sakthi Kasi Rajan

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 2
Material Submittal Template
RSG-CN-TMP-0007

TABLE OF CONTENTS
1 PRODUCT INFORMATION ........................................................................................................................ 7

2 STATEMENT OF COMPLIANCE .................................................................................................................. 8

3 SCOPE OF WORKS ..................................................................................................................................... 9

4 SPECIFICATION COMPLIANCE CHECK LIST ........................................................................................... 10

5 TECHNICAL DATA SHEET ........................................................................................................................ 11

6 SAMPLE (LIST / PHOTOS) ........................................................................................................................ 12

7 TEST REPORTS ......................................................................................................................................... 14

8 LEED COMPLIANCE & CERTIFICATES ..................................................................................................... 15

9 COUNTRY OF ORIGIN – CONFIRMATION LETTER ................................................................................. 16

10 PRODUCT AUTHORITY APPROVAL ........................................................................................................ 17

11 DRAFT WARRANTY ................................................................................................................................. 18

12 MANUFACTURER RECOMMENDED SPARE PARTS ................................................................................. 19

13 PREVIOUS PROJECT APPROVALS ........................................................................................................... 20

14 TRADE LICENSE ....................................................................................................................................... 21

15 MANUFACTURER CONFIRMATION OF THE LOCAL AGENT .................................................................. 22

16 PROJECT REFERENCE LIST....................................................................................................................... 23

17 COMPANY PROFILE ................................................................................................................................ 24

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 3
Material Submittal Template
RSG-CN-TMP-0007

Compalince
Sl
Description Not Not Remarks
No Provided
Provided Applicable

1 Statement of Compliance ☒ ☐ ☐
2 Scope of Works ☒ ☐ ☐
3 Specification Compliance Checklist ☒ ☐ ☐
4 Technical Data Sheet ☒ ☐ ☐
5 Test Reports ☒ ☐ ☐
6 LEED Compliance ☐ ☐ ☒
7 Country of Origin ☒ ☐ ☐
8 Authority Approvals ☒ ☐ ☐
9 Draft Warranty ☒ ☐ ☐
10 Recommended Spare Parts ☒ ☐ ☐
11 Trade Licence ☒ ☐ ☐
12 Project References ☒ ☐ ☐
13 Previous revision comment tracker ☒ ☐ ☐
Above checklist is the minimum requirement, subject to review by the Employer and or Assistants.

Prepared By Reviewed By Approved By

Name Sakthi Kasi Rajan

Designation HOD – Design & Tendering

Sign

Date 11/09/2023

Stamp

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 4
Material Submittal Template
RSG-CN-TMP-0007

PREVIOUS REVISION COMMENTS AND CONTRACTOR

RESPONSE

Program: XX
Project: XXXX
Package:

Material
Document Number
Revision
Revision Date
Discipline
Submitting Contractor
RSG-CN-TMP-0007 FOR INTERNAL USE ONLY
Rev. 00, 01 Oct 2022 Page | 5
Material Submittal Template
RSG-CN-TMP-0007

Insert the Comments sheets issued by the Supervision Consultant with required responses in this sheet.

For Revision 0 submission, note “ NOT APPLICABLE” }

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 6
Material Submittal Template
RSG-CN-TMP-0007

1 PRODUCT INFORMATION
[ Following table to be populated as minimum}

Sl
Description Value Remarks
No

01 Material Description As per the table attached

Specification Drawing BOQ

02 Reference

04 Manufacturer As per the table attached

Name: Gas Solutions

05 Supplier
Address: Riyadh, KSA

06 Country of Origin KSA

RSP vendor List

07 Yes or No -
Compliance

Project location to be
08 Red Sea
used

09 Required Date on Site -

Manufacturing duration
10 12 to 16 weeks
(Ex- Factory)

Shipment duration
11 1 week
(Ex-factory to Site)

16 to 18 weeks from the date of payment

12 Expected Arrival on Site
and materials approval

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev.00. Oct. 01, 2022 Page | 7
Material Submittal Template
RSG-CN-TMP-0007

2 STATEMENT OF COMPLIANCE
[ Following statement of compliance template can be used by the Supplier / Manufacturer and must be produced in
their Company letter head signed and stamped by the Authorized representative}

Statement of Compliance

Date: 11th September 2023

Program:

Project: Rosewood Resort Triple Bay

Package: Fuel Transfer System

Subject: Statement of Compliance for the Fuel Transfer System

I, as the Authorized representative from the Supplier/ Manufacturer, acknowledge and certify the material submission
covered under this document [ insert material name] is produced in accordance with the following.

☐ Compliance with Contract Specifications

☐ Compliance with Contract Drawings

☐ Compliance with Contractual Requirements

☐ Compliance with Authority Requirements

☐ Compliance with LEED requirements

Name:

Title:

Signature:

Stamp:

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 8
Material Submittal Template
RSG-CN-TMP-0007

3 SCOPE OF WORKS

The scope of work comprises the delivery, installation, testing & commissioning and handing over of the diesel fuel
transfer system as per the project requirements.

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 9
Material Submittal Template
RSG-CN-TMP-0007

4 SPECIFICATION COMPLIANCE CHECK LIST

[ Following shall be part of this section

1. Line by line compliance with specification requirements

2. Append the relevant specification sections

3. Justification by the Manufacturer for any variance

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 10
Material Submittal Template
RSG-CN-TMP-0007

5 TECHNICAL DATA SHEET

RSG-CN-TMP-0007 FOR INTERNAL USE ONLY

Rev. 00, 01 Oct 2022 Page | 11