WH-WHG-629-0000-SAK-NCR-QL-

NCR No:
000001
Revision: 00
Date: 04 July 2024
Page: 1 of 3

(NCR) Non-Conformance Report

Part 1 – Issue / Receive / Distribute
Employer: Diriyah Company
Contractor: SHADE Contracting Company
Project: Wadi Hanifah Buildings Package
Contract/ DD-2021-281
Work Package:
Construction SAK
Supervisor:

NCR Classification:

Spec. Ref. No.: Section 01 11 00 Cl. 1.3 Corrective Action

13-Jul-2024
Drawing Ref. No.: Response Due by (Date):

Type of Discipline
Civil / Structural

SAK has identified the following non-conformities related to the progress report submissions by the Contractor:

1. Daily progress reports are consistently delayed and not submitted on a timely basis.
2. No weekly progress reports have been submitted to date.

The Contractor is required to investigate the root cause of these non-conformities and promptly present a corrective
action plan.

No. of
H
Reference 0 Zone Area Level Grid / Location CWM02
CWM02
Attached

Originator: Mohammed Fasil Signature:

Package PM
Adnan Al Aqel Signature:
Authorisation:

QA | QC Head: CM ǀ CS Head: Stamp: SHADE

Mohammed Fasil Adnan Al Aqel
Stamp: SAK ENGINEERING CONSULTANCIES

Signature: Signature:
 WH-WHG-629-0000-SAK-NCR-QL-
NCR No:
000001
Revision: 00
Date: 04 July 2024
Page: 2 of 3

Part 2 – First Action to be taken (To be filled out by Contractor and returned to Construction Supervisor)
Cause of Non-Conformance

Corrective Action Taken

Preventive Action Taken

Name (Contractor)

Signature Date
 WH-WHG-629-0000-SAK-NCR-QL-
NCR No:
000001
Revision: 00
Date: 04 July 2024
Page: 3 of 3

Part 3 – Verification of First Action taken (To be verified by the Consultant)

Technical Office Verification

Disposition: Accepted Rejected *

Package PM [ Name & Signature] Date:

Construction Supervision Verification

Disposition: Accepted Rejected *

Verified by:
[ Name & Signature] Date:
(Discipline Engr.)
Authorised by:
[ Name & Signature] Date:
(Package PM)

Note: If NCR is still “REJECTED”, previous comment/s must be attached by the Contractor on the next response action.

‒ Action/s for the Non-Conformance has been verified and closed. YES NO
‒ Further action is required YES NO

QA/QC Head: CM ǀ CS Head: Stamp: SHADE

Stamp: SAK ENGINEERING CONSULTANCIES

Name: Name:
Role: PROJECT MANAGER Role: PROJECT MANAGER
Signature: Signature: