(f), Mil s6: QTS21-02/P9QUII'.nUMI

TAc NGHI~P GIAI QUYET cAc LO~Liln ban h1mh:01

Ngay: 07/11/2015I;VNNPC HlNH DICH VV' THEO HU<1NGMOT CliApc; SAC KAioI T.:\I PI!oNG GIAO DICH :KFI;ACHHANG Trang: 49/50

CONG TY DIJ):NLVC BAc K4.N

PHULUC4CACBIEUMAU

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IT TenphI} ll}c, bi&um~u

1 Gifty dS ngh! mua di~n ph\lc V\lml,!Cdich ngoai sinh hO:;lt.

2 Gifty dS ngh! mua di~n ph\lc Vl,l ml,!cdich sinh hO:;lt.

3 Phi€u ht;n khao sat dp di~n.

4 K€t qua khflOsat va phuang an dp di~n

M~usa01

02

03

04

5 Bang d\f toan v~t tu (dlll1gnQi bQ) 05, ,

--l-.

6 Phi€u xuftt Iwo 06

7Bien ban treo thiio, nghi~m thu va ban giao h~ th6ng do d€m di~n

07anang (dung cho cong to' di~n 1pha CO' khi)

8Bien ban treo thiio, nghi~m thu va ban giao h~ th6ng do d€m di~n

07bnang (dung cho cong to' di~n ill)

9Bien ban treo thiio, nghi~m thu va ban giao M th6ng do d€m di~n

07cnang (dUng cho cong to' di~n 3 pha)

10 H6 sa khach hang mua di~n ph\lc VI,!ml,!cdich ngoai sinh ho?t OSa

11 H6 SO' khach hang mua di~n phl,!cVI,! ml,!cdich chinh sinh ho?t OSb

,

EB, Ma so: QT821-021P9

~UlI'FIUNE)!Un ban hanh: 01

TAc NGHI~P mAl QUYET cAc LO~INgay: 07/11/2015HiNH Dl~H VVTJHEOH1J6N<? M<)T,CUA

eVlN!NPCIPCJaACKAN T4I PRONG GIAO DJCH KHACH HANG Trang: 50/50

CONG TY m:eNUfC RAe ~N

12 Van ban de nghi thi nghi~rn v~t tu, thiet bi cong trinh 09

13 Van ban de nghi nghi~rn thu eong trinh 10

14Thong tin chung dang kY d~u n6i eho cae khaeh hang su d\lng di~n 11co tr?ill rieng d~u n6i vao lucri di~n trung ap

ThOng tin ve nhu ciiu su dl,mgdi~n eua cae khaeh hang SU: d\lng15 di~n co tr?ill rieng d~u n6i vao lucri di~n trung ap 12

16bien ban khao sat v/v th6ng nhftt mQt s6 nQi dung lien quan den l~p 13thOa thu~ dftu n6i

17 ThOa thu~ dftu n6i va cae yeu du kYthu~t ea ban giUa (dan vi 14phan ph6i di~n) va ... (ten khaeh hang de nghi d~u n6i)

18 Bien ban nghi~m thu kYthu~t 15

19 Bien ban dong di~n 16

20 H6 sa nghi~m thu eong trinh di~n 17

21 Bien ban nghi~m thu khoi luqng hoan thanh xay l~p 18

22 S6 tiep nh~ va giai quyet yeu du eua Khaeh hang. 19

23 Phieu de nghi giai quyet dieh V\l 20

•

cerNG TYB$N rArc ,B$N LlJC ,

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. CONG HoA XA.HOI cHiT NGHiA VIJ1;TNAMDoc Hip - TIT do - Hanh phuc

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GIA.Y DE NGHl MUA DIJ!:N(ph!,c v!, m!,c dich ngoid sinh hO(lt)

1. pRAN BANG KY SU DlJNG BI~N CUA KRACH HANG:A , 'h' 'h A' , d"Ten to chuc o~cca n an co nhu cau mua lyn: , , " "" ".." " .

Il~i di~nla ang (bil): " " " " " " chUcV\!, , , ,..s6 chUngminh thU'/hQchi~u: ", ,." "" "..ngh cAp / / t~i., ..", " ".." .Th ,A • , > h' • ,eo gJaYuy quyen , , ' , ng"y t ang , nam .. , cua "" "."..'

, , A r

. S6 Fax" ,.. , S6 BT: .. , " " So BT nh~n tin nhan:,." " " .T" kh' AT' A h' E '1al oan so : ".".. ~1ngan ang: ,.., ",.... mal " " .

Ilia chi noi a ho~c van phOngCong ty: .. , ,",., .. " ,' ,.. , .. , .. ,. , , , , , , ,., , ,

............................. , , , " " .Ilia chi nm su:d\lng di~n: ' ,"',.,."., ,., .. , , , .. " " ' .. ' ,.. " , ,.,.,

Ilhghimuadi~n: Ipha 0; 0 3pha, Congsu~tdangkYsud\1l1g: KW.

M\!c dich su d\!ng di~n "., : " " " " ,:" .

Tinh tr~g su d\mg ai~n hi~n t~i: Chua co di~n 0; Bang dung cong ta chung 0

n.BON Vj: Il:mN qrc IlA. ~ NBfJNG GIAY TO:

(J

I, Oiiy til' lien quau den dja diem mua di~n:

o Gi~ychlrngnh!in quyfn so'huu nM;

o Gih chu'ngnh(l.nquyfn sir d\lllg d~t;

o Hqp a5ng thlle nha;

o H9'j)d5ng thlle a~t;

D H9'Pd6ng iry quyfn quim I)' va sir d\mgnha;

D Gi~yxiic nh~n cua CO' qllan quan I)' cila c~pco th1.mquyfn vf aia di~m mua di~n;

o Gj~yxac nh~ncua chfnh quyfn aia phuangt;ri nO'idf nghj mlla ai~n vf dja ai~m l1111adi~n.

Thai gian Ben ban di~n nh~ du hb so'Ngay." "... thang .... " ..nam", '" " ..

B~ D~NBEN BAN B~N(K:y va ghi ro h9 ten)

2. Oiay to' lien quan dell khach hang mua ai~n:

D Gidy chUngnh~ dang kY doanh nghi~p;

D Gi~y chung nh~ dang kYho~t d9ng chi nhanh, vanpMng d~i di~n;

D Oj~y phep dilu tu

D Quy~t dinh thanh l!ip don vi;

D Oidy xac nh~ cua ca quan quin 1)' cua cApco thfunquyfn vf nganh ngh€ ho;rt d9ng;

D Oidy xac nh~n eua chfnh qllyfn dta phuong t~i nO'idfnghj mua di~n vf nganh nghf ho~t d9ng;

D Bin xac nh~n da thanh toan h~t nq;

D Bi€u d6 ph\! tir!.

""."" ngay.. "."." thcmg , nam"."" .Bp"'!D~N BEN MUA B~N

(Ky va ghi ro h9 ten)

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.~ : 7.j~

."'f, G 1G BAi

"c',' :ON::~ ; LIJ:( i SA\<~=

Ghi chit: Truang h9'P kh6ng co n19! !rong cac IO(Ii gi6y ter trenthi phili ,6 xae nh~n eua UBND phwng I x{i

xAc ~ C-gA UBND PHtrONG (X.A)TJ",rNOr Bl£ NGH]: MUA B~N

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Llfu j:

- Niu chlfa nh~n c11f(1cbat Cli' giay tir nao thl khang tlanh dau WlOI1lflC II

- Bilng k€ cang suat thiit bi se tllf(1Ckhe kIwi tfdpldin khtlo scit.

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CONG TY BIEN L1jC .BIEN LVC .

86 DT: .

Mall s8 02

CONG HoA xI HOI cm'JNGHiAmT NAMDQcl~p - Tv do - H~ phuc

GUY DE NGHl MDA B:q;N(phl;lc Vl;Im'?/c tlich sinh hO(it)

1.PMN DANG KY SU D1;JNGDD):NCVA KHACH HANG:D 'd" 1" (b')I:J(l1 lyn aong a: .86 chung minh thulh9 chdu: <lugc dp ngay thang nam.... t(li .

A ~., h . /. ill' th . nh' . nh""So awn t 0(11:. So yn 0(11 (llltm an: .Email... .. .. .86 hQdUng chung: 19 (danh sach dinh kem) .

./. . ).. h' -.Thea glay uy quyen ngay tang nam cua ., . kh' /. T' A h'Tal oan so : 11-1ngan ang: .

Dja chi lien h~: .Bia chi nai sU d\lllg ill~n: .Bb nghi mua ill~n 1 pha 0 ;3 pha 0 <l~su d\lllg m\lC dich chinh sinh hO(lt.Di~n nang su d\lllg cho m\lc dich mac (nSu cO):. .C6ng su~t dang kY sU d\lllg : kW.Tinh tr(lllg su d\lng <li~nhi~n t(li: Chua co di~n 0; Bang dUng cong to' chung 0

II. DON Yj:DIJi;NV;JC DA.~ NHf1NG GIAY TO:

o Hi?khdu thllong tn)

o 86 ~m tru dai h~n

o H9]J d6ng uy quy~n quan ly vaSlrd\lngnha.

o Quyet etjnhphan nha ddt

o H9'Pd6ng mua ban nM adt

TMi gianBen ban di~nnh~n au h6 saN' h' -gay .... t anff...... nam .....

DAI DIJ!;N BEN BAN DIJ!;N(Kyva ghi ro h9 ten)

o Hgp d6ng thue nha co xac nh~ Clla co quan co thfun quy~n

o Gidy chUngnh~n quy~n sa hUudilt (tren dilt Qaco nha a).o Gidy uy quy~ncua cac h(\ Slrdl,lngai~n chung

o Ban xac nh~n d1ithanh toan het nq

o Ban cam ket thanh toan h8t nq cua h(\ tach m6'i

........ , ngay thcing niim .DAI DIJ!;N BEN MUA D:IJ!;N

(Ky va ghi ro h9 ten)

Ghi eM: Trui7ng h9'P khong co m9t trong cac 109i gi6y ta trenthz'phaic6xac nhtjn cua UBNDphuong/xii

xAc NIL:\.N eVA UBND PHl10NG (XA)T~ Nor DE NGRJ MUA D:IJ!;N

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Mausa 03CONGTY Dl$N INc .

DJ$N L1,TC .

f)i~ntho<;Li: " .

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CONG HOA xA HOI COO NGHIA Vlt;:TNAM

Doc Hlp" TO' do ..Hanh phuc

Luu

oCONG TY BI$N L1,TC .

Bl$N L1,TC .

Di~ntho~i:

S5: .

CQNG HOA. xA HQI CHU NGHlA Vli;:TNAM

Doc Jap - TIT do ..Hanh phuc

Giao Till

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rIDEU HEN K:HAOSAT cAp BIEN.' .(Mifi ltin viii hai lien: 1lien giao khdch hi'mg va 1lien luu)

Kfnh gui:

Bja chi: ....

Ngay thang nam 20... , Bi~n l\fc da nh(in duvc denghj cua Quy IGlach hlmg.

Bi~n l\fc xin kfnh baa (ISQuy Idu'ichhang biet :

Vao hili gil)" ngay / /20 Bi~n h,rc se cu' nhiin

vien den IdlllOsat thiet kil. V1tyde ngh, Quy Ichachhang (ho~c nguiri dai

di~n dUQ'cuy quyen) co m~t tai dja diem mua di~n de ph6i hQ'pcung Bi~nl\l'cholm thitnh nhi~m V\1.

LUllY (nell'co): Be holm thi~n h6 SO',de nghi QlIYKH chu~n h, sAnnhli'ng. , . . 'J'" [glay to' can t Heu n m SatI:. .

(Mifi ztin viit hai Zien: 1 lien giao khtich hang va 1 lien hru)

Kfnh glri: .

Bja chi: .

Die.n IU.'C da nh(in dUQ'CdeNgay thang nam 20 .

ngh, , clla Quy Khiich hitng.

Bien luc xin kfnhMa de Quy lchach hitng biet :

Vaa h6i giiJ ngay / 120 Di~n h,rc se clI nhfu1

vien den lchao sat thi6t ke. V(ly de ngh, Quy Id,ach hitng (hoac nguiri dai

di~n du9'c uy quyen) co mat tai dia diem mua di~n de ph6i lwp cung Di~nh,rchoan thanh nhi(\mV\J.

Luu Y (neu co): De holm thi~n hi; SO',de ngh! Quy K1-T chu~n bi sAnnhG'ng,< A • th" hglay tv' can leu n U' sau: .

Xin l1'antrQngcam O'n!

xAc NHAN CVA KRACH HANG(kj va ghi r6 hr ten)

xAc NHAN CVA KHAcH lIANG(kj va ghi ro hr ten)

Ngay thting nam 20 .NGVOI VIET GrAy ~N(kj va ghi ro hr ten)

Xin tran trQng cam un!

Ngay thang nam 20 .NGVOI VIET orA Y ~N

(kj va ghi r6 hr ten)

, ' (j (!.,"',.',,'"

Ghi cluJ: MBu nay dO'ngthitnh s6. Milu nay dung cha cac truong hgp Idulch himg !chOng cO'di~n tha:;ti d~ lien l:;tc,SU: d,mg ca cha vi~,ctIm:cong to', nang cong suilt .....Vi d,l cach ghi milu rum san:

- Ngay thang nam 20 , Di~n I,rc cia nhiin ehrQ'cct~ngh] cilp diel1 1116iclla Quy Khach Mng.

- Ngay : thitng nam 20 , Dien h,rc da nhiin dngc ct6 ngh] thay cong to Quy Khach bimg.

- Ngay thiing narn 20 , Di~n h,rc dil nhiin dUQc d~ ngh] di chuy@n cong to Quy Khach hang.

CONG TY DI~N LlfC .DI~N q1e .

s6 BT: """."" " "" ..,,

CONG HoA XA HOI COO NGHIA VIET NAM. . ,ElQcl~p - TV do - H\lnh phUc

Maus804

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KET QUA KHAo SAT vA PHUONG AN cAp f)~NI. Thong ti.ll ban dflu:

Ten khach hang: " " " """" ,, "". SBT: " ..D' h' '. d ..•,'IlIa c 1 nm SU \illg Wyn: " " " ,""" , " .

M\J.c dich su d\J.ngdi~n: " " ..D\r ki€n cong su~t SDB: .

II. Phh khiio sat va giiii trinh phuong an cftp di~n:d. /.. A;" ". b0,{ ;1. Blem dau: C9t so: " " L9:" " Tr;;un len ap: " .

2. M\J.cdich su d\illg di~n: , " : , , .

3. Gia ban di~n : , " " : , , .

4. Cap dfuJdi~n xu6ng cong ta: (la tai san Cllangiinh di~n):

O D- • COL" .' L . ., d" hi' d".ua co san ap mOl: 0i1-1: tlet lyn: , c eu al. " ..

5. Cap dfuJ di~n til cong ta vao nM ho~c ph\! tai clla khiich Mng:

o KMch hang d~u ill 0 Thue dich V\l twn goi clla ngiinh di~n.

LOi1-i: " , ti€t di~n: " , chi@udai , ,.." ,,' .

(Niu Khach hcmg t,e chudn bi vat tu phia sau cong t(J'thi iM nghj Quf; Khtich hemg phai chu6n bi Vljt tu ilapl'mg cac tieu chudn kfi thuat, s6 IU971g nhu' trong bernkhCtosat, thdt ki at aam baa Van himh an toem JUDo{m?~. .6. LOi1-ih(lp cong ta: O l~p moi 0 da:co sful D thay th€ hQp0

(' hi - th h' h 'h' . I . h- " )............... " " " " can g ro ay t e c 0 may 9P va Olill 9P may cong ta .7. Cong ta di~n 10i1-i: "." , " ,,, ,, ,, .

8. Vi tri I~p di;ltcong ta: :BS danl bilo an toan, my quan, tllU~ 19'icho ben ban di~n ghi chi s6 vaben mua di~n ki@mtra chi s6 cong ta, hai ben th6a thU?n va th6ng nh~t l~p cong ta trong h(lp baov~, Quqctreo ti)i: """" " .. , ,"" ,,, ". : " " " .. " .

9. D\I kiSn ngay I~p Q~tcong ta va Icy HBMBB : "../. / " " " .

1O. Cac y ki€n tJ.Cfngi)i (n€u co): : " " " .11. Bang ke cong su~t cac thi€t bi dung di~n:

M1JCdich Ten C01O'g 86 86 ngay sir TMi gian T6ng f)i~n nang Tyl~S11d\lllg thi6! bi sua! hrqng d\mglthallg S11d\lllg cong 5U~! (kWhlngay) % ill\lC(kW) (gib/ngay) 511d1Jng dich sir

(kW) d\lllgdi~n

JJ AS8H

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TONG

- D~e tint 1.1 tlm%teong ngM eua thi~t bi 811 dvng Qi~n:.....

m. SO'dil oBi dav miic dien hIm ha th~:, , .. , , ..

SO'(f8 nay diing ilt minh hra, klti kltiio slit phiii ve thea thv:c ti

ATM

0,4 kV

C(lt 11- 191

KIf mua di~n

D;li di~n khach hang(Kyam va dongd~u)

Ngay ./. ./. .Nhan viell khiio sat

(Ky ten va ghi ro hQ ten)

Ngay ./. .I. .TP .KJNH DOANH TONG HQP

(K Y ten va ghi ro hQ ten)

Lu:u y: Mvc t7l1 ng(li klti cap ai?n dung al ghi cac trU:O'l!g It(fp khOng cap au:(J'cilif-n WI glti Iy dokhOng clip ilu:(J'Cilif-n.

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CONG TY: .BmNL1;JC:

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'" i Mau s8 05CONG HoA xA HOI COO NGHlA VIET NAM

BQcl~p - TV do - H\mh phuc

BANG mr TOAN VAT TU(DUNG TRaNG NOi BO)

Ten khach himg: SDT: .

....~

Thanh ti6n(d6ng)

-------

Bon gia(d6ng)

s6lugngthi~tk~

ChUngIO(ll

Bon vitinh

B6ng

------.+-.m

Danh m\lC

Dja chi nai su d\lng di~n: .

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_ I N"imh Clienah til' I......1.....:!:J:2E.~.~?..V.~.c:.2.l1:~.!':l:.(?.~~9.J)J:11!...~i.~.l1:).. g.~.i........ . ......? g?.l1:.!i..!<J..A~.~..~.i~r:t 9.~L....... . ..... } _9.:h.:ip..:.:.:.:.:.:.:.:.:.:..:.:.:.:.:AAM ..::.::.::::.:.::.::.::.1... I.:l.2 _ .

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I CgugII Khach himg dlin til'A V~t til'I Day d~u sau cong ta m

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...1. y1J.IX ..s.'l.: ..3.~.................................................... .. S.~.i... _ .5 Moe chan tre ham day caiB Nhan c6n" l~nalit1 Keo day sau cong ta (khong bao g6m B6ng/m

lien c6ng dllng ci)t) '.2 Lip xa da day sau cong to' (ho~c

cong sun)3 KMo sat lip ~t, thi~t l~pban ve ~u

nbi

TONG HOP Dtj ToAN:LV~tli~u: , : , .2 T' nhA

A. len an cong: , .3. V~n chuy6n (n€u co): .

1

4. Chi phi chung: .5. Chi phi khao sat, thi~tk~, nghi~m thu: .6. T6ng tien tnrO'cthll~: .8. Thll~GTGT: '" .9. T6ng cQng: , ,' .

Ngay .I.. , .. .!.. .Nhan vien l~p dJ! toan(Ky ten va ghi ro h9 ten)

Ngay .1. ./ .TP KH -KT - VT DUYJ)',T(Ky ten va ghi ro h9 ten)

Luu y: Danh nllj.c nely dung ttl tham khao, cac CtJng Iy J)L phdi xiiy d(rng chuflnchung cho tlO'nv! minh.

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CDTONG CONG TY D~N LljC MIEN BAc

CONGTYD~NLljC .Dll)'N LVC. .

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PI-H:EU XUAT RHO

Ngay l(ipphieu: ... ../. .... ./2014.," LLIen so: . uu: .

MausiJ 0686: .

HQ va ten nguai nh(in hang: Dja chi (b9 philn) ' .Ly do xu1lt leho: .Xu1lt t!li IdlO: " .

SIT Ma:VT Ten, nhan hi~u qui cach v(it tu DVT S6luc;rngDongia Thanh ti~n Tai Idlofm

Yeudu Thl,Ic xu1lt Nc;r C612345678910

T6ng c9ng (Bfulg s6): '" .T6ng gia tl"jXl11lt(b~ng chu): ' " .

Xl11lt,ngay thang nam 2014NOUaI LAP PHrEU PHl) TRAcH VAT TU NOUaI NI-IANI-JANG THO TRUONO DdN VI TIm I<JIO

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" • - v '" ,eCONG L DIJ!.NLyC .Di%nIVc: .

J Maus801aCQNG HOA xX HQI CHU NGHlA VIJ1;TNAr ,DQcl~p - TV' do - H\mh phUc

s6:, ,., J,., .. , . .. , ngily th{mg nam .

BIEN BAN TREO THAO, NGH~M THU VA BAN GIAOHE THONG DO DEM BIEN NANG 'Co-UNG CRO CONG TO DiN 1 PHA)

1. D\li di%nben ban Qi%n:Ong (Bil) , , , ChUcV1J •...•.... , .••..•..•...•.•. , ..•.•..•.•......•••.•...

Ong (Bil) , ChUcV1J •......•...•...••..•..•.•..•...•... , •..•.....• , ••..

Ong (Bil) , ChUcV1J .•.• , ....•.•...••.• , •.•. , .••....••. , •.•.. , •••... ".

2. D\li di~n ben mua di%o:Ong (Bil) , ChUcV1J ..•.•. , ••..••.••.. , •....•. , ..•..•.•.•..••..•......

Hai ben cung nhau chtmg ki6n vil xac nh?il vi~c treo thao va niem phong M th6ng do d6m di~n nang d6ph\ICVl,l vi~cmua bandi~n t\li:

Hom C9t. Tr\lm , , , .3. Ly do treo thao cong too:Thay djn.l:lky D ; Thay bilt thm'mg D; Phat tri6n mai D Thanh Iy D

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1. PRAN TREO, THAOThai gian treo, thao cong ta: , ,., , , , .Tinh tr\lllg hOmcong ta: , , , .. , , .Niem phong hOm cong to': s6 IUC)'Ilg Ky hi~u , , ,.Tinh tr\lllg .

......... , , , ,' .' , ".,." , .

.............. , , , , , ,., , .

ThOng so Cong to'thao CongtO' treoI Chi s6 congta

s6 ch6 t\lollo(li C. ta/nam .. . . . , . , .. . .. , .. .I ........... ./. . . . .. ....... .. ........... , ... ./ ............ .I, ... .. ... . .. ...SX

Dong di~n, di~n ap, CCX ..... ,., ..... A , 220V, CCX ...... .. ........... A , 220V, CCX .. .... .....- Tinh tr\lllgchi booc .......................................... .... " .............................. . .. .. .- s6 vien / Ky hi~u ......... .I. .............................. .......... ./..... , ... , .. .......... , ........- Tinh tr\lllgchi tai .. . ....... , .. . .... , ............... , ..... ...... .... .. .. .......... .......... .. ......- s6 vien / Ky hi~u . .. .. . . , . , .... .I ............ ............. ....... ./........ . ... , ........ . .... .. ... ........Hi~u l\fc ki~ll1djnh . . . . , . . .. ............... . . , ... ... ......... ...... . . . ........ . ... . . .... . .. .. .. . . .. . . .. . . ...- Tinh tr\lllgchi hOm ........................................ . ..... ............. .. . .. ..... .... .. .....s6 vien, kY hi~u .............. .1. ...... , ................. .... " . ....... .1 ......... ............ ....

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8

••• ._ • ••••• _ •• ._. • __ • _ ••••••••• _ •••••• • _ •••• _ ••• __ n •• _.' •••• _~ _

n. V~TTi1LApD~TKHACKEMTHEO.. . ,I- H9P cong tcr : 10?-l so m;mg ., .... ,). d"- Cap nh\lP chleu aI m

A. • . 01 h" I .- P to mat: c lec, 0\ll .

- Day nhi tM chibu did m

III. V~TTUTHUH61••• , •••• , ••••••••••••• , ••• , ••••••••••••• II •••• 0 ••••••••• , •••••••••••• , ••••••••••••• 0 •••••••••••••••••••••• , •• , ••••• II ••••••••••

........... .................... ............................................... ............ .....................................IV. NHUNG NIEM PRONG SADKHI RoAN THANH VIl);CLAP C6NG TO

Tinh t1'(lIlghO\lt dQng cua cong tcr va m\lch d~u day sau khi treo thaoScrd6 d~u day: .Tinh tr(lIlgho;tt dQng cua cong tcr: .. .. . . . . . . .. . .. . .., , , , , , . , , , , , ,

Nhihlg rliemphong khac: ... . . .. ........ .. .. . , , .., , , , , , , ..

V. NHUNG VAN BE PRAT SINH, XU LY, KIEN NGRI........................ , , , , , .... , , , " ,., , " " , " .

VI. BANGIAD QUAN LY1. Cac cong tcr thao 1'a(nSu co) cung v6i nhihlg niem phong do ben ban di~n thu h6i d6 quan Iy theo quy djnh.

2. Ban giao cho dQiquan 1ykhu y\TCva Ben mua di~n cimg quan Iy, bao v~ nguyen vyn toan bQh~ th5ng dodSm di~n, niem phong cfmg nbu M th5ng hQp cong to. M9i S\Ithay dbi cM quan khong co S\Tchung kiSn clla ~Ben mua va Ben ban di~n d6u dugc coi la vi ph\lm SlTd\mg di~n. .'{:

3. Ranh gio'i sa hUll tai san va quan ly v~n hanh: Tai san thuQCsa huu Cllaben nao thl ben do chill t1'achnhi~m ~~~.d~u tu x@,yd\Ing, v?il himh, sua chua, bao duang diun bim cac Mu chuk ky thu~t va quy djnh cua pMp lu~t. ),

4 C• .• k't th . t' I ' . . , . ,,",. ong Y1yC e uc an oan uc: glO ngay............................ -//-~.".

5. Bien bim dugc I~p thimh: ban, c~c ben th5ng nh~t kY xac nh?il. Dil giao kh:ftchhanghrugiii ban. .

(Ky, ghi 1'0h9 ten) BIH quan ly khu V1!C

(Ky, ghi 1'0h9 ten)

Ngtriri treo thao

(Ky, ghi ro h9 ten)

Ngtririniem phong

(Ky, ghi 1'0h9 ten)

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LImy: "

- Danh m!lc v(it ttf liip dijt khac kbn thea al tham khi'to, cac Cong ty phi'ti xay d!mg danh m!IC?lr'~clw dO'nvi minh, danh m!IC nelY nlu1m m!lc dich ph!lC v!l cong tric quy€t toan v(it til:. "

- M!lc v(1ttu:thu h8i ph!lc v!l vifc thu h8i v(1ttu:khi ldp aijt (cang to' dULY k~t, thtlo hOm 2 thay bc1nghom 4.....)

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CONG TYD~N LTJC .Di?n l\fc: .

86: J .

MJus807bCONG HOA xA HOI cHiJ NGHlA VIl):T NAM

Ilgc l~p - TV do - H\llJh phuc

, th' -............... , ngay ang nam .

1. Cong to';

()

BrEN BAN TREO THAo, NGHIJ);M THU vA BAN GIAO~ THONG DO DEM ml);N NANG(DUNG CRO CONG TO B:IBN TU)

1. D\li di~n Ben ban di~n:

Ong (ba) Ch(rc danh .Ong (ba) Chuc daoo .Ong (ba) Chuc danh .

2. f)\li di~n Ben mua di~n:

Ong (ba) ChUc danh .Cungnhau treo tMo va xac OO%nvi~c treo tMo h~ th6ng do d8m di~n nang mua ban giu-aben ban di~n va ben mua

1i~nt?-i: , , , , : , , "" , ,., , ... . . .. . . . . , , , , , . , , .3. Ly do treo thao: .

4. Thai gian treo, tMo: .

5. Niemphong hOm cong to'; S6 hIQng Ky hi~u .

TiOOtr~ng niem phong .

I. PRAN11IAo,TREO

Thong 86 CongtO'thao Cong to' treoHuu Cong Vo cong Huu cong Vo cong

Chi 86 T6ng - Giao

Chi 86 gioBT

Chi 86 giir CD.

=:hi86 gia TD

.- Chi 86 T6ng - Nh~n IChi 86 gia BT

Chi 86 gicrCD

Chi 86 gicrTD

Cong to' Thao Cong to'Treo

I ' . . h" ,( '- Chi taL Ky hi~u .......................... s6 vien ............Chi tm: Ky l~U.......................... So Vlen............Hi~u hrc ki@mdinh ....................... '" ............... Hi~u lirc killm dinh .........................................

. . K' h" ,( '- Chib' K'hi- ,( '-Cill booc: y l~U.......................... So vlen ......... ooc: Y ~u.......................... Sovlen .........Tlnh tr~ng:Chi tai .................. chI boac ................ Tlnh tJ.~ng:Chi tai .................. chi boac ................Tern c6ng quang ky hi~u ......... ...... ... s6 vien ....... Tern o6ng quang kYhi~u ............ S6 vien .............Chi c6ng quang kYhi~u ................... S6 vien ....... Chi c6ng quang kYhi~u ................... S6 vien .......

1

2. May biSn dong, may bign ap aa !trang.

Bbi chiSu bien bim kiSm ainh +Nhiln mac, abi chiSu h6 So'+ ghi n'en nhiln mac.

Tinh tr~ng:Tem ................ Chi C. quang ............... Tlnh tr~ng:Tem ................ Chi C. quarrg............. ,

............ KiSu ...... : ........ Nam SX ......... - -Sb chS t~a Sb chS t~a ............ KiSu ............... Nii.m SX ......... -Ring sb cang to' .................... CC xac ............... Ring sb cang to .. .................. CC xae. ..............Bi~n ap........... Dimg ai~n .. .. ...A T5.n8b ... .... , ... Bi~n ap ........... Dong ai~n . ...... A Tim sb ...........Sb limmilt ai~n ............. T.Gianmilt ai~n ..... ... . .... Sb l~nmilt ai~n ............. T.Glan milt di~n .............T.aiSin milt ai~n lim cubi cling ............................ .• •.• I' '.,T.alem mat al~n an CUOlcung ............................Sb l~n milt pha A ......... Thai gian ...................... SbiAn milt pha A ......... Thiri gian ......................Sb I~nmilt pha B ......... Thiri gian ... : .................. Sb I~nmilt pha B . ........ TMi gian ......................Sb IAnmilt pha C ......... ThO'igian ...................... S&l~n milt pha C . ........ Thai gian ......................Sb lim nguQ'cchi@ue.su1lt. ................................. Sb IAnnguQ'c chi@ucang su1lt.............................T. BiSm nguQ'cchiSu C.su1lt............................... T B" . h" '.. IelTInguqc C leu C.sual .. , ...... " ..... , ....... , ......Ty sb, sai sb TI,TU ail cld aat. ............................ ITysb, . '11 TU a- , .• ,<sal SO, a Cal Q~l., .•...........••. , , •.......•

Sblfin lap trinh .... ,.......................................... s'l' [".n'nho an ~P'l ...............................................",..' • , I' ,.

Th" ill' I' 'nh' ,.Thm alem I~p tnnh an eUOl...............................01 em ~p tn . Ian CUOl...............................

H~ s6 nhan CllR h~ thAne itl') (t~!'!'! H~ 30 lilian elia h9 th611guo a-Sm .. " ,......................... ..... , .... , ......... .... •ThOng s6 m(leh san khi trea. ---'~ThOng sb m(leh tmae khi thaa.

Thfr l\r pha ...................... Coscp....................... TM 1\1' pha ...................... Cascp.......................Ua.............. V, Ub ............... V, Uc ............... V Va.............. V, Ub ............. V, Vc ............... Vla .............. A, lb ............... A, Ie ............... A la .............. A, lb ............ .A, Ic ............... AUa Ia .............. , Vb Ib.............. UeIc ............... V Ua Ia.............. , Db Ib.............. UeIc ............... V

Ki~mtr::l ,t~ir."b.~b~!!gfui~tbj: , ' , , .

May biSn dong do IU'ang :

May bi€n ap do luang:

TI Thao TI Trea ~Fha A: No ............... Lo~i ............ Nam SX. . . . . .. PhaA: No ........... .... Lo;D............ Nam SX ... .... 1cilp cx ....... Ty sb biSn............... Sam ............ VA C1lpex ....... Ty sb bi@n............... Sam ............ VA ,.~rf'.'--- ,

"I __ :tJ.Fha B: No ............... Lo~i ...... ,..... Niim SX ........ Pha B: No ............... Lo~i ............ Narn SX ........eilp CX....... Ty s&biS11............... Sam ............ VA cilp CX....... Ty s6 bi~ll............... Sam ........... VAPhaC: No ............... Lo~i ............ Nii.mSX ........ Pha C: No ............... Loai ............ Nam SX ........e~p CX....... Iy s&biSn............... S6m ............ VA cilp CX ....... Ty 8b biS11............... Som ........... VAKy hi~\Jniem pllOng:....................................... Ky hi~u 11iemphong: .......................................Hi~u lIreki€m ainh:. ............ . ......... , ...... .... , .... Hi~u l~'ckiSm ajnh: .......... . . , .............. " . , .........

TU Thao TV TreoPha A: No ............... La(li ............ Niim SX ........ Pha A: No ............ .. Lo"i ....... .. ..Niim SX ... . ...c1lp ex ....... Ty sb bi€n ............... Sam ............ VA C~p CX ...... Ty sb bi~n . . , . . . ....... Sam ............ VA

2

Pha B: No ............... Lo~i. . ...... .. .Niim sx ........ Pha B: No ............... Lo~j ............ Nam SX ........

C~p CX ....... Ti' so bien ............... Sdm ............ VA C~p CX ....... Ti' s5 bi€n ............... Sdm ............ VA

Pha C: No ............... Lo~i ... : ........ Nam SX ........ PhaC: No ............... Lo~i ............ Nam SX ........

cip ex ....... Tjr s6 bi€n .............. Sdm ............ VA e~p ex ....... Tjr s6 bien ............... Sdm ............ VA

Ky hi~u niem phong: ....................................... Kyhi~ll niem phong: .......................................

Hi~ll IlfC ki€m dinh: ......................................... Hi~u 1\l'cki€m oinh: ..................... ...................

H~ s6 nhan clla h~ th6ng 00 06m . . "H~ so nMn ella h~ thong do dem .

II. V~T Ttr LAP D4,T KHAC I<:EMTIffiO

........................ , , ., , , , , , , , ,

III. V4,T TtrTHUHOI()

- Hi)p congtcY: lo~i s61u9ng .

- Cap nh(lp , .. , ehieu dai m

-Ap to mat: 01 chi€c, lo~i ., ., h" d"-Daynhl thu e len al .. , m

- TI : S5 luqng ehung lo~i.. .

- K,p cap , .. , .- Day dai hOm , .- Cac v(ll tu khae: .

••• ~ •••••••••••••••••••••••••••••••••••••••••••••••••••••••• 0 •••••••••••••••••• ~ ••••••••• , ••••••••••••••••••••• 0 •••••••••••••••••••••••••••

••••••••••••••• •••••••• ••••••••••• , ••••••••••••••••••••••••••••••••••••• 0 ••••••••••••••••••••• , ••••••••••••••••••••••••• , •••••••••••••••••

IV. r;1IfJ'NG vAN-DEFRAT SINH, KI:ENNGHf,XlJLY................................................ , .

.................... , ., .

VI. BAN GIAO QUAN LY

I. Cong ta eilng nhu' cae thi€t bi clla h~ th6ng do luang thaa 1'acling vo-i nhung niem phong ghi trang bien ban nay,do ben ban di~n giii o~ th\!Chi~n cae thu 1:\Jcgulin ly theo guy djnh.

2. Bau giao eho di)i quan ly klm V1ICva Ben mua di~n cill1gquan ly, bao v~ ngnyen v~n loan bi)M th5ng 00 d€mdi~l1,niem phong eilng nlm M th6ng Mp e6ng tao M9i S\T thay 06i cM quan kllong e6 s\! chlrng ki€n ella Ben mua vaBen ban oi~n d€u Guge eoi Ia vi plwlll su d\lng di~n.

3. RanIl gi6i sa hil'lltili san va qulm ly v(ln hanh: Tai sau thu9c s6' hQu eua ben nao tIll ben d6 chiu trach nhi~111dkuttl' xay d,rng, v(ln hanh, sua chua, bao duo'ng mm bao cac tieu ehuftn kji thu(lt va guy dinh eila philp lu(l!.

4 C' " k' th' 'I' ., ,. ong Vl,e el ue an toan ue glO " ..ngay " , .

5. Bien ban ouge I(lpthanh , bin, cae ben th6ng nh~t xac nh(ln. E/[ giao khaeh hilng luu giii ban.

D~ D~N BENMUAD~N

(Ky ten va d6ng d~u) B(Ji quan If khu y,!c

( Ky, gmr5 h9 ten)NguOi treo thao

( Ky, gill 1'5h9 ten)

Nguiri niem phong

(Ky, gill 1'5 h9 ten)

3

Llruy: .,

- Danh mflc v~t nr [lip a~t klulc kem theo ad tham khlLO,cac Cong ty phili xi1y d(mg dllnh mflc I7lly_cho aO'nvi minh, dllnh mflc nlly nham Ill//C dfch phflc vfl cong Me quylt tOlln v(it tu:,

-MflC v(it tu: thu hai thang kf. v~i tu: thu hai khi frip d(1t (cong to' clulY k?t, tluIo hom 2 thay banghom 4.... .) nh&m m(IC tlich quylt tOlln v~t tu',

..----.,'.~

4

.'

, CONGTYDIl);NL1)C .Bi~n!l;rc: .

C(lNG HOA XA H(lI CHU NGHlA VIJ!':r NAMDQc I~p - T\f do - H(lnh phuc

S5: .1 , . , th' -.................. , ngay ang nam , .

BIEN BAN TREO TIIAO, NGHIIJ;M THU vA BA.N GIAO.. HE THONG DO DEM BIEN NANG

(DUNG CHO CONG TO EJlEN 3 PHA)1. Dlj.i di?n ben ban di?n:

ang (Ba) ,', Chll'e \'\1 , , .. ,., , .

ang (B a). , , , , , Chll'e V\J .•.. , ..••.. ,.,., , ......•.......... , .

ang (B a) , , ChUe V\l ' ............•....•...................•

2. Dlj.i di?n ben mna di?n:

0ng (Ba) " , , ChUe V\l •••.........•.......•.....•..•... ,', .••••. " .

Hai ben cling nhan tilln himh vi~e treo thao va niem phong h~ th6ng do dllm di~n nang tai: . , ... . . .. ... . .. , , , , , , , , , , , ,

3. Ly do treo thao eong to,: , ,., ,., , .I. PH.AN TIIAO, TREO

ThOng s6 Cong to' thao Cong to' treoHfrn Cong Vo cong Hfrn eong Vo cong

Chi s6 c6ngto'

S6 ehll tao/1olj.iC. ........ ./ ...... / .......... .. ...... .I. ..... / ..........to'/nmn SX

Dong ai~n,ai~n ap ... " ..." ..... I .......... . .............. / ...........- Tinh trang chi b06c ..................... , ..... . , . . , . , . . .. . . . . . . . .. , , . . . ...- S6 vienl Ky hi~u ." ...{......... ,', ....... . .... .1. .....................- Tinh trang chi tai ... ;...................... . .................... , ........S6 vien / Ky hi~u ..... .1.. .................. . .... ./.................. , ...- Hi~l11\1'ckibm ajnh ........................... . .................. " ........CCX, TY sa tmySn .. . , ....... ./............. . .. , ....... ./................- Tinh trang chi hOm . , ...... , ............................ , .......... .... . . , . . . . . ... , ., .. . , . . . . . . . . , .. . ... . . . . . ., .. . . . ..I . s6 vien, kYhi~u .............. ./ ............... ,. ,............. .............. ./ . . . .... . . . . . . , . ..... . . . . . . . . . . . . . .

o

Thongs6 TI Thao TI TreoPhaA PhaB Pha C PhaA PhaB PhaC

s6 ch€ tao/nam SX IChUng 10aiTY s6 billnC~pCX, SamKy hi~u niem phongl-li~u I\rc ki&mainh

ThOng sa TU Thao TU TreoPhaA PhaB I PhaC PhaA PhaB PhaC

s6 ehll tao/nam SX I1

'.

-.-Chimg lc~iTy s6 bi@n

dpcx, SamKy hi~Llnie111phcngRieu hl'c ki6m ainh i. '. .

n. V.b.Tnl' LAP B~ T KHAC REM THEa

-H(ipcongtc': lc~i""" ' , s61u911g , ,'. , 1 " - '. Cap nh~p , c lleu da!. m

- Ap to illat: 01 chi6c, Ic~i " .. ", '. h" "- Day nh) thu "c leu da.!. ,,111

- K~p cap, " , , , "

- Day aai h0111.. , , .. , .. , .. , "., .. " " ,' '"- Cac v~ttLYkhac: ", , , ",,"

C)

m. V.b.TTl1THUROI

............................................................ , - .IV. T:I:NHTRANG NIEM PRONG TRl1dc KID 'IBAO

R~ s6 nhan (Tinh ili~n nang thilnh kWh): .. , .

Thill t:;llg ho:;tt Gong cUJ. cong to', m&y ti€l:L d0D.i1) ilia)' Ui~llUi~Ilap no iuong, sa do dau day:

.................. , , , , , . , , , , .., . , , ,

Thong s6 nO'dugc tmo'c khi tMc (n6u co) " " .

v. T:I:NHT~G NIEM PRONG SAU KID TREO

R~ s6 nhan (Tinh ili~n nang thimh kWh): " "

Tinh tr~ng hc~t a(ing clla cong to', may bi@ndong, may bi@nai~n ap dO'luo'ng, SO'd6 aiu day:

. . . . . . ... . . . .. . .. .. . .. . . . . .

VI. NRtrNG vAN B:E,pRA-r SINH,XlJ LY, laEN NGHI

............................................................. , .

VII - BAN GIAO QuAN LY

I. Cong to cung rum cae thi@tbi Clla h~ th6ng ao d6m di~n nang thao ra clmg cac niem phang (n@uco) dugc ~i di~n

ben ban di~n thu h6i va quan Iy thea quy dinh,

2. Ban giae chc a(Ji qUM Iy khu vt,rc va Ben mua di~n cimg quan Jy, bae v~ nguyen vyn tcim b(i h~ th6ng dO'ct@mcti~n,niem phang cung nlm M th6ng h(ip cong tao Moi sIr thay d6i eM quan khong eo S\L'ch(mg lci6n eua Ben mua va Ben bandi~n aen dugc cai ]a vi ph~ Sll'd\ll1gdi~n.

3, Ranh gio"iso.Mu tai sim va quan ly v;ln Mnh: Tai San thuQc so' hu'u Gllaben nac thi ben ao chju trach n1ri~ma&u tLL'xay d\mg, v(inhiln11,sll'a chua, bac duo'ng dam bac cae tieu chuin J...--y thu;lt va quy dinh cua phap lu~t.

4 C' "k' th. t' I' '. , h' •, cng Vl,C et uc an can uc: .. "." " "1510',, " .••.• "." .ngay ,," ,t ang" "" ..nam ",,"

5, Bien bimduge l;lp thimh: ." .. ". " '" ,bim, eac ben th6ng nhit leYxac nh~n, Da giac khaeh himg luu giu" . " ..ban.

(Ky, ghi r6 h9 ten) B(ii quan If khu Vl)'e

(Ky, ghi T6 .119 ten)NgrrOi tree thac

( Ky\ ghi r6 h9 ten)NguOi niem phcng

( Ky, gbi r6 h9 ten)

2

I :' --.-.-..-..--------.-.--.----.--~_.----:--_.-•..---_._-_.--- _._- _. -- --_._----_ .._----- ----- -------- -_._------------------ --' --- -_ .._._---_.

LU:ll y:- Danh mflC v~t tlr lap af!t klulc kern theo td tham khao, cac Cong ty pluii xay dr;:ngdanh mflc nay.

cho ao'n vi minh, danh mllc nc1ynh&m mflc etlchphllC Vfl cong tac quyit toan v~t tu:o

- MllC v~t tu: tllU hai th6ng k€ v~t tu:thu hai khi lap a~t (cong to' c1uiykf-t, thlio hOm 2 thay be1nghom 4.... ojnh&m m!IC tllch qllyft toan v~ttu:o

()

3

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. .\

-~

o

C3

••

."

Mausa OSa

HO sa :ICHACH HANG MUA DIl);N PHlJC VlJ l\'f9C BICH NGOAI SUill HO~T

Ten kha.ch himg:, ,," ,.,.,.,' .. ,""', ,',' , , , .

Dia chi su d\lng oi~n: , .. " , , .

.. . . . .. . . .. .. ... " , , , . . . . . . .. . .. . .Ma Khach hang: , , Ma ngimh ngh@: , , .

M\lc oieh su d\lng oi~n: , .

.. . . . , '" , '" , .I. HO sa MUA BIJ!:N GOM co:

1. Gi&yo@ngbj mua oi~n va cac gi&ytil' dn thi~t khac.

2. Phi~u h~n khao sat thi~t k~.

3. Ket qua khao sat va phuang an cdp oi~n.

4. Bimg d\l toan v~t ill.

5. Phieu xu&tkho.

6. Bien bim treo thao, nghi~m thu va bim giao M th6ng 00 oem oi~n nang.

7. H9P 06ng mua ban oien.

II. THOl GIAN

1. Ngay nh~n dan: " .

2 N' kh' . I' h ., .•.•. gay ao sat ~p p uang an cap ul"n: .

, N' d 't h ., Q"J. gay uy" p uang an cap l"n: .

4. Ngay thi cong, treo cong to va nghi~m thu ban giao: .

5. H9P d6ng mua ban di~n dugc th\lc hi~n til' ngay: .

6 N' . b' .h' h' , •. gay ma la g 1 C 1 SO cong to: .

7. Ngay ghi chi s6 cong to 19nthITnhit: .

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HO SO KIIACH HANG MUA DIJ);NPHQc VVMl}cDicH cHiNB SINH HO~.T

Ten khaeh himg: . .................................................

IY h' ,- d "'.via e 1 Su l,IngQJ~n: .

............................................................ , .

Mil.Khaeh hang: "', , Mil.nganh ngh6:, , .

M1,leitieh SlI dl,lng di~n: '" .. , ." , ~ , .

....................................................................................... .. , .

I. HO sa MUA DIl);N GOM co:1, Gi~y d6 nghj mua di~n va cae gif!y ta dn thigt khk Truong h91' KH xin tach cong to phaie6 them han ehl,lp h6a dan ti6n di~n ella thang tmae d6, y kign ella eM h91' dang eil Q~ di6uehinh sa hi;)dung di~n sau eong to eil, Ngu dung nha luai di~n la tai san ella KH phai e6 gif!ydang y ella eM tai san.

2. Phigu h~n khao sat thigt kg.

3. Kgt qua khao sat va phuong an eilp di~n.

4. Bang d\1 toan v~t tu.

5. Phigu xu~t kho.

6. Bien ban treo thao, ngill~m thu va ban giao h~ thang do dgm di~n nang.

7. Hqp dang mua ban di~n.

n. THOIGIAN

1. Ngay nh~n dm>: .

2. Ngay khao sat l~p plmang an ci\p di~n: .

3. Ngay duy~t phmmg an ci\p dien: .

4. Ngay thi cong, treo cong to va nghi~m thu ban giao: .

5. H9P dang mua ban di~n duqc th,rc hi~n ill ngay: .

6 N' 'b' h' h' A •. gay rna la g 1 C I so cong to: .

7. Ngay gill chi sa cong to lim thll' nhilt: .

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CQNGHOAxAHQICHUNGHlA VJ[$TNAM iDQc I~p - TI].' do - Hlimh phUc

MiIu sa 09

s6: ICVV/v Thi nghi?m VTTB cong trinh

................. , ngay thang nam 20

Kinh gui: Cong ty Bi~n h,IC B~c K:;m.

•

Mo ta cfmg trinh:

a) Ten cong trinh;

b) Bia diSm xay dvng;

c) Bang ke kh6i lUQ'llgthi@tbi dn thi nghi~m

ThOng tin d~ kY k~t hgp dBng:

1. H9 va ten khach hang :

2. C6 tn,I sa dang kYt:;ti:

3. Nguai d:;tidi~n:

4. ChUc danh:

5. S6 chUng minh nhan diinlH9 chiSu:

6. Bia chi lien l:;tc:Di~n tho:;ti:" ' ' ; Fax:

7. Ma s6 thu@

Noi nh{m:- Nhrr kinh giri;- Ltru: VT

; Email:

G!AMDOC

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Bang ke kh8i lmfng v~t tu

"-

STT Ten daub ml}c DVT S8Ghi chlilm;mg

1 Thf nghi~m May bi~n ap 3 pha < IMV A May

2 Thi nghi~m ti~p dia tr~m HT

3 Till nghi~m cap ll,rc4 ruQt SQ'i

4 Thi nghi~m Aptomat dong di~n <50A Cai •,

I5 Thi nghi~m AptomM dong di~n <150A Cai -------

6 Thi nghi~m Aptomat dong di~n <400A Cai

7 Till nghi~m Aptomat dong di~n <lOA Cai

8 Thi nghi~m ch6ng set van 35kV Cai

9 Till nghi~m ch6ng set van 35kV, K=0,8 Cai

10 Thi nghiem ch6ng set van ha th~ Cai. .

11 Thi nghi~m may bi~n dong Cai

12 Thi nghi~m may bi~n dong K=O,8 Cai

13 Thf nghi~m ampe met - AC Cai

14 Thi nghi~m von met - AC Cai

15 Till nghi~m cong ta 30ha Cai

16 Thf nghi~m du dao each Iy 35kV BQ

17 Till nghi~m c&uchi 35kV BQ

18 Thi nghi~m su VlID-35kV Qua

19 Till nghi~m su chu6i Polime Chu6i I I20 Thf nghi~m ti~p dia duang day VT

I

I. .'

•

Mau s810CQNGHOAxAHQlcmJNGHlA vq:TNAM

D(lc l~p - Tlf do - H~nh phuc

S6: ICVVlv Nghi?rn thu cong trinh.

................. , ngay thang nam 20

Kinh gui: Cong ty Di~n h,rcB~c K~.

Mo til cong trllllh:

a) Ten cong trinh;

b) Dia diSm xay d\ffig;

c) Bang ke h6 sa giao nh~

Thong tin d~ kY k€t I:J.qpd6ng:

1.H9 va ten khach hang :

2. C6 tn,Jsa dang IcYt~i:

3. Ngum d~i di~n:

4. ChUc danh:5. S6 chUngminh nhan danlH9 chiSu:

6.Dia chi lien l~c: Di~n tho~i: ; Fax:

7.Mil s6thu@

Nui nh{in:• Nhu kinh gfri;-LUll: VT

; Email:

GlAMDOC

DANH MVC TAl LI¥.U HO sa NGHI¥.M THU CONG TRiNHs1\

Danh ml)c h6 SO' sa ban Gbi chli1'1' Gbi cbli

I Phfrn h6 SO'thi~t k~

1 np h6 sa TKBVTC (thuyet minh) 2 g6c

2 T~p h6 sa TKBVTC (Bim vel 2 gac3 T~p h6 sa TKBVTC (D\I toan) 2 g6c

4 Ket qua thitm tra TKBVTC 2 gilc/sao chUngth\lc

5 Ket qua thitm tra D\I toan 2 sao

5 Quyet dinh phe duy~t TKBVTC - D\I toan 2 gac/sao chUngth\lc

6 Thaa thu~n dilu nbi 1 sao

n Ph5.n GPM-B

J H6 sa cAp dilt neu co (neu co) '2 gilc/sao chUngth\fc

J Phuong an b6i thuimg GPMB (neu co) 2 saoQD pM duy~t PA b6i thuerngGPMB -(neu co)

-- - -----_._-- ----3 2 g6c/sao chUng th~rc

2 Bien ban thbng nhilt vj trf di).tTBA 2 g6c!sao chimg thl,Ic

III Ph~n xay i~p

1 QD v/v pM duy~t ket qua l\Ia ehQn nhi th!i.uxay 2 gilc/sao chUngth\rc

2 Bien ban thuang thao hQ}Jd6ng 2 gilc/sao chUngth\fc

HQ}Jd6ng thi eong xay d\Ing gee/sao chUng thl!c--

3 2

4 Giay pMp thi eong 2 g6c/sao chUngth\fc---

Bien ban dinh vi, giao tim mbe va mi).th!i.ngxay gac/sao chtmg thl,Ic5 'd\rng 2

._----- --- -------. __ ._- ._----~ -6 K6 hO(lch bilOv~ moi truerng 2 sao

- --- ---g6c/~aochtmg tll\IC ---7 Thong hao v/v Chap 11Mnke hO(leh baa v~ MT 2

Phuong an tb chire thi eong va BPATLD------

8 2 sao-

gae9 Cae bien ban thi nghi~m 2

10 Ly hch thiet bi 2 Sao

11 BB thbng nhat diSu chlnh, bb sung thiet ke (neu 2 g6c/sao chUngth\fC

12QD v/v phS duy~t diSu chlnh bb sung TKBVTC-

2 gae/sao chUng thl,!CDT diSu chinh (neu co)

13 Cac BB nghi~m thu cong vi~c xay lip + giai dO(lIl 2 g6c/sao chUngth\lC

14BB nghi~m thu hoan thinh cong tdnh dS dua vao

2 g6c/sao chUngthucSlr d1J.ua

15 BB kiSm nghi~m v~t tu TBi dua vao su' d\lng 2 g5c/sao chung thgc

16 Bim ve hoan cong 2 gae/sao chUng thl)'c

17 Nh~t kYthi cong, nh~t IcYgiam sat 2 gee/sao chUng thl,fc

18 Baa cao giam sat thi eong 2 g6c!sao chUng th\Ic

,

'.

I ..'

•••••••••••• 0 ••••••••••••••••••

............................ ,...

Mau s8 11CQNG HOA xA HQI cHiT NGmA VJlJ);TNAM

DQc l?p - TV do - Hl.mil phUcV/v chingIcYd&unbi cong trinh di~n

Kinh gui : .

THONG TIN DANG KY DAu NO! eRO KHACH HANG SU DVNGmEN DAu NOI VA.OLU6l: mEN TRUNG AI>. .

I. THONG TIN CHUNG1. ThOng tin khach hang co nhll. cftu dlin nBia) Ten don vi c6 nhu cau dftu nbi:

b) C6 'tr\1 sa dang IcYt';li:c) Ngum d';li di~n!Nguai dugc uy quySn:

d) Chuc danh:d) sb chUng minh nhful dan/HQ chi@u:e) Dia chi lien I';lc:Di~n tho~: ; Fax: ; Email:

2. HB sa phlip IfCac tai li~u vS tu each phap nhful theo quy dinh cua pMp Iu~t.

3. Mo ta dl}' ana) D~ nghi dftu nbi: (mo til nhu cau dftu nbi)

b) Tendv an:c) Dia diSm xay dvng:d) I:rnh VVC hO';ltdQng/lo';li hinh san xuftt:d) Ngay dv ki@nd6ng di~n diSm dftu nbi:e) cftp di~n ap dv ki@ndftu nbi:

II. THONG TIN vE NHU CAU SU DVNG DrtN1. SB li~n vS di~n nang va cong snlit djnh mITCCong suftt su dl,lllg IOnnhftt: (kW)Di~n nang tieu thl,l!ngay/thang/nam: / /2. sa lien du bao nhn ch dien tai di~m dlin uBi. . . .

(kWh)

Phong, ban, ca nMn su dlmg: - 32- Nai dong ddu kdm soat .

Dangk)! Nam Nam thu2 Nam thu 3 Nam thu4 Nam thu 5su dl,lngdi~n hi~n t?iC6ng su&tl6n nh&t(kW)81m lU91lg di~ntrung binh nam(kWh)

- Khach hang phai cung c&p cac thong tin vS t6ng cong su&t l~p d?t cua cacthiSt bj di~n, chS dQ tieu th\1 di~n (ca, ngay lam vi~c va ngay nghi).

- Dbi v6i khach hang S11 d\1ng di~n san xu&t, kinh doanh, djch V\1 c6 TBArieng phai cung c~pcae thong tin vS BiSu d6 ph\l Uti ngay di6n hi1h1. ella naill

VilO v(ll hlmh (ho?c nam dV kiSn thay d6i d&unbi hi~n c6) va 04 nam tiSp theo.3. Yeu du v~ rnrrc do drr phOng

Dbi vai Khach hang slr d\Ulg di~n nh~n di~n tI\rc tiSp ill luai di~n phanph5i la khach hang quan tr9ng theo danh m\1c duqc UBND c&ptinh pM duy~t c6nhu cfLUnh?-n di~n ill hai ngu6n tra len dn neu r5 ngu6n dv phOng va cong su&tdV phOng yeu duo

4. D~e Hnh ph\! tiii va cae yen du khac (nSu eo)Chi tiSt vS d?c di6m day chuySn cong ngh~ cac Thanh phfrn ph\1 tai cua

Kh:ich hang slr d\Ulg di~n nMn di~n tI\l'c tiSp tty luai di~n phan phbi, trong d6d?c bi~t luu y cung dlp thOng tin vS cac ph\l tai c6 th6 gay ra clao etQng qua 5%tbng cong su&t clla Khach hang SLYd\!ng di~n nh~n di~n tI\YCtibp ttr lLrui cli~nphan phbi t?i di6m et&unbi va muc gay nh&p nhay (ti~n ap Clla cac ph\! tai et6.

. h' 0................. , ngay tang nam .Dh-I DI.JJ:NBEN MUA :BI~N

(Chi hp len, chUc danh, kj len va dong d6u)

'.

Phong ban, ca nhdn sir d,mg: - 33 .. j\lo"i dong ddu kidm s06/

Mflus612

•• 0••••••••••••••••••• 0'.' ••• 0.

••••••••••••••••••••••••••••••• 0

V/v cung dp thong tin ph\lc V\l

vi~c dau n6i cong trinh di~n

CONG HOA xA HOI cnu NGIDA VIET NAM. . .DQc I~p - TJ! do - H~nh phUc

THONG ']['INvE NHU cAu sir'Dl}NG DllN eVA cAe KRACHHANG sir Dl}NG 3f)~N eo TR4M RIENG IDAu NO][ v Ao LtrOIDlt.N

TRUNGAP

Thong tin ap d\lllg cho cac KMch hang S11 d\!ng di~n co tr\l-m rieng d~u n6iVaGluoo di~n trung ap, khong sa hfru nha may di~n, t6 may phat di~n bao g6m:

1. sa li~p.v~ di~n nang va cong SIU~tdjnh mITc

a) 85 li~u tieu thl} di~n nam dliu

_ B6i vai nhu cfru thay d6i dilu n6i hi~n co, KMch hang cung ciip cac thongtin v@ph\! tM di~n hi~n co t\l-idiSm dilu n6i, BiSu d6 ph\! tai ngay diSn hinh cuanam gful nhilt d6i vai kh,kh hang S11 d\!ng di~n san xuilt, kinh doanh, dich V\l cocong suilt SU: d\lllg cvc d\l-itir 40 kW tra len, trong do bao g6m cac s6li~u sau:

+ Cong suilt mc d\lllg va cong suilt phan khang nh?il tir luai di~n pharr ph6i;

+ Cong suilt tac d\!ng va cong suilt phan khang tv phat (nSu co).

_ B6i vai d@nghi dilu n6i mai, Khach hang phili cung cilp cac thong tin v@nhu cdu ph\! tai di~n t\l-i diSm dilu n6i bao g6m cong su~t cvc d\l-i, di~n nang vaBiSu d6 ph\! tai ngay diSn hinh cua nam VaG v?il hanh d6i vai khach hang S11

d\lllg di~n san xuilt, kinh doanh, dich V\l co cong suilt S11 d\lllg cvc d\l-i til 40 kWtra len, trong do baa g6m cac s6 li~u sau:

+ Cong suilt tac d\lllg va cong suilt phan khang nh?n tilluai di~n pharr ph6i;

+ Cong su~t tac d\!ng va cong su~t phan khang tv phat (nSu co).

b) DJ! bao nhu cliu di~n dl}' ki~n trong 5 nam ti~ptheo. - B6i vai d.@nght thay d6i d~u n?i hi~n co, KJ:ach hang d@nght thay d6i d~u

noi phai cung dip phl( tai di~n dv kien ,t\l-idiSm dau n6i, g6m cong su~t cvc d\l-i,di~n nang va Bieu do ph\! tai ngay dien hinh tUng nam cho 05 nam tiSp thea.

Cong suilt tac d\lllg:

Cong suilt phan khang:

Bi~n nang tieu th\!/ngay/thanginam:

2. S5 lieu drr bao nhu d.u dien tai di~m dh n5i. . . .

(MW)

(MVAr)

(kWh)

Trang do xac dinh r6 nhu du cong su~t tac d\!ng, phan khang nh~ til luai di~nphan ph6i va tJ,rphat;

- D6i vai dS nght d~u n6i mai, Khach hang dS nghi d~u n6i mai phai cungdp nhfrng thong tin dJ,rbaa nhu du di~n chi tiih, baa g6m cong su~t CJ,rCd~i, di~nnang va BiSu d6 ph\! tai ngay diSn hinh tUng nam cha 05 nam ti@pthea til ngayv~ chinh thuc. Trang do xac dinh r6 nhu c&u cong su&t tac d\!ng, phan khangnh~n tu luai di~n phan ph6i va tl,Tphat.

e) Cae s8 li~u lien quan tOi dt! bao lllhu dn di~n (n@uco): baa g6m cac s6li~u lien quan tai tieu th\! di~n nhu san luqng san phk, su~t tieu haa di~n chamQt don vi san ph~m, ch@dQtieu th\! di~n (ca, ngay lam vi~c va ngay nghi), t6ngcong su~t l~p d?t clla thi@tbi di~n va cong su~t CJ,rCd~i,M s6 cong suk ..

3. Yen e~n v~mli'e0t? dl)' phongD6i vai Khach hang su d\!ng di~n nh~n di~n trJ,rcti@ptu luai di~n phan ph6i'

la khach hang quan tr9ng thea danh m\!c duqc UBND c~p tinh phe duy~t co nhu_~~~~_L~_ .:J-':~_+,~~L ....: _ ...•..~~~~ +_..!.. 1~_ .•?~., ~t:" ~L1 ~.~.\..Ia.ul.ul~J.l Ulyll '-I.l llaJ. HbUVll UV lClll, yc:;u vau \.Ill.! l.V.

- Ngu6n dJ,rphOng;

- Cong su~t dJ,rphOng yeu du (MW va MVAr).4. D~c tinb phI} tai (nSn co)Chi ti@tvS d?c diSm day chuySn cong ngh~ cac thanh ph&n ph\! tai clla

Khach hang sir d1,lIlgdi~n nh~ di~n trJ,rcti@ptu luai di~ri phan ph6i, trang do d?cbi~t luu y cung dp thong tin vS cac ph!,!tai co th€ gay ra daa dQng qua 5% t6ngeong su~t ella Kh:kh hang SiT d\lilg di~n nh~n di~n trJ,rcti@ptlr lum di~n phan ph6i-1-..,: ..=t:~ A~H ...-.P.: ..•,~ ..•...•...•~"'Vro ...-..g ..• , ..•...•'hg .•.•.•.•...•h,.!; ..•.•A.~g.,.." .; •...• ,.....;•.••... roo!..,", ..•...,"l--" ..• 4-,z,: A,(L~U UJ.'-'.U.l U<:I.LL.l.LV.1 v C:L.L1.lU\..I /Sa J .lll.l('Ll:-" U.J.H.Ly "-L.ly.l.l ('LP VUU vu"", l:-'.lJ.i;-i- Lu.,i '-.Lv.

5.Cac yell cfiu kh1ic co lien qmm t6"ipilJ.l tili di~n"................ , ngay thang nam 20 .

D~I DI~N BENMUAD~N(Ghi hI;!ten, cMc danh, kY ten va dong ddu)

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CQNG HOA xA m;n CHU NGHIA Vl~T NAMDgc n~p - TlJ do - H~nhphUc

~ ? ? ,

BIEN BAN KHAO SATV/v thBng nhlit rnQt s8 DQidung lien quan d~n l~p thOa thu~n dh nBi

Cong trinh .

Hom nay, ngayg6m:

/ / t . h' t", :;tl c ung 01

1. J9~i di~n CTDLmL :

0ng. 00 •••••••••• 00 •• 00 •••••••••• chuc V\l: .00 •••••••••••• 00 •••••••••• 00 ••••••••••

~ h'Ong c uc V\l: 00 •••••••••••••••••••••••••••••• 00 ••

2. D~i di~n khach himg mua di~n :

'h' ..<~Ong 00 ooC uc V\l: 00....... ••••••• ••••••••••••••••••• •

Ong 00.00 ••••••••••••• 00 ••••• chuc V\l: 00 •••••• 00 ••••••

3. NQi dung:

Sau khi khaG sat thvc t€ lum di~n khu V\Ic, hai ben d6ng y thOa thu~ cacn9i dung dSphl,lcV\lvi~c dfiu n6i cong trinh di~n nhu sau:

. ill' , d ., .1. Ella em su l,lngdl~m: .

2. Ml,lc dich su dl,lllgdi~n: .

3. Nhu cfiu cong sufit va thai gian su dl,lng:

Nhu du cong sufit kW.

Thai gian su dl,lllg:Thang nam .

4. Kha nang d.p di~n cua lu6'i di~n khu V\ICcho khach hang.

Ten tr:;unBA: , cong sufit TBA MYA

Ten 19xufit tuy€n cfip di~n cho khach hang: .

T. ~td" , ~t t ~ IIe Iyn cap xua uyen: max .

Lucri di~n khu VVC co du kha nang c~p di~n cho khach hang theo cong su~tdang kYo

5. Di€m d~u n6i cho cong trinh:

5.1. Vi tri di€m d~u n6i: .

5.2. Dv kiSn duemg day trung ap khach hang phai xay dvng mai d€ ph\lc V\l d~un6i: Day tiSt di~n chi@udai dV kiSn m.

Bien ban nay duqc l~p thanh 3 ban, co gia tri nhu nhau ben ban di~n gift 02ban, khach hang gifr.0 1 ban va la ca sa dS CTDL/DL l~p phuong an c~pdi~n, khach hang chuful bi cong tac thi~t k~, d~u tu cong trinh di~n.

D~IDI~NerroL

••••••••• 0 •••••••••••••••••••••

................................

MJus614CQNG BOA xA HQI cHiJ NGHiA VI¥T NAM

IDi}cn~p- TJ! do - Hlimh phu!:

THOA THUAN DAuNO! VA cAc YED CAD KY THUAl' co BANGrUA (DON '-1 PHAN PHOI Dl$N) VA ... ( TEN KRAcH:HANG DE

NG~DAUN6I)So:

_ Can cD:ThOng tu s6 ./ ITT-BCT ngay thing nam cuaB(\ twang B(\ Cong Thuong ban himh Quy djnh h~ th6ng di~n phan ph6i;

_ Gin cD:Quy~t djnh s6 832/QD-EVN ngay 01 thing 9 nam 2015 vS vi~csua d6i, b6 sung B(\ Quy trinh kinh doanh di~n nang ap d1,1ngtrong np doanDi~n Igc Qu6c gia Vi~t Nam;

_ Can cD:don dS nghi d&un6i ngay ... thang ... nam ..... cua [ten khachhang d~ nghf tldu niJi}glii [Don vf phi'mph8i di?n};

_ Can cD:h6 sa dS nghi d~u n6i cua [ten khach hang d~ nghf ddu} gui [Donvf phdn ph6i di?n} ngay ... thang ... nam .... ;

_ Can cD:vaGbien ban khfw sat Vlv th6ng nh~t ill(\t s6 n(\i dung lien quand€n I~p tMa thu~ d~u n6i cong trinh ;

- Can cD:vaGyeu c~u va khii nang cung c~p dich V\l pharr ph6i di~n,Hom nay, ngay ... thing ... nam ... t~i ... , chUng toi g6m:Ben A: [Boonvi phan ph8i di~nlD~i di~n Ia: .ChD:CV\l: .Dia chi: .Di~n tho~i: ; Fax: .Tai khoan s6: .Mli s6 thu€: .Ben B: [Ten khach hang d~ nghi dliu nailD~i di~n Ia: .Chuc V\l: .Dia chi: .Di~n tho~i: ; Fax: .Tai khoan s6: .Mli s6 thu~: .Hai ben d6ng y kYk~t TMa thu~n d~u n6i va cac yeu du leY thu~t v6"icac

n(\i dung sau:Di~u 1. [Ten Don vf pMn ph6i di?n} th6ng nh~t phuong an d~u n6i nha

may di~n [Ten nha may] ella [ten khach hang ad nghi a6u n6i} vao luai di~nphful ph8i, q.l th~ nhu sau:

1. Quy rna cang trinha) Di~m d~u: .b) Di~m cu8i: .c) dp di~n ap d~u n8i: .d) Day dfuJ.: S8 m?ch: .e) KSt du: .g) ChS dQv~n hanh: .h) Chi@u dai tuySn: .2. Ranh giai do d~mRanh gi6i do dSm mua ban di~n nang l~p d~t t?i vi tri .

3. Ranh gi6i d~u tu

4. Yeu c&uv@giai phap ley thu~t4.1 DuOng day trung thS- Day d~n: .

B' ,- ao vy: .

- Xa: .- Cach di~n: .

r>!::.l-.- yl .

- Mong cQt: .- TiSp dia: .C. , ; kh' (; ~Iac yeu cau ac neu COl _ _ _ .

4.2. Tr?m biSn ap- Vi tri d~t: .- Tieu chuful di~n ap: .- Kieu tr?ID: .- C6ng su~t: .- KSt c~u tr?m: .

+ CQt di~n: .+ M6ng CQt: .+ Xa tr?m: .+ Cach di~n: .

- Bao v~:+ Phia tmng thS: : .+ Phia h\l thS: .

:

- Ti~p dta tr\lm: .- Cap: .T' d" h '- u len a ap: .. ...........................................................................................................................C' , ) kh' (,( ~\ac yeu cau ac neu co; .4.3. H~ th6ng do d~m- Congta:

+K" 1 . C' d" ,leu, 0\11: ...•.......•..........•...............•.•. ap [tenap: .+Vi tri l~p diit: .. .+M' b" d' d"ay len ong lten: .+M' b" d" ,ay len ltenap: .

C' , ) kh' (,( ~lacyeu cau ac neu co; .4.4 T\l bU:Ki6u vt tri l~p di;it: .C~p di~n ap: Baa v~ .4.5. Yeu du vS n6i d~t5. Yeu c~u vS M s6 cong su~tBen B co trach nhi~m duy tri h~ s6 cong sudt (coup) tc;livi tri ai;itthiit bt ao

aim ai~n nang theo hr;p a6ng mua ban ai~n khOng nh6 han 0,9.6. Yeu cdu vi can bang pha: Trong chi ai?lam vit%cbinh thur'rng,ben B phai

aam baa thiit hi cila minh khong gay ra thanh ph6.n thu t1:'nghich cila ait%nappha t(1iaidm adu n6i qua 5% ai~n ap danh atnh.

7. Yeu cdu vi song hai:a) Gia tri ClfCag.icha pMp da t6ng ai?biin dg.ng song hai dong ai~n aur;c

quy ainh nhu sau:- D6i voi adu n6i co cong sudt nh6 han 50kW: gia trt dong ait%ncila song

hai brjccaa khOng vur;t qua 20% dong ait%nph,?!tai;_D6i voi adu n8i co cong sudt tic50kW tro-len: gia tri dong ait%ncila song

hai brjccao khOng vur;t qua 12% dong ait%nph,?!tai.b) T6ng ai?biin dg.ngsong hai ao tg.iaiim adu n6i aur;c ao aim theo tieu

chu6n lEClOOO-4-7, keo dai it nhdt24 gi!'Jvm chu kY 10 philt 1 16.n.Ch(lm nhdtsau (06) thang kd tic tMi aidm phat hit%nthiit hi cila khach hang khong ag.taur;cgia trt quy ainh tg.i m,?!ca Didu nay, ben B phdi ap d,?!ngcac bi~n phap khacph?tc ad ag.tau(!c t6ng ai?biin dg.ngsong hai trang gioi hg.ncho phep.

8. Yeu cdu vi nhdp nhfty ai~n ap: Tg.iaidm adu n6i, muc nh6p nhay nganhg.n (Pst) khOng au(!c vur;t qua 0,9 va muc nhdp nhriy dai hg.n (PIt) khOng a~'9'Cvu(!t qua 0,7 din cu lieu chu6n lEClOOO-3-7.

9. Gia trt dong ngan mg.ch Ion nhdt cho phep:Dong ngan mg.ch Ibn nhatcha phep tg.iaidm adu n6i khOngvu.(!tqua 25kA.

5. Cac h6 sa kern theo- Tai li~u dinh kern: s6 1, s62, s6 3, s6 4, s6 5

Di~u2. Tnich nhi~m cua cac ben1. Trach nhi~m cua Ben A[Ten Don vi phdn pht3i ai?n} co trach nhi~m d~u tu xay dvng luai di~n pharr

ph6i d~ k@tn6i vai luai di~n clla [ten khtich himg co nhu c6u a6u nt3i} theo dungranh giai d~u tu xay d\lfig quy dinh t~i khoan 3 Di~u 1 clla ThOa thu~n d~u n6inay.

2. Trach nhi~m cua Ben Ba) [Ten khtich himg at nghi a6u n6i] co trach nhi~rn d~u tu xay dvng luai

di~n pharr ph6i clla rninh d@k~t nbi vai luai di~n Clla[ten aon vi phdn ph6i ai?n}theo dung ranh giai d~u tu xay dvng quy dinh t~i khoan 3 Di€u 1 clla ThOa thu~d~u n6i nay.

~ ,. r" ,.

b) [Te."rykhcch hang ae nghj tl6.u noi} C3.:."'TI ket qU&"t} ly} v{L.""1 h?rrrh h~ thongdi~n ella mlnh tuarr tM Quy dinh h~ th6ng di~n phan ph6i va cac quy dinh kbacco lien quan.

J!)i~u3. Ngay oftu ubiNgay dong di~n dVki~n la engay, thang, nam).Di~u 4. Chi phi ki~m tra va thii' nghi~m bB sungChi phi ki@rntra va thu nghi~m b6 sung trong tmemg hgp quy djnh t~i

ThOngtu Quy djnh h~ th6ng di~n phan ph6i va duQ'chai ben th6ng nh~t nhu sau:1. .

Di~u 5. Cae thOa thu~n kh:ic1. Trong qua trinh v~ hanh, lilli co s\r thay d6i hay sua chua lien quan tai

di@md~u nbi ho~c thi~t bi d~u nbi, ben co thay d6i phai thong baa b~ng van banva gui cac tal li~u ky thu~t lien quan tai ben kia; so~ thao Ph\l h,ICThOa thu~nd~unbi d~ ca hai ben ky lam tai li~u kern theo Thoa thu~ d~u nbi va cac yeu duky thu~t nay.

2 .3 .Di~u 6. Tach o~u ubi1. Ben B co quy~n d€ nghi tach d~u nbi tv nguy~n trong cac tmemg hgp C\l

th@va pMi tuarr tM cac quy djnh co lien quan t~ thOng tu quy dinh h~ thbngdi~n pharr phbi do Bc?Cong Thuang ban hanh.

2. Ben A co quy€n b~t buc?ctrong cac wang hgp theo quy djnh t~i thOng tuquy dinh h~ thbng di~n pharr phbi do Bc?Cong Thuang ban hanh.

Di~U17. Hi?lll 1U}'c thi Mnh

D:;tidi~n Ben A(Ten, chrrc dauh)

,

1. ThOa thu~n diu n5i va cae yeu e~u kY thu~t nay co hi~u h,rek@tir ngaykyo Hai ben co traeh nhi~m Min tM cae th6a thu~ nay khi thiSt kS, thi eongeong trinh di~n eua mdi ben.

2. Thai hsm co hi~u h,re eila ThOa thu~n diu n5i va cae yeu e~u kYthu~t: .

3. ThOa thu~ diu n5i va cae yeu du kY thu~t nay dUq'e lam thilnh 05 banco gia tri nhu nhau, mdi ben giu 02 bin va 01 bin gui tai dp di~u de>co quy~ndi~u khi@n.l.

D:;tidi~n Ben B(Ten, chuc danh)

Ghi chu: Phtm in nghieng tily thea quy ma va tfnh chat cong trinh tJi?nco thi xemxet bOqua ntu khOng can thilt.

sb: IBB-

Maus815CONG HOA xA HOI CHI) NGIDA VIET NAM. . .

!!Qc I~p - Tu do - JEI<lnh phUc................ , ngay ..... thcing..... nam 20 .....

,., '" - --BIEN BAN NGHIEM THU KY TlHUAT. .Cong trinh: .

Hom nay, 1uc gia phut, ngay thang nam .I. THANH PHA.N:1. D~i di~n cM diu ill:

+ ang ( ba) : Chue Vl,l: .

2. D~i di~n dan vi thi eong: .+ ang (ba) Chuc

Vl,l: .

+ ang ( ba) Chue Vl,l: .

n. NQ! DUNG:

• "A • A .J.. k;'3. D~I dl~n dan Vl tu van thIet e: .+ ang ( ba) Chuc Vl,l: .4. D~i di~n dan vi QLVH: _

+ ang (hi) Chue Vl,l:.................................. ""~.5. D~i di~n ['I

.:G 1

Tren ca sa xem xet cae h6 sa, tai li~u lien quan va ki@mtra th\IC t@hi~ntruang eac h~g m~e eong trinh. HQi d6ng nghi~m thu th5ng nhih l~p bien bang6m cac nQi dung sau:1. PhAn h8 sO' cong trinh di~n g8m co:- H6 sa thi@tk@va d\I toan- Phuang an c€tpdi~n, thOa thu~ thi@tk@- Phe duy~t thi@tk@ky thu~t va tang d\I toan- Ban ve hoan cong- Bien ban nghi~m thu kh5i lugng giua cM d~u tu va nM th~u- Cae phi@uxu€ttxuang v~t tu, thi@tbi2. Thai gian xay d\Illg cong trinh:

C' t inh d hi' . ;.ong r ugc t cong theo d\I an so: .B .. J. J..an V) thiet ke: .N . kh" , N . h . th~_1.. .gay 01 eong: gay oan i:Ulll ••••••.•..•.•.••.••.•.•.•.•••.

3.N9i dung nghi~m thu:

D Khong d\l-t

3.1. Ph~n chrll'l1g day tR'en khong:D(lc diSm d&un6i duang day:C<)td&un6i: TuySn: .D" • th." k" kV D' A • A h~-l.. leVlyn ap let e: lyn ap v;;tn CUlll: .•.....•.••••••..

Phfln DDK: + Chi@udiJ.i: met + Lo;;tiday d&n: .Danh gia ch&tlugng thi cong: D D;;tt D Khong d;;ttPhful cap ngflm: Chi@UdiJ.i: met, Lo;;tiday d&n: .Danh gia ch&tlugng thi cong: D D;;tt D Khong d;;ttXiJ.LO\l-ix8.!S6lugng: .Danh gia ch:1tlugng thi cong: D D;;tt D Khong d;;ttCach di~n:Danh gia ch:1tlugng thi cong: D D;;tt D Khong d;;tt

- Lo;;ticap Chi@udiJ.i .TiSt di~n .- PhiSu thi nghi~m cap luc: DD;;tt D Khong d;;tt

, . D- Cach di~n : Kiem tra bang M.Q - , D;;ttHanh lang Imyi di~n:••••••••••••••••••••••••••••• e •••• '" ••••••••••• e e •• eo 0 •• e •••••••••••••••••• o ••••••••••••••••••• o ••••••••••• e •••••••••••• 00 •••••••••••••••• 0 ••

Khoang cach giao cheo giila DDK, veri cac tuySn duemg day h;;tthS, cap thOngtin:

Nhilng t6n t;;tiva bien phap kh~c phvc:.......................... " - .KSt IU?nphful duangday: .3.2. Phh thiSt hi cao thS, vo tr?m, tiSp dia trl;lm:Dao cach ly lo;;ti:du chi t1! roi IOl;li: sa SX NrrO'cSX:Dong djnh muc cflu chi: A, Dong c~t ng~t m~ch kADong chay djnh muc cua day chi: A, Tern thi nghi~m: 0 C6 Khong 0Thu loi van IOl;li: S6 SX: NrrO'cSx:- Trj s6 dong set Ian OO:1t:10 1<...!\.,Tern thi nghi~m: 0 C6 0 Kh6ng- Trj s6 cach di~n phfln cao thS (Dao cach ly dt, chi cao thi dt)

- Pha A - B = MD, Pha B - C = MQ, Pha C - A = MD.- Pha A - 0 = MQ, Pha B - 0 = MD,Pha C - 0 = MQ.

TiSp dja tr\l-ID:G6m C9C L , dai IJ1Jc9c lien leSt v6i OOaub&ng s~t d~tx

•

KiSm tra di~n tra ti@pdia tr\lm: Rtd = 0 , 0 D\lt 0 Kh6ng d\ltH~ xa tr\lm: 0 Dung thi@tk@ 0 Kh6ng dung thi@tk@Cac day ti@pdia n6i cac xa vai nhau va vai ngQn cQt,vai day dong til xa xu6ngm\lllg lum ti@pdia co ch~c ch~n kh6ng: 0 Co 0 Kh6ngKhoang cach pha d~t nho nh~t: mm 0 D\lt 0 Khong d\ltK@tlu~n:........................................................................................

.~i

oo

KhongDang

m m, 0 D\lt

mm,

NuO'e SX:

MOMQ

DC.

A

/

MQanhi~t d9

3.3.Phh tqm bi~nap:Dung hrQng: , Hang SX:Di~n ap dinh muc (cao/ h\l) :Dong dinh muc: Cao ap A - H\l apCo m~y n~c phan ap: n~c.S6 SX ghi tren may va tren phi@uthi nghi~m: 0 Trimg nhau 0 Khong trimgMay bi@nap co binh thO'khong: 0 Co 0 Kh6ng coTinh tr\lllg h\lt hUt fun: 0 Co 0 Kh6ngCo mang d~u a binh thO'khong: 0 Co 0 KhongTinh tr\lllg ri d~u gioang miittmay, ty su, binh d~u phl,!:0 Co 0Cac van a canh tan nhi~t, binh dau ph1,!(khOng co): 0 Dang rna 0dong Tinh tr\lllg va may: 0 Binh thuemg 0 Han IiTi@pdia va may b~t co ch~c chk kh6ng: 0 Co 0 khOngKiSm tra cach di~n J'v1BA:

Rcd cao / h\l =

Rcd cao/vo =Red h~/v6 =

Do bfulgMO:H9P ch1,!psu O,4kV :Khoang cach gk nh~t t\.rhQp d@nty su cao ap:

Khong d\ltKhoang cach gk nh~t t\.rhQp d@nty S11 h\l ap:

Khong d\ltK@tMn:........................................................................................

3.4 PhAn cae thi~t hi do d~m:3.4.1 Do d~m: 0 Cao th@

a. May bi@ndong di~n:- KiSu:- S6 No Thi@tbi:

o H\l th@

S6 SX

•

- £)i~n ap dinh muc:- Ti s6 biSn:- C~p chinh xac:- Cong su~t dinh muc:- Hang san xu~t:- Tern thi nghi~m:- Gi~y chUng nh~n ki@mdinh:- Khoflllg cach pha-pha:- Trinh tr~lllgl~p d(1t:

b. May biSn di~n ap:- Ki@u:- 86 No ThiSt bi:

363X

- iJI~ll ap tJ:jnh mlre:- Ti s6 biSn:- dp chinh xac:- Cong su~t dinh muc:- Hang san xu:lt:- Tern thi nghi~m:- Gi~y chUng nh~ ki@m(tinh:- Kho3JDg deb ph:'l-ph:'l:

o Kh6ng

MQ.MQ Pha C-A =,

- Trinh tr~lllgI~p d(it:KSt lu~ : .

3.4.3Cap tlmg, til h? th~, lip to mat:Cap T6ng ttl m(it l\1BA dSn Ap t6 mat: Lo:;tiTri s6 cach di~n cap t6ng: (Ap t6 mat dang dt)PhaA-B : = MQ, Pha B - CPha AO=BO= CO = M12.Do bfuIgM 12- V, a nhi~t dQ: 0 CAt to mat t6ng: ChUng 10:;ti: A Nuac san xuk86 8X tren thiSt bi va phiSu TN c6 trimg nhau khong: 0 C6 0 KhongTern thi nghi~m: 0 C6 0 Kh6ngap to mat c61~p d(it t~m ngan cach gifra cac pha khong: 0 C6Tinh tr:;tngl~p d(it:Thanh eai, thanh cai 0, 4kV da bQcbang cach di~n : OC6 0 KhongKhoang each Pha - Pha c6 dam baa thea quy ph:;tmkh6ng: 0 C6 0 Khong

, , ,(>7nmm "'o-z'"0'; /'0 mnf ca'c.7,z "";;M '> 77 M_M_ -1:()-' •. ;;., 7.'-.2,. _ ',1. U ~.~_ 1.1.", - ~'-'" ~ fA, ~ •..•..........tI,,<-.,. •• r [{"'..cIt.:=- I I IfHfL l,...•• I. VUI. f\.!J.fllJll.O' f.f7f.YI k.rJrJYlu KYlI/• '. J • - - •••• --.0 ---- .. '-'--'."b .... _W/

•

DS ap to mat c616t lap cach di~n mong d~ dam bao khoang cach, cach di~n:Pha - d~t.: D C6 0 Khong

Tri s6 each di~n til O,4kV: (at t6 mat t6ng, eae c6u dao xu6t tuyin aang dt)Pha A - B = MO, Pha B - C = MQ, Pha C - A = MQPha AO =BO = CO = MODo bing M 0 - V 6'nhi~t d9 0 Cdu dao xu~t tuySn 19 1:ChUng 10\1i A, Hang SX Nuac Sx:Tinh tr~g l~p d~t:du dao xu~t tuySn 192:Chung 10\ll A, Hang SX Nuac Sx:Tinh tr~g l~p d~t:Tinh tr~g l~p d~t thiSt bi do dSm va cac tan t\li khac:KSt lu~n:•••••••••••••••••••••••• 0 •••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

4. Cae tan t{li- kiin nghj:............................................................ ,-, -, .

5.Kit lu{in eila hri dang nghifm thu:

Bien ban l~p xong luc gia cung ngay va dugc cac thil.nhvien th6ng nh5.tkY ten.

HOI :DONGNGm::EM THU KY xAe NHAN

.Ol

.T

.i.'cONLV.BA.".~

D4.1 DJlN em) BAu TIf

D4.ID~N flYTmET KE

:D4.1DI¥N fly TID CONG

DD. BEN BAN fHJ!;N

•j

.eO •••••••••••••••••••••••••••• eo ••••••••

Mau Sa 16CONG HOA.xA HOI CHU NGHiA VIET NAM. . .

D{lc I~p - Til}' do - H:].nh phuc

"" '? , -BIEN BAN DONG DI~N

Ten cong trinh :• 1, •••••••••• 0 •• 0 '" •••••••••••••••••• 0 ••• 0. " .0. II. 1, •••••• 0.0 •••• , ••• 0 ••••••• I ••••••••••

Hom nay, ngay thang nam 201 .Tiiii: ....................... . ........................... .... . ........... ... ...... . ............. .......Thanh ph~n daan nghi~m thu g6m co:

I. IDai dien lkhach hang .1. Dng: Chue V\l: .

2. Ong: Chue V\l: .

n. f)~i di~n Cong ty IDi~n ll}'c ./ Di~n lI,n: .1. Ong: Chue Vl,l .•.•....•••......••.•.•.••...........••..............

, h'2. Ong: . C ue V\l: .

3. Dng: Chue Vl,l: ............•.•..•.•..........................•..•

4. Dng: Chue V\l: ." h'5. Ong: C uc V\l: .

6. Dng: ; Chue V\l: .

Ill. Dai dien DO'nvi thi cong: ... .1. Dng: Chue V\l: .

2. ang: Chue V\l: .

Sau khi kiSm tra th\IC t@cong trinh, h6 sa thi@tk@va cae bien ban nghi~mthu kYthu~t cling cac bien ban thi nghi~m, chung Wi k@tlu~n:Cong trinh: ....................................................... Dll di€u ki~n dong di~n.

- Cha pMp dong di~n vaa duang day: .

Dong di~n h6i:toano

gia phUt ngay thang nam 201... ... Dong di~n an

- Cha phep dong di~n vaa TBA: .............. ...... . ........... . ...... ... ........ .............. .................... ...... .. .....Dong di~n h6i:to:im.

gia phUt ngay thang nam 201... ... Dong di~n an

- f)i~n l1,rc va ben thi cong co tnlch nhi~m thea d5i duangday va TBA trang 72 gia ch(!ythl'r lien WckS tu khi mang tai.

Bien ban k~t thUch6i: ngay thang nam 20 ..... Cac ben dii nh&ttri thong qua.

D/D~N CTYilL ./ IDL...... DfDI~N

,

Maus817

HO sa NGHIEM THU DONG DIEN CONG TRiNH. .I. DO'il vi ngoai ngimh di~nthi~t k~, thi cong:

1) Truae ngay dv ki~n dong di~n, khfich himg iiJ nghi iiau n8i phai cung capcho Ed!! vi J?hlin.ph8i ilifn 02 (hai) b~ h8 sd ph{lc V{lki€m tra iliJu ki~n ilongili~n iliem ilau nai, baa gam:a) H6 sa haan cong eong trinh thea quy djnh eua Bt? Xay d\fllg (Ban ve haaneong, Nh~t kYeong trinh, Nh~t kYgiam sat);

b) H6 sa thi~t k~ eong trinh;c) rai li~u huang dfut v~ Moo va quan ly thi~t bi eua nha eh~ t1).O;d) Cae bien ban nghi~m thu tUng phful cae thi~t bi dfm n6i (tuan thU cae tieuehuful ky thu~t Vi~t Nam ho~e tieu ehuful qu6e t~ duqe Vi~t Nam eong nh~ vadap tmg cae yeu dm ky thu~t eua thi~t bi d~u n6i quy djnh v~ h~ th6ng di~n pharrph6i do Bt?Cong Thuang ban Mnh;e) Lieh eh1).ythlr va dong di~nv~ hanh cae trang thi~t bi di~n (n~u co);

f) Cae quy djnh nt?ibt?eho an toan v~ hanh thi~t bi d~u n6i;g) Danh saeh cae nhan vien v~ Mnh eua khaeh hang (bao g6m hQ ten, ehUedanh ehuyen man, traeh nhi~m kem theo s6 di~n tho1).iva s6 fax lien l1).e).

2) Sau khi nh~ du tM li~u, trong thai gian 03 ngay Bun vi phan ph8i ili~n cotrach nhi~m chuy€n eho khaeh hang d~nghi d~u n6i cae tM li~u sau:a) Sa d6 danh s6 thi~t bi ho~e bang ten duang day, tr1).illbi~n ap;

b) Cae Quy trinh lien quan d~n v~n hanh M th6ng di~n phan ph6i va quy trinhph6i hqp v~ hanh;c) Danh saeh cae can bt? lien quan va cae ky su di~u hanh M th6ng di~n kerntheo s6 di~n tho1).iva s6 fax lien l1).eho~e Ten, dia di~m, s6 di~n tho?i, s6 fax euaD9ilT6 quan 1.9v~ haOO(QLVH) 1uai di~n khu V\fe;d) Cae yeu du khae n6u co.e) Trong thai h1).ll10 ngay lam vi~e k~ ill ngay nh~ d~y du h6 sa dong di~nhqp l~, Dan vi phan ph6i di~n co traeh nhi~m hoan thaOOdong di~n eh1).ythlr,n~hi~m thu va dong di~n vao v~n hanh ehinh thue eha khaeh hang d~ nghj d~unoi.

2. Cong ty JE)i~nIIJc nh~n th~u cong trinh trQn goi:

.:~

.iN:.Vc. ':; c"l$i':'\1[',

1) Truae ngay dv kiSn dong di~n, khach himg dJ nghi dau n8i phrii cung capcho f)(Jn vi phiin ph8i difn 02 (hai) b9 h8 S(JphlJc Vfl kiim Ira diJu kifn dongdifn iJiim dau n8i, baa g6m:

a) Lieh eh~y thu va dong di~nv<%nhanh cae trang thiSt bi di~n (nSu co);

b) Cae quy djnh nQibQeho an toan v~n hanh thiSt bi d~u n6i;

c) Danh saeh cae nhan vien v<%nhanh eua khaeh hang (baa g6m h9 ten, ehUedanh ehuyen man, traeh nhi~m kem thea s6 di~n tho~i va s6 fax lien l~e).2) Sau ldli nh~n du tai li~u, trong thai gian 2 ngay /)(In vi phan ph8i difn coIrtich nhifm chuyin eho khaeh hang dS nghi d~u n6i cae tai li~u sau:

a) Cae Quy trinh lien quan dSn v~n hanh h~ th6ng di~n phan ph6i va quy trinhph6i hgp v~n hanh;

b) ~anh saeh cae cal}bQ lien quan va cae 1<)1 su d!~u h?nh h~ th6ng sti~n kemd " ..•.•'" ,; , ; ",-. i' " i ; _ , I ,,' ...•.• -t-' " ,,+- '"_,; . ",-. •mea so Qlyn mO~llva so lax nen l\le nO\le 1en, u!a mew, so lllyll LllOiin,so Iax euaD9i/T6 quan ly v(inhanh (QLVH) lucridi~n ldlu Vl,J:e;

c) Cae yeu e~u ldlae nSu co thea quy dinh t~ thong tu quy djnh h~ th6ng di~nphanph6i.3) Trang thai h~ 2 ngay lam vi~e k@ill ngay nh(in d~y dll h6 scrd6ng di~nhgp l~, Dern vi phan ph6i di~n co traeh nhi~m holm thanh dong di~n eh~y thu,n~hi~m thu va dong di~n vao v~n hanh ehinh thUe eho ldlaeh hang d~ nghi d&un6i.

,•

I ·

...............................'0' ••••••••••••••••••••.••••••••

Maus618CONG BOA xA HOI cHiT NGB!A VIET NAM. . .

IDQci~p - T\f do - H~nh phue

BIEN BANNGm~M THUKHOI u1QNG xAY LAP HoAN THANH

(Khi nganh di~n lam djch V\l trQn g6i)

1. Ten cong frinh : .

2. ThiYigian ti~n h:mh nghi~m thn:. d' 'th.-Biit au: ngay.......... ang nam .K~ th. 'thO'et ue: ngay.......... ang nam .T\U............................................................................................................................

3. Eja tli€m xay dlfng: 0 •••••••••••••••••••••••••••••••••••••••••••••••••••••

4. Thanh phh tham gia nghi~m thn :4.1.D~i di~n ehUdh ilr :aug: 0 0...... . 0 0 0......... .0 0 - .

ang : .. .4.2J)~i di~n Galll vi nh~D thiiu eong tll"lInhtll"gngoi:ang : .. .ang : .. .

5. Ciin eli'nghi~m thu:Cae ben d1i xem xet eae h6 sa, tii li~u :- Phiriu yeu c6u nghifrn thu cua nha th6u thi cong xdy d~mg;H6 sO'thih k~ bimve thi cong aU(fc c6p th6.rnquy&npM dUYft va nhimg thay a6i thiit ki aG aU(fcchdp thu~n; Quy chu6.n, tieu chu6.nxdy dvng au9'Cap dllng; Tai lifU chi d6n kYthUJ?tkern thea h9P a6ng xdy dvng; Cac kit qua kiirn tra, thi nghifm ch6.t lU(Jngv~t lifU, thi~t bi au9'c thvc hifn trang qua trinh xay dvng; NMt kY thi cong, nhgtkY giarn sat va cac van ban khdc co lien quan a~n a8i tU(Jngnghifrn thu; Bienbim nghifrn thu n(3ib(3cong vifc xdy dvng cua nha th6u thi cong xay dvng.- H6 sa dv taan, h6 sa rnai thdu.- H9P a6ng kinh dgiaa nh{m th6u xay hip.- Cac bien bim nghifrn thu kY thu~t(nghifrn thu tnj., c(3t;nghi~rn thu kea daydan; nghifrn thu tiip aia ...) va cdc ph1j.l1j.clien quan ain a(ft nghi~rn thu.

T'Ai;.U(.u(. Xc

- Cae tili ZiifuvJ VTTB: Bien ban nghiifm thu wit tu B cdp, gi6y chUng nh(m xu6txu hcmg h6a, phiiu thu nghiifm xu6t xuang, phdu thu nghiifm !dim Ira eh6tZU(J1lgeua QUA TEST lien quan din dflt nghiifm thu.- Cae van bem, bien ban min ehinh tuyin aur'rng day, sz'raa6i aiJu ehinh thiit kida aUflc duyift bao g6m : " .. " ' ' " .- Bemg ke kh6i IU(J1lgxily lap holJ.nthanh lien quan ain &/t nghiifm thu.- Bem ve hoan eong &;rtnghiifm thu.- S6 nh(it kY eong truang.6. Danh gili cong trinh xay dVng :6.l.Ki~m tra t~i hi~n tnrimg: (Neu kit qua kiim Ira)6.2.Nh~n xet v~ thi'ri gian thi cong, khfli IUQ1lgva ch~t h.R'Q'ng:

a) Thi'ri gian thi ding:- Ngay khai cong: ....!....!. .

Thih giGn thi cong tZf: "" dinb) Khai IUQ'ngxay !~IPIlOan thi'tnh chinkb.I. Kh6i lugng xay l~p chinh ph~n auang day:

Ngily Tit cQt ........... Lo~iday Chi~u dili tuy~n dmyng dayd~n CQt...........

Thi~t k~ Th,!c t~ thi cong

Thi@tbj/CWll thi@tbj Qugc nghi~m thu:

IT Ten thi~t hj dm]'c D01l SS 10'0'1110 No'j ch~ t~o Ngay xuftt. "nghi~m thn vi xuO'ng

Vi d\l1 MBA 320kVA B(J

2 B(J

3 B(J

c) Chilt IUQ'Dgthi cong so vo-i thi~t k~dii dU'Q'cphe duy~t: (ghi ro &;It haykhOng agt theo yeu c6u thidt M, ghi C'(l thi cae t6n tgi can chinh sua)7. Nhfrng sITa dan trong qua trinh thi cong xay d\fng va I~p d~t thi~t bi sovOi thj~t k@ dli oU'Q'cphe duy~t : (neu nhiing sua a6i Zan)8. K~tiu~n:

ch6p nh(in hay khOng chdp nh(m nghiifm thu va a6ng y Iriin khai giai dognthi eong xay demg tidp theo.

l'

so TIEP NH.~N, G:n:AJ[QlLJYElr YEU CAD eVA KRACH HANG

Thing nam 20 .

Mall sa 19

HQ ten, dja chi, Ngay Hinh Ngay ChuySn giai quySt NgayTT di~n tho<li khach N9i dung dS nghj tiSp thuc h~n

Ngay Elan vjKSt qua giai tra Iai Ly do t6n

tiSp tra Ky quySt dQnghimg nh(in chuySn nh(in KHnh(in lai nh(in

".

LBMS/KDDN-s6 Ban hanh Z6n 1

Mflusa 20:ONG TV DJJ;N LlJC BAc KAN CONG HOA XA HOI Cm) NGHiA VIBT NAM

MBm sa 20c6NG TV DJJ;N LlJC BAc jQ.N CONG HOA xi\. HOI CHU NGHIA VIBT NAM

'J~NLlfC: .

)i~n lho~i: .

DQc L~p- TI}' do - H~nhphuc

I LUll I

DI~NLife: .

Di~n (ho~i: .

D{ic L~p- T\r do - H1J.nh plnic

PRIEU DE NGm CIAI QUYET DJCH VT)

(LUll t~ Phimg GDKH)

~inh giri: .

"en Idu'tchhang d@nghj: .;6 di~n tho~i lien h~: .

N(\i dung d@nghj : .. ... .... . .... ... ... ....... .. . . ....... ........ ....... .. ...... ........ . ......... .............................................................................................................................................................................

Phimg GDKH d@ngh, dan vj .Jiai quy~t theo chuc nang nhi~m V\l d@nghj clla khiich hang va chuy~n.~t ' '- h' GDKH . .. I' N' / 201.~ quavep ong tmac gICY pmt. gay .t~Phimg GDKH Ira k~t qua d~n khach hang d@ngh,.

Tran IrQng cam an./.

Ngay thing nam 20

xAc NI-IAN CVA DV mAl QUvET

(!<y ghi r5 hQ ten)

PHIEU lI.lENGHJ mAli. QUYET meR VlJ(Giao cho dan vi giai quy6t djch Vl,l)

Kinh giri: .

Ten khach hang d@nghj: .N(\i dung d@nghj : .

Phimg GDKH a@ngh, dan vj : .Giai quy~t theo chuc nang nhi~m Vl,l d@nghi cua khach himg va chuy~nk~t qua v@phimg GDKH tmoc gia pMt. Ngay ..I. ./201.. ..d~ Phimg GDKH Ira k~t qua d~n khach himg d@nghi .

Tran tr9ng cam an.!.

Ngay thing nam20

PHONG GIAO DICH KHACI-:I HANG

(ky ghi r5 hQ ten)

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