form syabas devforms_01
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FORM KA 1/1
(Rev. 2007)
Your Ref.
Our Ref.
Syarikat Bekalan Air Selangor Sdn. Bhd
(SYABAS)
Melalui,
Ketua Wilayah
(Pengurus Besar/Penolong Pengurus Besar/Pengurus Kanan)
SYABAS Wilayah
PART A
Handing Over of Water Reticulation System
On Lot No : .
..
..
I/We, the undersigned being the developer / proprietor of the abovementioned development hereby agree :-
i. To surrender without any conditions to Syarikat Bekalan Air Selangor Sdn. Bhd (SYABAS) all
rights to all pipelines and waterworks fittings within the development, after which these water
supply installations shall be the properties of the State Government of Selangor or Federal
Government (as case may be) to be operated and maintained at SYABASs expenses unless
otherwise provided for in the Water Supply (Selangor) Rules and Enactment 1997 and any
other rules made hereunder.
ii. That SYABAS shall be relieved of all financial responsibility in respect of liabilities incurred in
the execution of water supply system by developer.
iii. We, confirm that there is no financial encumbrances on SYABAS in respect of pipelines and
ancillary works surrendered hereby to SYABAS.
. ..
Name + Signature of Consultant Name + Signature of Developer / Proprietor
Date . Date
SYARIKAT BEKALAN AIR SELANGOR SDN BHD
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PART B FORM KA 1/1
(Rev. 2007)
(To be completed by Consulting Engineers/Developer)
Handing over of Water Reticulation System.
On Lot .
.
1. Pipeline :
Nominal Diameter
(mm)
Material Type Class/Rating Name of Approved
brand
Length
(m)
2. Sluice Valve 3. Air Valves
4. Fire Hydrants: 5. Scour Valves:
Size
(mm)
Name of
Approved brand
Nos.
SYARIKAT BEKALAN AIR SELANGOR SDN BHD
Size
(mm)
Name of
Approved brand
Nos.
Size
(mm)
Name of
Approved brand
Nos.
Size
(mm)
Name of
Approved brand
Nos.
-
FORM KA 1/1
(Rev. 2007)
6. Butterfly Valves 7. Zone Meters
Size
(mm)
Name of
Approved brand
Nos.
8. Water Sampling Points 9. Others :.
(Specify details)
10. Construction Costs
i. Pipes and joints supply RM
ii. Specials and valves supply RM
iii. Labour for lay and fix RM
.
iv. Others RM
.
Size
(mm)
Name of
Approved brand
Nos.
SYARIKAT BEKALAN AIR SELANGOR SDN BHD
Size
(mm)
Nos.
Location
Nos.
-
FORM KA 1/1
(Rev. 2007)
11. We enclosed herewith the following :-
i. Copies of Invoices of pipes, joints and fittings, value of tender/ Quotation works.
12. These pipelines cover the following requirement :-
No of Units
i. Low Cost
ii. Terrace House
iii. Bungalow Semi Detached
iv. Shop House
13. a. We hereby certify that the above installation have been supervised by us and laid in
accordance with the plans and specifications approved by SYABAS vide letter reference no.
. Dated
b. We hereby undertake full responsibility for the design and construction of water reticulation
works, any non-compliance and deviations of the said external water supply works.
Agreed by Developer, Certified by Consultant,
. ..
Signature Signature
Name : Name :
Stamp of developer : Stamp of Consultant : .
Date : .. Date : .
SYARIKAT BEKALAN AIR SELANGOR SDN BHD
v. Others 11 Units .... (Shop Office)
-
PART C (For Office Use) FORM KA 1/1
(Rev. 2007)
Handing over of Water supply Reticulation
On Lot
.
1. As Built Plans Ref : No
2. Checking and approval of As-built plans.
Checked by Technician Reviewed by Head of Development
section/ Technical Manager :
Signature Signature
Name : Name : .
Date : Date : .
3. Updating of plans by Mapping unit.
Updated by Head of Mapping unit:-
.
Signature
Name :
Designation :
Date :
4. Approved by Ketua Wilayah,
.
Signature
Name :.
Date :.
SYARIKAT BEKALAN AIR SELANGOR SDN BHD
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