Download - SignBoard 3rd Party
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8/9/2019 SignBoard 3rd Party
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may 2012
Annx C3
modl for of crticatfor typ S tporary works1
Na of Projct _________________________________
Na of Structur _________________________________Structur Rf No _________________________________
1. We certify that reasonable professional skill and care has been used in the checking of the design for
the temporary works comprising (description of temporary works)2listed in the attached schedule.
We also certify, but without undertaking any responsibility other than towards (name of organisationprocuring the temporary works) that in our opinion the erection proposals and proposed temporary
works details specied in the attached schedule for the execution of (project title) are satisfactory for
the proper discharge of his responsibilities, for the safety of the said part of the Works and for theirsafe execution in accordance with the drawings and specication and without detriment to the related
permanent works3, 4
.
Signed ________________________________
Name ________________________________
Temporary Works Checker
Engineering Qualications ________________________________ 5
Name of Organisation ________________________________
Date ________________________________
Signed ________________________________
Name ________________________________
Position held ________________________________
Name of Organisation ________________________________
procuring the temporary works
Date ________________________________
2. The permanent works Designer is satised that the temporary works have no detrimental effectson the permanent works6
Signed ________________________________
Name ________________________________Permanent Works Designer
Engineering Qualications ________________________________ 5
Name of Organisation ________________________________
Date ________________________________
C/6
DeSIGN AND CHeCK CeRTIFICATe
(Typ S Tporary Works)
Na of Projct
Na of Structur
Structur Rf No
Dat
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8/9/2019 SignBoard 3rd Party
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may 2012
Nots
1. A copy of this certicate should be forwarded to the TAA for retention with the AIP, except for Category 0, for the permanent
structure to which it relates.
2. The description to be inserted must dene unambiguously the extent of the structure to which the check is to be applied.Where necessary the extent of the Works must be shown on the drawings and the relevant Drawing numbers stated.
3 Delete and without detriment to the related permanent works if the check is carried out by permanent works Designer.
4. If there is a detrimental effect on the permanent works, an Addendum to the permanent works AIP must be submitted to the TAA
for review.
5. Engineer with appropriate qualication and experience for Categories 0 and 1, and with CEng, MICE, MIStructE or equivalent
for Categories 2 and 3.
6. This clause is not required if the check is carried out by permanent works Designer.
C/7
DeSIGN AND CHeCK CeRTIFICATe
(Typ S Tporary Works)
Na of Projct
Na of Structur
Structur Rf No
Dat