Ph lc s 8

Mu trnh ph duyt nh mc d ton mt s cng tc xy dng

iu chnh, xy dng mi s dng lp n gi xy dng
trong cc gi thu s dng vn ngn sch nh nc p dng hnh
thc ch nh thu theo quy nh ti khon 6 iu 13
ngh nh s 112/2009/N-CP

(Km theo Thng t s 04/2010/TT-BXD ngy 26/5/2010

ca B Xy dng)
(Ch u t)
vit nam

Cng ha x hi ch ngha

c lp - T do
- Hnh phc
S hiu vn bn
thng .. nm ..

.., ngy ..

V/v: iu chnh, xy dng

mi nh mc d ton xy
dng cng trnh

t trnh
nh mc d ton mt s cng tc xy dng iu chnh,
xy dng mi s dng lp n gi xy dng cng trnh ..

Knh gi: (ngi quyt nh u t)

Cn c vo c im tnh cht ca cng trnh xy
dng, trn c s h thng nh mc d ton xy dng cng
trnh c cc c quan c thm quyn cng b, thc
hin khon 6 iu 13 ca Ngh nh s 112/2009/N-CP ngy
14/12/2009 ca Chnh ph, (ch u t) xin knh trnh nh
mc d ton mt s cng tc xy dng ca cng trnh bao
gm . mc, trong iu chnh nh mc d ton xy
dng cng trnh c cng b l ... mc v xy dng mi
nh mc d ton xy dng cng trnh l mc nh Ph lc
km theo t trnh ny.
80

Knh ngh (ngi quyt nh u t) xem xt quyt

nh lm c s cho vic xc nh n gi xy dng
cng trnh theo quy nh.
Ni nhn
- Nh trn;

(Ch u t)

(k tn, ng

- Lu.

du)
Ph lc
(km theo t trnh s .. ngy ca ..)
nh mc d ton mt s cng tc xy dng c iu chnh, xy
dng mi s dng lp n gi xy dng cng trnh ..

1. nh mc d d ton mt s cng tc xy dng

cn iu chnh
1.1.
Tn
cng
.

tc:

- Thnh phn cng vic:

- Bng nh mc:

n v tnh:
nh mc
M hiu

Cng tc
xy dng

Thnh phn hao

ph

Vt liu

Nhn cng
Bc
My thi cng

81

n
v

c
cng
b

iu
chnh

1.2.
Tn
cng
.

tc:

2. nh mc d ton mt s cng tc xy dng b

sung mi
2.1.
Tn
cng
.

tc:

- Thnh phn cng vic:

- Bng nh mc:

n v tnh:
M hiu

Cng tc
xy dng

Thnh phn hao

ph
Vt liu

Nhn cng
Bc
My thi cng

82

n
v

nh mc

2.2.
Tn
cng
.

83

tc: