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Client: Mr.

Kamil Hashim
Mohammed Essarohe

Page 1 of 2 Doc Ref.: EAS-RMA011 Form sheet Title: Request For Material Approval

R.M.A No. 011 Rev. 00 Date Wednesday, 13 April 2022

 New Submittal  Re-Submittal

Project No. S159 Project Code End User

Project Title G+2P+6TYP+7+R COMM/RESIDENTIAL BUILDING


Consultant Eng. Adnan Saffarini Office (EAS) Contractor Al Hazami Building Cont(HABC)
Consultant's Eng. Eng Emad Jadaan Consultant's MEP Eng.
Sub-contractor Trade

Description / Technical Literate / Material Submittal for:

Polycoat RBE 15 “SBS Modified Bitumen Emulsion”

ATTACHMENTS  Sample Technical Date  QA/QC Reports  Method Statement  Others

Area of Application / Location


Drawings Ref. Sub-Structure Copy Attached for Reference
Bill No: 6 - THERMAL & MOISTURE
Specification Ref. B.O.Q. Ref.
PROTECTION
Origin: Manufacturer Name: Henkel Polybit Industries Ltd.
Local Agent: Tel: 043273123 Email: [email protected]
CONTRACTOR`S ATTESTATION

Material / Submittal Comply with Specifications  Yes  Alternative

If Alternative, State Details:

Requested By Contractor Received by Consultant


Name: Eng Abdulrahman Alnaser Name: Eng Emad Jadaan

Signature: _________________________ Signature: _________________________

Date: 13 / 04 / 2022 Time: _____:______ Date: / / Time: _____:______


Client: Mr. Kamil Hashim
Mohammed Essarohe

Page 2 of 2 Doc Ref.: EAS-RMA011 Form sheet Title: Request For Material Approval

Consultant’s Comments (Project Manager / Resident Engineer)

Approval Status: Name of Consultant’s Representative:


________________________
 Approved
 Approved As noted
 Re-Submit As noted Signature: _________________________

 Rejected
Date: / / Time: ______ : ______

Name of Contractor’s Representative:


________________________

Received by Contractor
Signature: _________________________

Date: / / Time: ______ : ______

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