SYARIKAT BEKALAN AIR SELANGOR SDN BHD

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

Date .

..
Name + Signature of Developer / Proprietor

Date

SYARIKAT BEKALAN AIR SELANGOR SDN BHD

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)

2.

Class/Rating

Sluice Valve
Size
(mm)

4.

Material Type

Name of
Approved brand

Name of
Approved brand

Length
(m)

3. Air Valves
Size
(mm)

Nos.

Fire Hydrants:
Size
(mm)

Name of Approved
brand

5.

Nos.

Name of
Approved brand

Nos.

Scour Valves:
Size
(mm)

Name of
Approved brand

Nos.

SYARIKAT BEKALAN AIR SELANGOR SDN BHD

FORM KA 1/1
(Rev. 2007)
6.

Butterfly Valves
Size
(mm)

8.

Name of
Approved brand

Zone Meters
Size
(mm)

Nos.

Water Sampling Points

Location

10.

7.

9.

Nos.

Nos.

Others :.
(Specify details)
Size
(mm)

Construction Costs
i.
Pipes and joints supply

RM

ii.
Specials and valves supply

RM

iii.
Labour for lay and fix
.

RM

iv.
Others
.

RM

Name of
Approved brand

Nos.

SYARIKAT BEKALAN AIR SELANGOR SDN BHD

FORM KA 1/1
(Rev. 2007)

11.

We enclosed herewith the following :i.

12.

Copies of Invoices of pipes, joints and fittings, value of tender/ Quotation works.

These pipelines cover the following requirement :No of Units

13.

i.

Low Cost

ii.

Terrace House

iii.

Bungalow Semi Detached

iv.

Shop House

v.

Others (Shop Office)

11 Units ....

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

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.

3.

Checking and approval of As-built plans.

Checked by Technician

Reviewed by Head of Development

section/ Technical Manager :

Signature

Signature

Name :

Name : .

Date :

Date : .

Updating of plans by Mapping unit.

Updated by Head of Mapping unit:-

.
Signature
Name

Designation :
Date
4.

Approved by Ketua Wilayah,

.
Signature
Name :.
Date :.