IPIC Internal

Internal Trial Scoping & Multi-Department Review

Project Name

Client Name

Trial Client Supervisor

Date

Location

Basic Information

Provide the essential project, client, and contact information required to initiate the trial and identify the key personnel involved.

Departments Involved

AgronomyR&DEngineersOther

Other Department(s) — please specify

Project Point of Contact (POC)

Key Person

Trial Manager

Trial Supervisor

Trial Client Supervisor

Project Scope

Define the scope of the trial by outlining its objectives, proposed solutions, responsibilities, performance indicators, and trial resources.

Objectives

State the main objectives the trial is expected to achieve.

Proposed Products / Solutions / Quantities

List the proposed products or solutions to be used, including the required quantities.

Scope of Work (SOW) — ReFarm Responsibilities

Scope of Work (SOW) — Client Responsibilities

Protocol Shared with Client (Indicate whether the trial protocol has been shared and acknowledged)

YesNo

Soil Analysis Result

Provide summary of available soil analysis results relevant to the trial site.

Attach Soil Analysis Document

Choose file

No file chosen

Key Performance Indicators (KPIs)

Define the measurable criteria that will be used to evaluate the success of the trial.

Product Name / Quantities (for Trial Use)

Specify the products that will be used during the trial and the quantities allocated.

Initial Assessment

Provide the preliminary planning information required before the trial begins, including timelines, resources, budget considerations, and potential risks.

Estimated Timeline (expected overall duration)

Trial Start Date (planned start date)

Estimated Budget (AED, if known)

Resource Needs (Staff, Tools, Partners)

List the personnel, equipment, materials, or external support required to conduct the trial.

Risks & Assumptions

Identify any potential risks, constraints, or assumptions that may affect the trial.

Risk Avoidance

Describe the actions that will be taken to minimize or manage the identified risks.

Decision & Next Steps

Record the recommended course of action for the project and obtain the necessary approvals before proceeding.

Recommended Action

ProceedReviseHold

Decision Comments / Next Step Directives

Approval & Sign-off

The authorized representatives should review the information provided and sign below to confirm their approval or acknowledgement.

Role	Name	Signature	Signature Date
Trial Supervisor
Trial Manager
POC
High Management (CFO)

Row 1

Role

Trial Supervisor

Name

Signature

Signature Date

Row 2

Role

Trial Manager

Name

Signature

Signature Date

Row 3

Role

POC

Name

Signature

Signature Date

Row 4

Role

High Management (CFO)

Name

Signature

Signature Date

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