HomeMy WebLinkAboutCedar Valley Corp-FY16 Midport Extension Phase III Cont 894-12/12/2016Form 640003
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CERTIFICATE of COMPLETION and
FINAL ACCEPTANCE of AGREEMENT WORK
Iowa Department of Transportation
COMPANY: Cedar Valley Corporation COUNTY/CITY
ADDRESS: 2637 Wagner Road PROJECT NO
KIND OF WORK: PCC PAVEMENT - GRADE AND NEW
AGREEMENT DATE: 08/13/2015
Black Hawk/Waterloo
RM -8155(748)--9D-07
FIELD COMPLETION DATE: 11/21/2016
This is to certify that the work covered by the above referenced agreement has been completed in accordance with
said agreement and is hereby accepted, subject to final audit of costs.
SIGNATURE:
*SIGNATURE:
District (Construction) (Maintenance) (Local Systems) Engineer
Approved and work accepted by the E�eaT-d-of--S ei*sar-s/City
Council of ) A- .
this `2� day of 2o' r
Year
DATE: 12/6
DATE:
SIGNATURE: DLe�j��
ehairmiaf ayo
Acknowledge completion of project in accordance with referenced agreement by the Iowa Department of
Transportation
this 2� 77/ day of fitg 20/ 7
Year
*On Local State Assisted
Projects District does
NOT certify but
acknowledges
completion of project.
SIGNATURE:
2016
Year
Year
Iowa Department of Transportation
DO NOT WRITE IN THIS BOX. CENTRAL OFFICE USE ONLY.
(Check or Initial Appropriate Box)
❑ Office of Audits
❑Copies to District
❑ Copy to Company
❑ Original to Files