HomeMy WebLinkAboutIowa Department of Transportation-4/11/2011Furor 830435wd
06-02
,,, Iowa Department of Transportation
STATEMENT OF COMPLETION AND FINAL ACCEPTANCE OF WORK
Contractor Vieth Construction Corp.
County Black Hawk
Kind of Work P.C.C. Recreation Trail Contract I.D. 07-8155-678
Letting Date 5/20/2008
Specified/Appro dmate/Late Start Date 8/4/2008
(Circle which type applies)
Actual Start Date 8/4/2008
Field Completion Date 5/28/2008
Project No. (s) STP -E -8155(678)-8V-07
Accounting I.D. No. (s) 26064
Site No. (s)
00
Iowa DOT Contract Acceptance
Signature
Date:
""tie'
Working Days Specified:
65
roject Engineer
4/1/2011
Working Days Charged:
64
Closure Days Specified:
Closure Days Charged:
C of Waterloo this
Signature
day of
.47 04- iji<<f,as it
Year
This work and test reports have been reviewed. A price adjustment, as provided in Article 1105.04 of the standard
specifications, has been made in the amount of $ . Acceptance is recommended.
Signature
District Maintenance Engineer
Signature
District Materials Engineer
Date
Date
Final payment will be made in accordance with Article 1109.09 following a review of the project reports and
subject to the provision of Article 1105.04.
AM,
Recorded Finance
Recorded Construction/Maintenance
NOTE: On county administered projects, the County Engineer is required to sign "Recommended for Acceptance"
and "Approved and Work Accepted on Behalf of the Board of Supervisors".
Project Engineer—Send original to District District —Rivard original +2 copies to office of Construction/Maintenance and 2 copies bade to Project Engineer.
Recomnnended for Acceptance
Iowa DOT Contract Acceptance
Signature
Date:
""tie'
7.
Signature
bit ecty
Date:
roject Engineer
4/1/2011
�r Bis(trle eeF
C1-Fo''ca? c�'C e; St ea etsZit1
C of Waterloo this
Signature
day of
.47 04- iji<<f,as it
Year
This work and test reports have been reviewed. A price adjustment, as provided in Article 1105.04 of the standard
specifications, has been made in the amount of $ . Acceptance is recommended.
Signature
District Maintenance Engineer
Signature
District Materials Engineer
Date
Date
Final payment will be made in accordance with Article 1109.09 following a review of the project reports and
subject to the provision of Article 1105.04.
AM,
Recorded Finance
Recorded Construction/Maintenance
NOTE: On county administered projects, the County Engineer is required to sign "Recommended for Acceptance"
and "Approved and Work Accepted on Behalf of the Board of Supervisors".
Project Engineer—Send original to District District —Rivard original +2 copies to office of Construction/Maintenance and 2 copies bade to Project Engineer.