HomeMy WebLinkAboutIowa Department of Transportation-Statement of Completion and Final Acceptance of Work-12.14.2009 Form 830435wd
06-02
rAIowa Department of Transportation
STATEMENT OF COMPLETION AND FINAL ACCEPTANCE OF WORK
Contractor Aspro, Inc. County Black Hawk
Kind of Work HMA Resurfacing Contract I.D. 07-8155-708
Letting Date April 28, 2009 Project No. (s) ESL-8155(708)-7S-07
Specified/Approximate/Late Start Date 08/10/09 Accounting I.D. No. (s) 26915
(Circle which type applies)
Site No.(s) 00
Actual Start Date 06/09/06 Working Days Specified: 50
Working Days Charged: 35
Field Completion Date 08/31/09 Closure Days Specified:
Closure Days Charged:
Recommended for Acceptance Iowa DOT Contract Acceptance
Signature, Signature
Project Engineer District Construction Engineer
Date: c‘g,tld ems.. 7,9( f Date:
Approved and Work Accepted on Behalf of the City of
WOriab this I"; day of b ErYi b.'"
Year
Signature .f' /.��
May [i vK-44v
For Maintenance Use Only
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 Date
Signature
District Maintenance Engineer 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.
For Central Office Use Only
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- Forward original+2 copies to office of Construction/Maintenance and 2 copies back to Project Engineer.