HomeMy WebLinkAboutIowa Department of Transportation-Certificate of Completion-10.26.2009 Form 640003
03-04 wd
1"A Iowa Department of Transportation
CERTIFICATE of COMPLETION and
FINAL ACCEPTANCE of AGREEMENT WORK
COMPANY: B&B Builders and Supply COUNTY/CITY: Waterloo/Black Hawk
ADDRESS: 5728 Sierra Drive Waterloo, Iowa 50701 PROJECT NO.: STP-E-8155(690)--8V-07
KIND OF WORK: Bicycle/Pedestrian Facilities -Trail Head
AGREEMENT DATE: May 16th, 2006 FIELD COMPLETION DATE: September 26th, 2007
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: .fU DATE: October 23rd , 2009
Project Engin=r(--4 onstruction)(Area Engineer)(County)(City) Year
(Consultant)
*SIGNATURE: DATE:
District(Construction)(Maintenance)(Local Systems)Engineer Year
Approved and work accepted by the Board of Supervisors/City
Council of City of Waterloo
this 26th day of October , 2009 .
Year
SIGNATURE:
Chairman/Ma r l r -t. y e
Acknowledge completion of project in accordance with referenced agreement by the Iowa Dep ment of
Transportation
this day of
Year
SIGNATURE:
Iowa Department of Transportation
*On Local State Assisted DO NOT WRITE IN THIS BOX. CENTRAL OFFICE USE ONLY.
Projects District does (Check or Initial Appropriate Box)
NOT certify but
acknowledges
completion of project. (l Office of Audits ❑ Copy to Company
Copies to District ❑ Original to Files