12. SOW Appendix B Substitution form.doc

SUBSTITUTIONS REQUEST FORM

To: Project Manager

Specified Item:

Section Page Paragraph Description

The undersigned requests consideration of the following:

Proposed Substitution: __________________________________________

The undersigned certifies that the following paragraphs, unless modified or clarified by attachments, are correct:

1.

The proposed substitution does not affect dimensions shown on the Drawings.

2.

The undersigned will reimburse FAA for review or redesign services associated with re-approval by authorities.

3.

The undersigned will coordinate installation and make changes to other Work which may be required for the Work to be complete with no additional cost to FAA.

4.

The proposed substitution will have no adverse affect on other trades, the construction schedule, or specified warranty requirements.

5.

Maintenance and service parts will be locally available for the proposed substitution.

6.

Attached data includes support items listed in Section 01600, and applicable portions of the data are clearly identified.

7.

Attached data also includes a description of any revisions to the Contract Documents which the proposed substitution will require for its proper installation.

The undersigned further certifies that the function, appearance and quality of the proposed substitution are equivalent or superior to the specified item.

Submitted by:

Signature _______________________________________________________

Firm ____________________________________________________________

Address _________________________________________________________

Date ___________________________ Telephone ______________________

List of Attachments:

For Use by the

DESIGN CONSULTANT

____Accepted

____Not Accepted

____Accepted As Noted ____Received Too Late