A21_0040422723_Form_CM-16,_Rehab_San_Jose_Convento.pdf

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SAAN REHABILITATE SAN JOSE MASONRY WALLS
Solicitation number
140P1319R0002
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CM-16 Transmittal Form

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Project:

A ct io n

Su bm itt al

In fo rm at io na l S ub m itt al

It em

N o.

Specification Section No.

P ar ag ra ph N o.

Description of Item

(Size, Type, Name, Manufacturer, Use, Etc.)

N o.

o f C op ie s Su bm itt ed

C on tri bu te s to m ee tin g

LE

ED

an d/ or F ed S us t.

R eq

M ee ts B uy A m er ic an

A ct

R eq

A lte rn at e M at er ia ls

P ro po se d

N o.

o f C op ie s R et ur ne d

A pp ro ve d

A pp ro ve d w ith N ot at io ns

D is ap pr ov ed

R es ub m it

A cc ep t

R ej ec t

Title: Date:

Title: Date:

Action by:

Approval of this submittal is subject to the provisions of the contract drawings and specifications This action is for general concurrence only and the government is not

Title: Date:

Contractors Signature:

I hereby certify that this submittal has been reviewed for accuracy, completeness, and compliance with contract requirements (FAR 52.236-21)

Review Comments:

Action Submittal

Informational Submittal

Contractor: NPS ACTIONSubcontractor / Supplier:

Recommended by:

TRANSMITTAL - NATIONAL PARK SERVICE

Park: PMIS No.: Contract No.: Date: Transmittal No.:

Sheet: 1 of:

Project:

A ct io n

Su bm itt al

In fo rm at io na l S ub m itt al

It em

N o.

Specification Section No.

P ar ag ra ph N o.

Description of Item (Size, Type, Name, Manufacturer, Use, Etc.)

N o.

o f C op ie s Su bm itt ed

C on tri bu te s to m ee tin g

LE

ED

an d/ or F ed S us t.

R eq

M ee ts B uy A m er ic an

A ct

R eq

A lte rn at e M at er ia ls

P ro po se d

N o.

o f C op ie s R et ur ne d

A pp ro ve d

A pp ro ve d w ith N ot at io ns

D is ap pr ov ed

R es ub m it

A cc ep t

R ej ec t

Contractor: Subcontractor / Supplier: NPS ACTION Action

Submittal Informational

Submittal

Review Comments

TRANSMITTAL CONTINUATION - NATIONAL PARK SERVICE

Park: PMIS No.: Contract No.: Date: Transmittal No.:

Sheet: of:

Date Received: Distribution 1 copy each: CMR Interim, A/E, DSC, Contr. CM-16 Rev. 03/10Date To Contractor:

specifications. This action is for general concurrence only and the government is not responsible for errors or omissions

CM‐16 Rev.03/10

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