submittal transmittal.doc

USDA

BARC

FMOD-E&P

SUBMITTAL TRANSMITTAL AND APPROVAL FORM

TO: FROM:_____ _____________________

CONTRACTING OFFICER CONTRACTOR

Job Order No.

Contract No.

Spec Section

Para. No./DWG No.

DESCRIPTION OF MATERIAL

A

AN

DR

RR

REMARKS:

Unless otherwise noted herein, the Contractor assumes total responsibility in complying with the requirements of the scope, intent, plans and specifications of the contract.

I certify that the above submitted items have been reviewed in detail and are correct and in strict conformance with the contract drawings and specifications except as otherwise stated in the remarks section.

Contractor

FOR GOVERNMENT USE ONLY

Reviewer Comments:

LEGEND: A - Approved; AN - Approved as Noted; DR - Disapproved, resubmit; RR - Rejected, resubmit

Distribution:

CO- 1

Contractor - 2

PM/COTR - 1

COTR/Project Manager Date

Inspector - 1 Transmittal Date: ____________________ Contracting Officer Date