6-SCCPSS-DP-Forms-for-AIA-Contract-Templates, 1.docx

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Attached to
208 Bull Street Design Professional Services
Solicitation number
RFP C26-06 (ESPLOST)
Issued by
Chatham County, Georgia

About this file

This document comprises mandatory addendum forms and exhibits for Owner/Architect agreements on projects funded wholly or in part with State Capital Outlay Funds provided by the Georgia Department of Education (GaDOE), specifically applicable to the Savannah-Chatham County Public School System's 208 Bull Street Design Professional Services project. The project involves the historic renovation and adaptive reuse of the 208 Bull Street facility, originally constructed in 1901, into a modern student-centered learning environment while preserving its architectural heritage. The scope of design professional services includes full programming, design, documentation, permitting, and construction administration. The document establishes that the Owner (Local Board of Education) and Architect must incorporate the mandatory addendum into their selected form of agreement, with the addendum terms prevailing over any conflicting provisions in the underlying contract.

The mandatory addendum establishes specific requirements for architect performance, including detailed consultation on the Owner's program within ten days of initial meetings, submission of cost estimates at preliminary, 65% completion, and check set stages, and design completion within the Stated Cost Limitation established by the Owner. The architect must maintain Professional Liability Insurance for six years after project completion, with minimum coverage varying by project cost (ranging from $1,000,000 to $3,000,000 per claim depending on project size), and must conduct site inspections at minimum monthly intervals with written reports submitted within three days. The architect is responsible for all GaDOE submittals and compliance with federal, state, and local laws and codes, and must provide Record Plans and Specifications in CAD format within thirty days of substantial completion. The document includes required affidavits for E-Verify compliance from contractors and subcontractors, certificates of substantial and final completion, staffing schedules, and insurance certificates, all of which must be filed with the GaDOE Facilities Services Unit prior to fund release.

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Exhibit A

Mandatory Addendum to the Owner/Architect Agreement For Projects Funded in Whole or in Part with State Capital Outlay Funds

[INSERT PROJECT NAME AND NUMBER]

The Owner may use any form of agreement mutually agreed upon by the Owner and Architect to contract for the Architect’s Services for any project funded in whole or in part with State Capital Outlay Funds provided by the Georgia Department of Education (“GaDOE”); provided, however, that this Mandatory Addendum must and shall be incorporated into the Owner and Architect’s selected form of agreement on any such State Capital Outlay Funded project. In the event of a conflict or inconsistency between the terms and conditions of the selected form of agreement and this Mandatory Addendum, the terms and conditions of this Mandatory Addendum shall prevail and govern over conflicting or inconsistent terms and conditions of the selected form of agreement. This Mandatory Addendum shall not be modified without prior written consent of the GaDOE. THE GaDOE SHALL NOT RELEASE ANY STATE CAPITAL OUTLAY FUNDS FOR AN APPROVED CAPITAL OUTLAY PROJECT IF THIS MANDATORY ADDENDUM IS NOT MADE A PART OF THE OWNER/ARCHITECT CONTRACT.

1. For purposes of this Mandatory Addendum, notwithstanding terminology used in the Owner/Architect Contract, the following terms are defined to mean:

a. “Architect” shall be the architect, engineer, or architect/engineer, whether individually or as a firm or other legal entity, engaged to perform the Architect’s Services.

b. “Architect’s Services” shall be the scope of the Architect’s services for the Project set forth in the Contract, including the services and requirements set forth in this Mandatory Addendum.

c. “Owner” shall be the Local Board of Education that is engaging the Architect to perform the Architect’s Services for the Project.

d. “Contract” shall be the form of agreement between the Owner and the Architect, to which this Mandatory Addendum is attached and is a part and shall set forth the Architect’s Services for the Project.

e. “Project” shall be the Project for which the Architect’s Services are engaged and performed pursuant to the Contract.

f. “Program” shall be the Owner’s policies, purposes, concepts, goals and objectives, and design, construction, scheduling, budgetary or operational needs, restrictions, or requirements for the Project.

g. “Stated Cost Limitation” shall be the maximum amount that the Owner is authorized to spend to construct the Project as determined and established by the Owner.

h. “Record Plans and Specifications” shall be the as-built plans and specifications including, but not limited to, actual location of utility lines, and any approved change orders.

2. The Architect agrees not to assign or transfer any interest or rights in the Contract to any person or entity without the advanced written consent of the Owner. The Architect agrees to utilize the design and management team represented to the Owner and agrees that no substitutions, additions, or deletions to this team shall occur without the advanced written consent of the Owner. The Owner agrees to provide a response to the Architect within 14 days of any such request by the Architect.

3. Prior to beginning the “Preliminary Plans and Specifications,” the Architect shall first consult in detail with the Owner to determine and understand the Owner’s Program. Within 10 days of such consultation, the Architect shall prepare and submit to the Owner a written report detailing and confirming the Architect’s understanding of the Owner’s Program. The Architect’s report must include, but is not limited to, the identification of any design, construction, scheduling, budgetary, operational, or other issues, problems or impediments foreseen by the Architect concerning the Project, the Program, or both. The Architect’s report should include proposed solutions or recommendations, for the Owner’s consideration, to resolve, eliminate, minimize or mitigate any such issues, problems or impediments. The Architect’s report shall also include any applicable educational specifications and GaDOE requirements.

4. The Architect shall obtain written authorization from the Owner before proceeding with each next stage of Architect’s Services, including the “Preliminary Plans and Specifications,” the “Check Set Plans and Specifications,” and the “Final Plans and Specifications,” as defined in “Guidelines for Submission of Documents for Review of Planning, Bidding, and Construction of Educational Facilities” (as may be amended from time to time, always using the most recently published edition).

5. The Architect agrees to comply with all applicable federal, state and local laws, codes and ordinances in the design of the Project. The Architect also agrees to comply with all applicable GaDOE rules and guidelines and to make required submittals in a timely manner to GaDOE’s Facility Services Unit. The Architect shall respond to GaDOE’s Facility Services Unit review report comments in a timely fashion so as to ensure that the review process may proceed orderly, efficiently and does not impede the Project or the Program.

6. The Architect assumes full responsibility to the Owner for the acts and omissions of the Architect and the Architect’s consultants, subconsultants and employees in connection with the Contract, the Project and the Program.

7. The Architect agrees to design the Project within the Owner’s budgetary limits and consistent with the Owner’s Program for the construction of the Project which shall be referred to as the Stated Cost Limitation, as follows:

The Stated Cost Limitation for the Project shall be $_____________________________________, which is composed of:

State Capital Outlay Funds in the amount of $__________________________________, and

Required Local Funds in the amount of $_______________________________________, and

Additional Required Local Funds in the amount of $__________________________.

8. The Architect shall provide reasonably reliable cost estimates to the Owner at the following design stages: (1) Preliminary Plans and Specifications stage, (2) 65% completion stage, and (3) Check Set Plans and Specifications stage (95% completion).

9. In the event the Architect’s final project cost estimate (at Check Set Plans and Specifications stage) exceeds the Stated Cost Limitation for the Project, the Owner may require the Architect, at no additional cost to the Owner, to consult with the Owner and to revise the design so as to enable the Owner to obtain a final cost for the Project at or below the Stated Cost Limitation. The Architect acknowledges and agrees that the Stated Cost Limitation shall not be exceeded except as provided herein; provided, however, the Architect further acknowledges and agrees that budgetary limitations are never a justification for breach, disregard or circumvention of sound principles of architectural and engineering design. Therefore, the Architect shall take no calculated risks in the design of the Project. The Architect agrees that, in the event that the Architect determines that the Project cannot be designed so as to be fully and finally constructed within the Stated Cost Limitation and in keeping with sound principles of design, the Architect will give written notice of such determination immediately, and in no event more than seven (7) days after the Architect makes such a determination, to the Owner and to the GaDOE Facilities Services Unit.

10. The Stated Cost Limitation may be amended by written mutual agreement signed by the Owner and the Architect at any time after the Contract between the Architect and Owner is executed. Prior to such amendment, the Architect shall provide the Owner with reliable and verifiable evidence through either internal-Architect estimates, third party estimates, materials supplier quotes, or other industry best management practices standards to establish that an increase in the Stated Cost Limitation is warranted and justifiable. The Owner reserves the right to request additional supporting documentation substantiating the need to increase the Stated Cost Limitation. The Owner reserves and has the right, in its sole discretion, to refuse to increase the Stated Cost Limitation.

11. All plans, specifications, design calculations, designs, drawings, or other documents or data produced pursuant to the Contract by the Architect, or the Architect’s consultants, subconsultants, or employees shall be the sole property of the Owner regardless of the stage in which the development of the design has progressed and shall be delivered to the Owner upon request. The Owner shall retain all ownership rights with regard to such plans, specifications, design calculations, designs, drawings, or other documents or data produced pursuant to the Contract.

12. The Architect shall provide and maintain Professional Liability Insurance at all times this Contract is in effect and for a period of six (6) years after execution by the Architect of the “Certificate of Final Completion” indicating final completion of the Project, with a minimum level of coverage as described herein below. Said coverage shall be written by an insurer licensed to do business in the State of Georgia and acceptable to the Owner.

Before the Owner executes the Contract, the Architect shall provide the Owner and the GaDOE Facility Services Unit with a valid Certificate of Insurance showing that the Architect is then insured with Professional Liability (Errors and Omissions) Insurance with limits not less than the following:

a. For Projects with a Stated Cost Limitation of more than $30,000,000:

i. For the Architect - $3,000,000 per claim and $4,000,000 in aggregate coverage;

ii. For the Architect’s subconsultant engineers and architects - $2,000,000 per claim and $3,000,000 in aggregate coverage; and

iii. For other professional subconsultants - $1,000,000 per claim and $2,000,000 in aggregate coverage.

b. For Projects with a Stated Cost Limitation of $20,000,000 up to $30,000,000:

j. For the Architect - $2,000,000 per claim and $3,000,000 in aggregate coverage;

ii. For the Architect’s subconsultant engineers and architects - $1,000,000 per claim and $2,000,000 in aggregate coverage; and

iii. For other professional subconsultants - $1,000,000 per claim and $1,000,000 in aggregate coverage.

c. For Projects with a Stated Cost Limitation of less than $20,000,000:

j. For the Architect - $1,000,000 per claim and $1,000,000 in aggregate coverage;

ii. For the Architect’s subconsultant engineers and architects - $1,000,000 per claim and $1,000,000 in aggregate coverage; and

iii. For other professional subconsultants - $1,000,000 per claim and $1,000,000 in aggregate coverage.

For such period of time that Professional Liability insurance is required for the Project, as set forth above, the Architect shall provide the Owner with an updated or renewed Certificate of Insurance at least annually, or more frequently if requested by the Owner, showing the required coverage and limits of coverage remain in place.

13. The Architect shall carefully inspect the work of the Contractor within 24 hours of the Owner’s request, and shall also, at a minimum, inspect work at the Project site ____________________________________, and in any event, no less frequent than once per month. At least once per month, the inspection shall be performed by an architect or engineer licensed in the State of Georgia. The purpose of such inspections, among other things, shall be to determine the quality and quantity of the work in comparison with the requirements of the contract documents for the Project. In performing such inspections, the Architect shall advise the Owner of deficient or defective work; real or potential delays in the schedule or the work of the Project; and, requests for payment by the Contractor which could constitute overpayment for work not yet performed or completed. Within three (3) days of each site visit, the Architect shall submit a written report of such site visit which, in addition to the information required by the preceding sentence, shall include and convey any relevant information, comments or recommendations to the Owner.

14. The Architect shall provide Owner a set of “Record Plans and Specifications” within thirty (30) days after execution by the Architect of the “Certificate of Substantial Completion.” Such “Record Plans and Specifications” shall include any authorized change orders, actual locations of all utility lines, and any other appropriate information. The drawings shall be presented in a Computer Aided Drafting (CAD) format or other format of the Owner’s choice, and the specifications shall be presented in a word processing format of the Owner’s choice.

15. The Contract executed between the Owner and the Architect, to which this Mandatory Addendum is a part, shall include a provision for the termination of the Architect’s Services (or be deemed to include this Paragraph 15) giving the Owner the rights of (1) termination of the Architect’s Services with cause and (2) termination of the Architect’s Services without cause. In the event of termination, the Owner shall pay the Architect for the reasonable value of the Architect’s Services performed by the Architect prior to the termination. Payment for the Architect’s Services rendered prior to termination shall be based on statements properly submitted by the Architect to the Owner and supported by time sheets, invoices and such other supporting documentation that the Owner may reasonably require; provided, however, that in no event shall the total payment to the Architect exceed an amount equal to the percentage of completion of the Architect’s Services for the Project at the time of termination.

16. The Architect shall be responsible for the timely submittal and completion of all forms required by GaDOE and shall respond to GaDOE comments on submittals within twenty-one (21) days of receipt of GaDOE comments. Such forms may be obtained from the Facilities Services Unit, Georgia Department of Education, 1670 Twin Towers East, 205 Jesse Hill Jr. Drive, SE, Atlanta, Georgia 30334. At the close of the Project, the Architect shall submit an “Architectural Certification” form, as provided by the GaDOE, to the Owner. Unless the Architect’s services are terminated by the Owner before final completion of the Project, the completion and submittal of this form is required prior to the Owner’s release of the final payment to the Architect.

17. All architectural plans and specifications shall bear the signature and seal of the Architect, which shall be licensed to practice in the State of Georgia. Civil, survey, structural, electrical, and mechanical plans and specifications shall bear the signature and seal of the respective engineer, who shall be licensed to practice in the State of Georgia.

18. A fully executed copy of the Contract between the Owner and the Architect, including a completed copy of this Mandatory Addendum, must be filed with the GaDOE Facilities Services Unit.

OWNER:

The Board of Public Education for the City of Savannah and the County of Chatham, Chairperson for the Board of Public Education for the City of Savannah and the County of Chatham

Date:____________________________________

Superintendent for the Savannah-Chatham County Public School District

ARCHITECT:

[Insert Architect Name]

Exhibit B Georgia Department of Education Facilities Services Unit Certificate of the Contractor or His Duly Authorized Representative

Reimbursement Request Number _______ Project Number(s) __________________________________________

Project Name ___________________________________________________________________________________________

To the best of my knowledge and belief, I certify that all items, units, quantities, and prices of work and material shown on this Reimbursement Request Number __________________________ are correct and that all work has been performed and materials supplied in full accordance with the terms and conditions of the contract documents between the __________________________(Owner) and ___________________(Contractor); dated: _______________ and all authorized changes thereto; and that the following is a true and correct statement of the contract account up to and including the last day of the period covered by this estimate and that no part of the “amount due this estimate” has been received.

1. Original Contract Sum..........................................................................................
$0.00
2. Net change by Change Orders .............................................................................
$0.00
3. Contract Sum to Date( I + 2)................................................................................
$0.00
a. Total amount earned for work in place (original contract)...................................
$0.00
b. Total amount earned for work in place (change orders).......................................
$0.00
c. Value of materials stored at site ...........................................................................
$0.00
d. Total amount earned (a plus b plus.......................................................................
$0.00
e. Amount retained (10%).........................................................................................
$0.00
f. Total earned less retained percentage (d minus e) ...............................................
$0.00
g. Total previously approved ...................................................................................
$0.00
h. Total due this request for contractor (f minus g)..................................................
$0.00
i. Amount due this request for architect ...........................................................……
$0.00
j. Total amount requested (h plus i)..........................................................................
$0.00

I further certify that all claims outstanding against the undersigned contractor for labor, materials and expendable equipment employed in the performance of said contract have been paid in full in accordance with the requirements of said contract, except such outstanding claims as are listed below or on the attached sheet, which statement contains all claims against the contractor which are not yet paid, including all disputed claims and any claims to which the contractor has or will assert any defense.

I further certify that all the materials indicated on this Reimbursement Request as being stored on the site, but not yet incorporated into the building have been purchased, delivered and are now stored on the site for future incorporation into the building, and until so incorporated the title to same is, upon payment of this statement, vested in the owner. Furthermore, the undersigned contractor assumes full responsibility for the existence, protection, and, if necessary replacement of the above mentioned materials until the completion of this contract.

Contractor/Construction Mgr. _____________________________________________ Date __________________

By _____________________________________________(Signature) Title _______________________________

Certificate of the Supervising Architect

I certify that I have verified this Reimbursement Request and that to the best of my knowledge and belief it is a true and correct statement of work performed and materials supplied by the contractor and that the contractor’s certified statement of this account and the amount due him is correct and just and that all work and materials in this Reimbursement Request have been performed in full accordance with the terms and conditions of the contract documents and authorized changes thereto.

Architect _____________________________________________________________ Date ___________________

By _____________________________________________(Signature) Title _______________________________

DE Form 0263, Revised June 2010

Exhibit C Contractor (Architect) Affidavit Required by O.C.G.A. § 13-10-9l(b) By executing this affidavit, the undersigned contractor (Architect) verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm, or corporation which is engaged in the physical performance of services on behalf of Savannah-Chatham County Public School System has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period, if awarded a contract, and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number Date of Authorization

Name of Contractor

[INSERT PROJECT NAME]

Name of Project

The Board of Public Education for the City of Savannah and the County of Chatham Name of Public Employer

I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on

___________________, 202________ in _____________________, and _________________________ City State

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON

THIS THE _____DAY OF __________________ , 202______

NOTARY PUBLIC

My Commission Expires

Exhibit D

Subcontractor Affidavit under O.C.G.A. § 13-10-91(b)(3)

By executing this affidavit, the undersigned subcontractor (subconsultant) verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services under a contract with ________________________ on behalf of the Savannah-Chatham County Public School System (“SCCPSS”) has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned subcontractor will continue to use the federal work authorization program throughout the contract period and the undersigned subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present an affidavit to the subcontractor with the information required by O.C.G.A. § 13-10-91(b). Additionally, the undersigned subcontractor will forward notice of the receipt of an affidavit from a sub-subcontractor to the contractor within five business days of receipt. If the undersigned subcontractor receives notice that a sub-subcontractor has received an affidavit from any other contracted sub-subcontractor, the undersigned subcontractor must forward, within five business days of receipt, a copy of the notice to the contractor. Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number Date of Authorization Name of Subcontractor Name of Project Name of Public Employer

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on___________________, ___, 201__ in _____(city), ______(state).

Signature of Authorized Officer or Agent Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE ______ DAY OF ______________,201__.

NOTARY PUBLIC

My Commission Expires:

THE PRIME CONTRACTOR OR ARCHITECT MUST GET THIS FORM COMPLETED BY THE SUBCONSULTANT/SUPPLIERS

Exhibit E

STAFFING SCHEDULE

Exhibit F

DESIGN PROFESSIONAL’S CERTIFICATE OF SUBSTANTIAL (MATERIAL) COMPLETION

Project Number: ____________________

Project Name: ______________________________________________

TO: _______________________________________(CMR)

____________________________________________________(DESIGN PROFESSIONAL)

The Design Professional issues this Certificate of Substantial (Material) Completion of the Project and certifies as follows. An exception to the below statements shall be identified and explained in Paragraph 13 below:

1. Having conducted observations and evaluations of the work in the presence of representatives of the Design Professional and its major consultants, the referenced project has been determined to be fully constructed and completed in accordance with the contract documents and all applicable laws, ordinances, codes, rules and regulations on __________________(date of Inspection for Substantial (Material) Completion) with the exception of items shown on the attached Final Punch List [Notice of Non-Compliant Work No.____________________].

2. The “work” includes all construction, documents, submissions, attic stock, certificates, reports (including initial HVAC test and balance report), warranties, Marked-up Construction Documents, Final Certification of Costs, etc., called for in the contract documents, including all addenda and change orders.

3. The Final Punch List specifies items that constitute either a Minor Item or Permitted Incomplete Work, as defined in the General Requirements, and also stipulates an estimated completion date for each.

4. There are no outstanding Notices of Non-Compliant Work which are not restated on the Final Punch List. Such items must qualify as a Minor Item or Permitted Incomplete Work.

5. The total contract sum as of the date of Substantial Completion (Material Completion) through Change Order No._______is $___________. The unpaid balance of the total contract sum (except as may be amended by future change orders) will be due and payable when all work has been fully completed and the contract fully performed at Project Final Completion.

6. There are no pending change orders resulting in credits or other credits due the Board.

7. The amount to be withheld from Payment for Substantial Completion (Material Completion) for each Minor Item or Permitted Incomplete Work are indicated on the Final Punch List.

Total Value of Minor Items:___________ X 200% =___$________
Total Value of Permitted Inc. Work:___________X 200% =___$________
Seasonal HVAC Balancing (Min. $1,000) ___________ X ______=__$_________
Major Equipment Certificates: (Number) 0 X $500.00=__$_________
Total Withheld =__$_________

8. All tests and inspections required by the contract documents have been made and were reviewed by a registered architect or registered engineer of the Design Professional. All work was found to meet or was brought into compliance to meet said tests and inspections in accordance with the contract documents.

9. No work has been certified for payment that was covered prior to consent of the Design Professional.

10. All mechanical systems, equipment, apparatus and controls (electrical, heating, plumbing, water, septic tank and sewage disposal fields, refrigeration, kitchen equipment, fire alarm, program and public address, etc.) have been started up, tested and inspected in the presence of a registered architect or registered engineer of the Design Professional, and have been found to be in safe operating condition, compliance with the contract documents and applicable codes.

11. All required operating instructions and maintenance manuals have been reviewed and approved for compliance with the contract documents by the Design Professional and transmitted to the Board.

12. The State Fire Marshal or local fire inspectors has (have) issued a Certificate (or Temporary Certificate) of Occupancy.

13. Exceptions _____________________________________________________________

This Certificate is executed by the Design Professional this ______day of _____________, 20____.

Name of Design Professional Firm

By:_______________________________________ ___________ ____________ (License Number and State

Printed Name:______________________________________________

Title:_____________________________________________________

SCHEDULE G

DESIGN PROFESSIONAL’S CERTIFICATE OF FINAL COMPLETION

Project Number: ____________________

Project Name: ______________________________________________

____________________________________________________(DESIGN PROFESSIONAL)

The Design Professional issues this Certificate of Final Completion of the Project and certifies as follows. An exceptions to the below statements shall be identified and explained in Paragraph 13 below:

1. Having conducted observations and evaluations of the work in the presence of representatives of the Design Professional and its major consultants, the referenced project has been determined to be fully constructed and completed in accordance with the contract documents and all applicable laws, ordinances, codes, rules and regulations on __________________(date of Inspection for Final Completion) including all items shown on the Final Punch List [Notice of Non-Compliant Work No.____________________].

2. The “work” includes all construction, documents, submissions, attic stock, certificates, reports (including initial HVAC test and balance report), warranties, Marked-up Construction Documents, Final Certification of Costs, etc., called for in the contract documents, including all addenda and change orders.

3. There are no outstanding Notices of Non-Compliant Work.

4. The total contract sum as of the date of Final Completion through Change Order No. _________is $____________.

5. There are no pending change orders resulting in credits or other credits due the Board.

6. All tests and inspections required by the contract documents have been made and were reviewed by a registered architect or registered engineer of the Design Professional. All work was found to meet or was brought into compliance to meet said tests and inspections in accordance with the contract documents.

7. No work has been certified for payment that was covered prior to consent of the Design Professional.

8. All mechanical systems, equipment, apparatus and controls (electrical, heating, plumbing, water, septic tank and sewage disposal fields, refrigeration, kitchen equipment, fire alarm, program and public address, etc.) have been started up, tested and inspected in the presence of a registered architect or registered engineer of the Design Professional, and have been found to be in safe operating condition, compliance with the contract documents and applicable codes.

9. The State Fire Marshal has issued a Certificate (or Temporary Certificate) of Occupancy.

10. Exceptions ________________________________________________

This Certificate is executed by the Design Professional this ______day of _____________, 20____.

Name of Design Professional Firm

By:__________________________________________________ ____________
(License Number and State

Printed Name:______________________________________________

Title:_____________________________________________________

Exhibit H

Design Professional’s Certificate(s) of Insurance

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