Amendment 5 Attachment 2 Substitution Request form.pdf
PDF 61 KB Posted
- Attached to
- Building 62 Renovation Federal contract opportunity
- Solicitation number
- 75F40122R00086
About this file
This document is a substitution request form for a school construction project. The form is to be completed by contractors requesting to substitute alternative products specified in the project specifications. It requires information on how the proposed substitution would impact the project design, other trades, and warranties. Contractors must also agree to pay any additional costs resulting from design changes needed to accommodate the substitution. The form is to be submitted to the architect for review and approval or rejection of the requested substitution.
The related federal contract opportunity is a solicitation to renovate Building 62 for the Food and Drug Administration. Offerors should see the attached solicitation documents for requirements and site visit information. The opportunity type is listed as a solicitation and the agency is identified as the Department of Health and Human Services Food and Drug Administration Office of Acquisition and Grant Services.
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Text version
JACKNP15.09 00 6325 - 1 SUBSTITUTION REQUEST FORM
JNPSD New Elementary School 03/02/2020
SECTION 00 6325
SUBSTITUTION REQUEST FORM
SEND TO:
WER ARCHITECTS / PLANNERS ATTN: MATTHEW SWAIM
901 W. 3RD STREET
LITTLE ROCK, AR 72201
PHONE: 501-374-5300 FAX: 501-374-5247
SECTION:___________PARAGRAPH:_________SPECIFIED ITEM:________________________
PROPOSED SUBSTITUTE:_______________________________________________
ATTACH, COMPLETE DESCRIPTION, DESIGNATION, CATALOG OR MODEL NUMBER, SPEC DATA
SHEET, AND OTHER TECHNICAL DATA, INCLUDING LABORATORY TESTS IF APPLICABLE.
ANSWER THE FOLLOWING QUESTIONS:
WILL SUBSTITUTION AFFECT DIMENSIONS INDICATED ON DRAWINGS? IS THE SIZE
DIFFERENT PHYSICAL SIZE?
WILL SUBSTITUTION AFFECT WIRING, PIPING, DUCTWORK, ETC. INDICATED ON DRAWINGS?
THIS INCLUDES LOWER OR HIGHER ELECTRICAL LOAD AND/OR VOLTAGE; DIFFERENT BTU
HEAT LOAD AND/OR OR VENTING; REQUIRED CLEARANCES, ETC.
WHAT AFFECT WILL SUBSTITUTION HAVE ON OTHER TRADES?
LIST ANY DIFFERENCES BETWEEN PROPOSED SUBSTITUTION AND SPECIFIED ITEM:
IF NECESSARY, WILL THE UNDERSIGNED PAY FOR ARCHITECTS/ENGINEER'S COSTS,
REQUIRED TO REVISE WORKING DRAWINGS, THAT ARE CAUSED BY SUBSTITUTION?
MANUFACTURER'S WARRANTY OF PROPOSED ITEMS ARE [ ] SAME [ ] DIFFERENT
PROPOSED COST SAVINGS USING SUBSTITUTION PRODUCT:_____________________________
REVIEW COMMENTS:
[ ] APPROVED
[ ] APPROVED AS NOTED (SEE ATTACHED EXPLAINATION)
[ ] NOT APPROVED / REJECTED
[ ] REJECTED / RECEIVED TOO LATE / NOT REVIEWED
REMARKS: ________________________________________REVIEWED BY: _________________
SUBMITTED BY:
FIRM: _______________________________________________
ADDRESS: ____________________________________________
SIGNATURE: ___________________________________________
DATE: _______________________________________________
PHONE/EMAIL: ________________________________________
END OF SECTION
PROJECT COORDINATING
OFFICER
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