APX 3 - FORM.pdf
PDF 12 KB Posted
- Attached to
- ON-CALL TREE REMOVAL (CLARENDON COUNTY)
- Solicitation number
- 5400025032
- Issued by
- Chesterfield County, South Carolina
About this file
This is a Notice of Damage to South Carolina Department of Transportation (SCDOT) Property form used by contractors to report incidents involving damage to SCDOT property. The form serves as an official notification mechanism requiring contractors to document and communicate damage incidents to SCDOT's designated office. Contractors must complete the form with their contract number, name, address, and contact information, along with details of the SCDOT representative from whom the notice originates. The form requires documentation of the damage location by route, direction, and mile marker, and must include a photograph of the damaged property as supporting evidence.
The form requires contractors to specify repair costs and any applicable liquidated damages, with a total cost calculation. Contractors must document the date of occurrence and provide the name, signature, and title of the SCDOT employee receiving the notification. This form functions as an administrative record for tracking property damage incidents related to on-call tree removal operations in Clarendon County, South Carolina, and establishes documentation procedures for potential cost recovery or claim resolution between the contractor and SCDOT.
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Other files
| File | Type | Posted |
|---|---|---|
| APX 2 - Non-Comp.pdf | ||
| Solicitation.pdf | ||
| APX 4 - Cert.pdf |
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Text version
APPENDIX 3 - NOTICE OF DAMAGE TO SCDOT PROPERTY FORM
DATE:
TO:
CONTRACTOR
CONTRACT NO.:
NAME:
ADDRESS:
FAX NO.:
FROM:
SOUTH CAROLINA
DEPARTMENT OF
TRANSPORTATION
OFFICE:
ADDRESS:
PHONE NO.:
RE: NOTIFICATION OF DAMAGE TO SCDOT PROPERTY
DESCRIPTION OF DAMAGE:
(PHOTOGRAPH OF THE DAMAGED PROPERTY IS ATTACHED).
DATE OF OCCURENCE: ! ROUTE: j DIRECTION: ! MILE MARKER:
I l
COSTS:
REPAIR COST=
LIQUIDATED DAMAGES=
TOTAL COST=
SCOOT EMPLOYEE (NAME I SIGNATURE I TITLE):
File details come from the government source that posted it. Updated .