Attachment_05_Submittal_Template.pdf

U.S. FISH AND WILDLIFE SERVICE

TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL SAMPLES, OR MANUFACTURER’S

CERTIFICATES OF COMPLIANCE FOR APPROVAL

(Read attached instructions prior to initiating this form)

Date:

Transmittal No.

Section I (Contractor) To: Infrastructure Management Division U.S. Fish and Wildlife Service 5600 American Boulevard West Suite 990 Bloomington, MN 55437

From:

Contract No.

Previously Submitted On Transmittal No.____

Project and Location:

Halfmoon Landing – Replace Three Platforms Upper Miss NW & FR – Winona District

Item No.

Description (Include Brand or Manufacturers Name)

Contract Specification Paragraph No.

Contract Drawing No.

COTR

Use Only Action Code *

Name & Signature of Contractor

Section II (Fish and Wildlife Service Engineering) Comments

Date Received

Reviewed by Signature Date

*Action Codes Distribution: Station A – Approved As Submitted C – Approved, Except As Noted – Resubmission Required E – Disapproved – See Comments – Resubmission Contract File B – Approved Except As Noted D – No Action Taken – See Comments Required Engineers File Resubmission Not Required Resubmission Required F – Other Returned to Contractor

SUBMITTAL INSTRUCTIONS

1. SECTION 1 will be completed by the Contractor.

SECTION 2 will be completed by the Fish and Wildlife Service.

2. Number each submittal consecutively as submitted throughout the contract.

3. Form is self-transmittal; letters of submittal are not required.

4. Submit in accordance with Section 01 3000 Submittals.

5. Mark submittal items to clearly indicate Item number.

6. The approving authority will assign action codes under column provided in Section I for each item submitted (Action Codes are defined at the bottom of form).