Attachment 7, Contractor Work Performance Notification Form.pdf

157 KB Posted

Attached to
7840601ADEM, SUBURB TRASH, 6-1, 6-2, 6-4
Solicitation number
6100051712
Issued by
Bucks County, Chester County, Montgomery County, Northern Cambria Borough, Claysville Borough, Pennsylvania

About this file

Written by GovTribe AI ·

This document appears to be a Contractor Work Performance Notification Form for a District 6-0 Roadside contract. The form is used to notify the contractor of work performance issues and deficiencies observed during an inspection, as well as to document the proposed remedy. The form includes details such as the contract number, inspection date and time, and a checklist of potential work performance issues across several categories like work zone layout and devices. The contractor is required to provide a proposed remedy within 24 hours of receiving the notification form.

The document does not provide any additional details about the overall contract, such as the project scope, quantities, response dates, award information, or contract term. It is focused solely on the process for documenting and addressing specific work performance issues that arise during the execution of the contract.

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District 6-0 Roadside (12/18) CWP Form

Page: __________ of __________

Stage:____________________________

Contract No: ______________________

Date Sent Time Sent recipient of Notification

� AM

� PM

MONTh DAY YEAr

Inspection Time reviewed Inspector

� AM

� PM

MONTh DAY YEAr

Emailed Copy to Contractor?

� Yes � No

Check Box if Meeting will be scheduled

Work Performance Issue(s) and SOW Section

AM Deficiency PM Deficiency Comments Date/Time Corrected

YES NO YES NO

CONTRACTOR WORK

PERFORMANCE

COMPLIANCE AND

NOTIFICATION

This Section is To Be Completed by Contractor* Proposed Remedy:

* Contractor must provide a Proposed Remedy within 24 hours of receiving this Form

Print Button:
Page Number:
Page Number 2:
Stage:
Contract Number:
Month:
Day:
Year:
AM Time:
PM Time:
AM Check Box: Off
PM Check Box: Off
Inspector:
Yes: Off
No: Off
Month2:
Day2:
Year2:
AM Time2:
AM Check Box2: Off
PM Time2:
PM Check Box2: Off
WZLD: Off
Recipient Notification:
Traffic Control Devices:
0:
1:
2:
3:
4:
5:
6:
AM Yes:
0: Off
1: Off
2: Off
3: Off
4: Off
5: Off
6: Off
AM No:
0: Off
1: Off
2: Off
3: Off
4: Off
5: Off
6: Off
PM Yes:
0: Off
1: Off
2: Off
3: Off
4: Off
5: Off
6: Off
PM No:
0: Off
1: Off
2: Off
3: Off
4: Off
5: Off
6: Off
Comments:
1:
2:
3:
0:
4:
5:
6:
Date/Time Corrected:
0:
1:
2:
3:
4:
5:
6:
Remedy:
0:

File details come from the government source that posted it. Updated .