Attachment 29 - Form 1477 Construction Inspection Record.pdf
PDF 500 KB Posted
- Attached to
- Multiple Award Construction Contract Federal contract opportunity
- Solicitation number
- FA4855-10-R-0006
About this file
Attachment 29 - Form 1477 Construction Inspection Record Any attachments currently shown as draft will be finalized and a modification will be issued to incorporate them into the contract at a later date.
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Text version
CONSTRUCTION INSPECTION RECORD
(TYPE OR WRITE ALL ENTRIES LEGIBLY IN INK)
INSTALLATION PROJECT NUMBER
CONTRACT NUMBER AWARD COST
FINAL COST
PROJECT TITLE
PROJECT DESCRIPTION
NUMBER OF CALENDAR DAYS IN CONTRACT DATE NOTICE TO PROCEED ISSUED (YYYYMMDD)
SCHEDULED COMPLETION DATE (YYYYMMDD) ACTUAL COMPLETION DATE (YYYYMMDD)
PRIME CONTRACTOR NAME OF AIR FORCE PROJECT ENGINEER
SUB CONTRACTORS
CERTIFICATION
I CERTIFY THAT I HAVE READ, UNDERSTAND, AND WILL REQUIRE COMPLIANCE WITH THE FOLLOWING ASPECTS AS PERTAIN TO THIS PROJECT: PLANS; TECHNICAL PROVISIONS; FEDERAL SPECIFICATIONS; PROGRESS SCHEDULE; AND FIELD TESTS.
I FURTHER CERTIFY THAT I UNDERSTAND THAT I HAVE NO AUTHORITY TO MAKE CHANGES IN THE PLANS OR SPECIFICATIONS AND THAT MY DUTIES CONSIST PRIMARILY OF SEEING THAT TERMS AND CONDITIONS OF THE CONTRACT ARE CARRIED OUT, TO PROVIDE A PERMANENT RECORD OF THE ACCOMPLISHMENT OF THE PROEJCT BY MEANS OF AF FORM , SUPPLEMENTED
AS NECESSARY BY ANNOTATED COPIES OF PLANS AND SPECIFICATION, AND FURTHER, TO PROVIDE TIMELY RECOMMENDATIONS TO THE BASE CIVIL ENGINEER FOR CHANGES IN THE CONTRACT PLANS AND SPECIFICATIONS, IF REQUIRED.
I WILL MAINTAIN THIS RECORD ON A CURRENT BASIS, IN ACCORDANCE WITH THE REQURIEMENTS OF PERTINENT REGULATIONS AND INSTRUCTIONS GOVERNING THE PREPARATION, MAINTENANCE, AND COMPLETION OF THIS RECORD.
NAME AND GRADE OF INSPECTOR SIGNATURE DATE
AIR FORCE CONSTRUCTION MANAGER PERIOD COVERED (YYYYMMDD)
FROM TO
COMPLETED REPORTS
1 THROUGH BOOK NO. OF BOOKS
PAGE OF PREVIOUS EDITION IS OBSOLETE. 1 PAGES AF IMT 1477, 19800701, V1
Attachment 29 FA4855-10-R-0006 11 June 2010
NON-COMPLIANCE ITEMS
ITEM
NO.
DATE
IDENTIFIED
DATE
COMPLETED PLANS OR SPECS DESCRIPTION REMARKS
OF PAGE 2 PAGES AF IMT 1477, 19800701, V1
DAILY INSPECTION RECORD
DATE (YYYYMMDD) TIME OF INSPECTOR'S VISIT TO SITE
ARRIVAL DEPARTURE ARRIVAL DEPARTURE ARRIVAL DEPARTURE ARRIVAL DEPARTURE
WEATHER CONDITIONS SATISFACTORY FOR WORK YES NO (IF NO, DESCRIBE CONDITIONS.)
CONTINUE REPORT ON PAGE 4
NOTE: WRITE ALL ENTRIES LEGIBLY IN INK. LINE OUT ALL UNUSED PORTIONS. INSPECTOR SIGNS FIRST NAME, MIDDLE INITIAL AND LAST NAME ON EACH COMPLETED DAILY INSPECTION RECORD
PAGE OF 3 PAGES AF IMT 1477, 19800701, V1
WORK FORCE - CONTRACTOR AND SUB-CONTRACTOR
TRADE NO. TRADE NO. TRADE NO. TRADE NO.
MATERIALS DELIVERED TO JOB SITE
ITEM QUANTITY ITEM QUANTITY
CONTRACTOR EQUIPMENT ON HAND
TYPE NO. TYPE NO. TYPE NO. TYPE NO.
WORK ACCOMPLISHED OR IN PROGRESS - TESTS PERFORMED
REPORT NO.
REMARKS (Delays; safety; special instructions given or received; reasons for rejecting materials and/or work.)
SIGNATURE DATE
PAGE OF 4 PAGES AF IMT 1477, 19800701, V1
RECORD OF SUBMITTAL DATA
OF PAGE 5 PAGES
TYPE
SUBMITTAL
DATE
DUE
DATE
RECEIVED
DATE
APPROVED ITEM DESCRIPTION REMARKS SECTION.
GOVERNMENT FURNISHED EQUIPMENT/MATERIALS
DATE
ORDERED
DATE
RECEIVED
DATE INSPECTED BY/REMARKS DESCRIPTION INSPECTED
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