J.10 DOT Form F4220.3_Preconstruction Conference Agenda and Checklist.pdf

OMB Control No. 2120-0595 (DOT F4220.3) FAA Template No. 12 (8/97)

DEPARTMENT OF TRANSPORTATION

PRECONSTRUCTION CONFERENCE AGENDA AND CHECKLIST

I. CONTRACT NO.

II. CONTRACTOR

III. CONFERENCE HELD AT

IV. DATE

V. CONTRACT DESCRIPTION AND LOCATION

VI. (1) CONTRACTING OFFICER, (2) CONTRACT ADMINISTRATOR,

(3) CONTRACTING OFFICER’S REPRESENTATIVE

NAME TELEPHONE NO.

(1)

(2)

(3)

VII. Place “X” in appropriate box if item is discussed with contractor. “X”

1. GOVERNMENT

REPRESENTATIVES

A. CONTRACTING OFFICER (Name and title)

B. AUTHORIZED REPRESENTATIVE (Name and title)

2. STATUS A. COMMENCEMENT, PROGRESS, AND COMPLETION OF WORK

3. PROGRESS A. SUBMISSION FOR APPROVAL

SCHEDULE B. ITEMS TO BE INCLUDED

C. COMPLIANCE WITH PROGRESS SCHEDULE AND ACTION BY CONTRACTING OFFICER IF CONTRACTOR FAILS TO

MAINTAIN PROGRESS

D. LIQUIDATED DAMAGES

4. CHANGES A. AUTHORITY

5. CORRESPONDENCE A. NORMALLY, ALL CORRESPONDENCE WILL BE ADDRESSED TO THE CONTRACTING OFFICER WITH A COPY TO HIS

REPRESENTATIVE

6. SUPERINTENDENCE

BY CONTRACTOR

A. NAME AND TELEPHONE NUMBER OF REPRESENTATIVE

NAME: TELEPHONE NO:

7. OTHER CONTRACTS A. COOPERATION WITH CONTRACTORS AND OTHER GOVERNMENT EMPLOYEES

B. USE OF ROADS AND UTILITIES

C. COORDINATION BETWEEN CONTRACTORS

8. SUBCONTRACTORS A. PERCENTAGE ITEMS OF WORK PERFORMED BY PRIME CONTRACTORS OWN FORCES

B. STATEMENT AND ACKNOWLEDGMENT, FAA Template 21, FOR EACH SUBCONTRACT. 3.6.2-22 “SUBCONTRACTS”

C. CONTRACTUAL RELATIONS BETWEEN SUBONCTRACTORS AND GOVERNMENT

9. PAYMENT TO A. RETAINED PERCENTAGE

CONTRACTOR B. PAYMENT FOR MATERIAL AND EQUIPMENT ON SITE

C. STORAGE AND PROTECTION

10. SHOP DRAWINGS A. SUBMITTAL OF SHOP DRAWINGS

B. SUBMITTAL OF EQUIPMENT LAYOUT

C. RESPONSIBILITY OF CONTRACTOR TO ALERT GOVERNMENT IF ITEMS ARE NOT FULFILLING CONTRACT

REQUIREMENTS

11. INSPECTION A. RIGHT TO REJECT DEFECTIVE MATERIAL OR WORKMANSHIP

B. NO REPRESENTATIVE IS AUTHORIZED TO CHANGE ANY PROVISION OF THE CONTRACT

C. PRESENCE OR ABSENCE OF INSPECTOR SHALL NOT RELIEVE CONTRACTOR FROM REQUIREMENT OF CONTRACT

D. ACCEPTANCE OF WORK

E. SPECIFICATIONS GOVERN WHEN DIFFERENCES EXIST BETWEEN DRAWINGS AND SPECIFICATIONS

12. OPERATIONS AND A. STORAGE AREAS TO BE AUTHORIZED OR APPROVED

STORAGE B. DISPOSAL AREAS

13. LAYOUT OF WORK A. GOVERNMENT ESTABLISHED BASE LINE AND BENCH MARK

B. CONTRACTOR RESPONSIBILITY FOR LINE AND GRADES

OMB Control No. 2120-0595 (DOT F4220.3) FAA Template No. 12 (Reverse) (8/97)

VII. Place “X” in appropriate box if item is discussed with contractor “X”

14. COORDINATION A. CONTRACTOR TO COORDINATE VARIOUS TRADES

OF TRADES B. CONTRACTOR TO COORDINATE SHOP DRAWING AND LAYOUT OF VARIOUS TRADES

15. GOVERNMENT-FURN. A. DELIVERY, INVENTORY, AND ACCEPTANCE

PROPERTY AND B. STORAGE AND PROTECTION

SALVAGED MATERIAL C. SALVAGE MATERIAL - SERVICEABLE OR UNSERVICEABLE

16. PROTECTION OF A. PROTECTION OF EXISTING STRUCTURES, UTILITIES, WORK AND VEGETATION

MATERIAL AND WORK B. PERSONNEL SECURITY CLEARANCE AND IDENTIFICATION (IF APPLICABLE)

17. LABOR A. EQUAL OPPORTUNITY

B. DAVIS-BACON ACT (Including Labor Department wage determination)

C. CONTRACT WORK HOURS STANDARDS ACT - OVERTIME COMP.

D. APPRENTICES

E. PAYROLL RECORDS AND PAYROLLS

F. COPELAND (“And-Kickback”) ACT

G. WITHHOLDING OF FUNDS TO ASSURE WAGE PAYMENT

H. SUBCONTRACTING - TERMINATION

18. NOTICE OF DELAYS A. NOTICE TO CONTRACTING OFFER OF ACTUAL AND POTENTIAL LABOR DISPUTES

B. OTHER ACTUAL AND POTENTIAL DELAYS

19. SMALL BUSINESS A. CONTRACTOR DESIGNATES LIAISON OFFICER

SUBCONTRACTING B. MAINTAINS RECORDS AVAILABLE FOR REVIEW

PROGRAM C. NOTIFIES CONTRACTING OFFICER IF SMALL BUSINESS IS NOT SOLICITED FOR SUBCONTRACTS

20. COMPLIANCE A. COMPLIANCE WITH LOCAL RULES AND REGULATIONS

21. SAFETY A. ACCIDENT PREVENTION

B. CLEANING-UP

22. NOTICE TO PROCEED A. DATE

23. DATE OF CONTRACT

COMPLETION

A. DATE

24. OTHER ITEMS

(Add as necessary)

(Key to previous items, if applicable)

CERTIFICATION: The preceding items marked by “X” have been discussed.

SIGNATURE FOR THE CONTRACTOR

SIGNATURE FOR THE GOVERNMENT

REMARKS (Continue on attached sheet(s), if necessary)

OMB Control No. 2120-0595 (DOT F4220.3) FAA Template No. 12 (Reverse) (8/97)