Attachment_4_Form_4025_Shop_Drawing_Transmittal.pdf

ENG Form 4025 *U.S. Government Printing Office: 1991 – 523.366/400989

TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL

SAMPLES, OR MANUFACTURER’S CERTIFICATE OF COMPLIANCE

(Read instructions on the reverse side prior to initiating this form)

DATE TRANSMITTAL NO.

SECTION I – REQUEST FOR APPROVAL FOR THE FOLLOWING ITEMS (This section will be initiated by the contractor)

TO: FROM:

CONTRACT NO. CHECK ONE:

THIS IS A NEW TRANSMITTAL

THIS IS A RESUBMITTAL OF

TRANSMITTAL

SPECIFICATION SECTION NO.

(Cover only one section with each transmittal)

PROJECT TITLE AND LOCATION

ITEM

NO.

a.

DESCRIPTION OF ITEM SUBMITTED

(Type size, model number/etc.)

b.

MFG. OR CONTR. CAT.,

CURVE DRAWING OR

BROCHURE NO.

(See instruction No. 8) c.

NO. OF

COPIES

d.

CONTRACT REFERENCE

DOCUMENT

SPEC. DRAWING

PARA. NO. SHEET NO.

e. f.

FOR

CONTRACTOR

USE CODE

g.

VARIATION

(See instruction No. 6.)

h.

FOR

CE USE

CODE

i.

REMARKS I certify that the above submitted items have been reviewed in detail and are correct and in strict conformance with the contract drawings and specifications except as otherwise stated.

NAME AND SIGNATURE OF CONTRACTOR

SECTION II – APPROVAL ACTION

ENCLOSURES RETURNED (List by Item No.)

NAME TITLE AND SIGNATURE OF APPROVING AUTHORITY DATE

SHEET ____ OF ____

INSTRUCTIONS

Reverse of ENG Form 4025 *U.S. Government Printing Office: 1991 – 523.366/400989

1. Section I will be initiated by the Contractor in the required number of copies.

2. Each transmittal shall be numbered consecutively in the space provided for the “Transmittal No.”. This number, in addition to the contract number, will form a serial number for identifying each submittal. For new submittals or resubmittals mark the appropriate box; on resubmittals, insert transmittal number of last submission as well as the new submittal number.

3. The “Item No.” will be the same “Item No.” as indicated on ENG FORM 4288 for each entry on this form.

4. Submittals requiring expedition handling will be submitted on separate form.

5. Separate transmittal form will be used for submittals under separate sections of the specifications.

6. A check shall be placed in the “Variation” column when a submittal is not in accordance with the plans and specifications – also, a written statement to that effect shall be included in the space provided for “Remarks”.

7. Form is self-transmittal, letter of transmittal is not required.

8. When a sample of material or Manufacturer’s Certificate of Compliance is transmitted, indicate “Sample” or “Certificate” in column c, Section I.

9. U.S. Army Corps of Engineers approving authority will assign action codes as indicated below in space provided in Section I, column I to each item submitted. In addition they will ensure enclosures are indicated and attached to the form prior to return to the contractor. The Contractor will assign action codes as indicated below in Section I, column g, to each item submitted.

THE FOLLOWING ACTION COIDES ARE GIVE TO ITEMS SUBMITTED

A -- Approved as Submitted

B -- Approved, except as noted on drawings

C -- Approved, except as noted on drawings.

Refer to attached sheet resubmission required

D -- Will be returned by separate correspondence

E -- Disapproved (See attached)

F -- Receipt acknowledged

FX -- Receipt acknowledged, does not comply as noted with contract requirements

G -- Other (Specify)

10. Approval of items does not relieve the contractor from complying with all the requirements of the plans and specifications.