Substitution_Value_Engineering_Request_Form.pdf

Substitution/Value Engineering Request Form

Project: ________________________________________________________

Location(s): ________________________________________________________

TO: City: City of Pasadena Architect: ________________

FROM:

Request for Substitution/Value Engineering and Substantiation for Request:

1. Section, Paragraph and Page Number of Technical Specifications to which this Request applies:

2. Item specified for which substitution is requested:

Name or Brand:

Manufacturer:

Catalog No.:

Underwriters’ Laboratory and/or ICBO No.:

3. The proposed substitution is:

Name or Brand:

Manufacturer:

Catalog No.:

Underwriters’ Laboratory and/or ICBO No.:

4. Contractor is required to provide product data for the proposed substitution consisting of the description of the product or item, reference standards and performance test data, together with substantiating data. No substitution request will be considered by the City without such data and substantiation. Attached hereto is complete technical data, including technical information, complete manufacturer’s catalogs, brochures and drawings, certified laboratory test reports and samples as applicable for the proposed substitution, installation and operating instructions, manufacturing warranties and other descriptive material. Reasons for substitution request:

5. Detailed comparison of significant qualities and properties (size, weight, durability, performance and similar characteristics) including the visual effect where applicable, for the proposed substitution in comparison with original requirements includes (list detailed comparison with supporting data, use separate sheets if required):

6. Installation changes and changes to Drawings and Technical Specifications required by the proposed substitution are (list all required changes, use separate sheets if required):

7. Does this substitution affect dimensions shown on Drawings?

Yes No

If yes, clearly indicate changes on each Drawing by Sheet No.:

8. List the effects of the proposed substitution on other parts of the Work or on separate contracts, including required changes in Drawings, dimensions, engineering and detailing costs and effect on other trades.

9. What effect does substitution have on applicable code requirements?

10. Identify differences between the proposed substitution and the specified item.

11. Attach a copy of manufacturer’s warranty; manufacturer’s guarantees and warranties of proposed and specified items are:

Same

Different

(Explain on attachment.)

Manufacturer shall provide a letter stating the fitness for intended use, and performance equivalence with the specified item.

12. List the name and address of three similar projects (not necessarily installed by

Contractor) on which the proposed product was used and date of installation:

1. Name of Project:

Address:

Date of Installation:

2. Name of Project:

3. Name of Project:

13. Use of the substitution will cause the Contract Time to be:

Same

Different (Explain on attachment.)

14. Use of the substitution will affect the critical path of the Construction Schedule as follows

(identify any proposed adjustment to the Contract Time):

15. Adjustment, if any, in the Contract Sum of $ will result from use of the substituted item.

16. Estimated cost of any engineering, design or agency fees required for work of all trades directly or indirectly affected by the substitution is: $ .

17. The date by which City must accept this Request in order for the time and cost estimates in Paragraphs 14 and 16 to remain valid is:

18. Contractor Affidavit. The undersigned, having thoroughly investigated the proposed substitution represents, certifies and declares, under penalty of perjury under the laws of the State of California that:

(1) Contractor has personally investigated the proposed substitution and determined that it is equal or superior in all respects to that specified except as specifically noted ;

(2) Contractor will provide the same warranty and correction responsibility for the proposed substitution that the Contractor would have provided for that specified;

(3) The cost data presented is complete and includes all related costs under this Contract except any redesign costs and agency fees;

(4) Contractor will pay redesign, engineering, detailing and special inspection costs caused by the use of this substitution;

(5) Contractor will coordinate the installation of the accepted substitution, making such changes as may be required for the Work to be complete in all respects.

(6) Contractor waives all claims for additional costs relating to the substitution which has subsequently become apparent; and

(7) Contractor assumes all responsibility for direct or indirect costs and/or time impacts as a result of the use of the substitution.

Submitted by:

(Signature)

For use by City:

___ Accepted ___ Accepted as noted

___ Not Accepted ___ Rejected as late

(Firm)

(By)

(Address)

(Date)