Exhibit-3-FS_Form_4025.pdf

Please wait...

If this message is not eventually replaced by the proper contents of the document, your PDF viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other countries.

david.dold1 10.0.2.20120224.1.869952

DATE:

TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL SAMPLES, OR MANUFACTURER'S CERTIFICATES OF COMPLIANCE

TRANSMITTAL NUMBER:

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

TO: FROM: CONTRACT NUMBER: CHECK ONE:

THIS IS A NEW TRANSMITTAL

THIS IS A RE-SUBMITTAL OF

TRANSMITTAL:

SPECIFICATION DIVISION NUMBER (Cover only one Division with each submittal) PROJECT TITLE & LOCATION THIS TRANSMITTAL IS FOR: (Check one)

FIO

GA

DA

CR

DA/CR

DA/GA

DIRECTORATE OF PUBLIC WORKS

PREVIOUS EDITIONS ARE OBSOLETE

FS FORM 4025, OCT 2015

SECTION II - APPROVAL ACTION

REMARKS:

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

ITEM

NO.

(See Note 3)

CONTRACT DOCUMENT REFERENCE

DESCRIPTION OF SUBMITTAL ITEM (Type, size, model number etc.)

SUBMITTAL TYPE

CODE (See Note 8)

NO. OF

COPIES

SPEC. NO.

SPEC. PARA.

NO.

DRAWING

SHEET NO.

CONTRACTOR

REVIEW CODE

VARIATION

Enter "Y" if requesting a variation (See Note 6)

FORT SILL DIRECTORATE

OF PUBLIC WORKS

ACTION CODE (Note 9)

a. b. c. d. e. f. g. h. i. j.

NAME OF CONTRACTOR SIGNATURE OF CONTRACTOR

ENCLOSURES RETURNED (List by item No.) NAME AND TITLE OF APPROVING AUTHORITY SIGNATURE OF APPROVING AUTHORITY DATE

PREVIOUS EDITIONS ARE OBSOLETE

DIRECTORATE OF PUBLIC WORKS

FS FORM 4025, OCT 2015

INSTRUCTIONS

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

2. Each Transmittal shall be numbered consecutively. The Transmittal Number typically includes two parts separated by a dash (-). The first part is the specification section number. The second part is the sequential number for the submittals under that spec section. If the transmittal is a re-submittal, then add a decimal point to the end of the original Transmittal Number and begin numbering the re-submittal packages sequentially after the decimal.

3. The "item No." for each entry on this form will be the same "item No." as indicated on ENG FORM 4288-R.

4. Submittals requiring expeditious handling will be submitted on a separate FS Form 4025.

5. Items transmitted on each transmittal form will be from the same specification division. Do not combine submittal information from different specification division in a single transmittal.

6. If the data submitted are intentionally in variance with the contract requirements, indicate a variation in column i, and enter a statement in the Remarks block describing the detailed reason for the variation.

7. FS Form 4025 is self-transmitting - a - letter of transmittal is not required.

8. When submittal items are transmitted, indicate the "Submittal Type" (SD-01 through SD-11) in column c of Section 1.

9. For each submittal item, the Contractor will assign Submittal Action Codes in column h of Section 1. The Fort Sill Directorate of Public Works approving authority will assign Submittal Action Codes in column j of Section 1. The Submittal Action Codes are:

A-Approved as submitted B-Approved, except as noted. Re-submission not required C-Approved, except as noted. Refer the attached comments. Re-submission required D-Will be returned by separate correspondence E-Disapproved. Refer to attached comments F-Receipt acknowledged X-Receipt acknowledged, does not comply with contract requirement, as noted G-Other action required (Specify) K-Government concurs with intermediate design. (For D-B contracts) R-Design submittal is acceptable for release for construction. (For D-B contracts)

10. Approval of items does not relieve the contractor from complying with all the requirements of the contract.

SD-01 - Pre-construction SD-04 - Samples SD-07 - Certificate SD-10 - O&M Data SD-02 - Shop Drawings SD-05 - Design Data SD-08 - Manufacture's Instructions SD-03 - Product Data SD-06 - Test Report SD-09 - Manufacturer's Field Report SD-11 - Closeout