Water System Modification Conditional Approval Letter and Construction Completion Report Form.pdf
PDF 792 KB Posted
- Attached to
- AFTC- Domestic Water System Rehabilitation
- Solicitation number
- 140F0121R0016
About this file
This document contains a federal construction contract solicitation and a related construction completion report form. The U.S. Fish and Wildlife Service is seeking a firm fixed price construction contract for domestic water system rehabilitation at the Abernathy Fish Technology Center, with a project magnitude between $500,000 and $1,000,000. The NAICS code is 237110 and the small business size standard is $39.5 million. Proposals are due under a total small business set-aside, utilizing the tradeoff source selection process. The selected contractor must commence work within 10 days of the notice to proceed and complete the project within 180 days. The construction completion report form requires the contractor's licensed professional engineer to inspect, certify and submit completion documents to the Washington State Department of Health Office of Drinking Water upon project closeout.
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Other files
| File | Type | Posted |
|---|---|---|
| Questions and Responses. Amendment 3_0003.pdf | ||
| Sol_140F0121R0016_Amd_0003.pdf | ||
| Sol_140F0121R0016_Amd_0002.pdf | ||
| Questions and Responses. Amend 1_0001.pdf | ||
| Revised Statement of Work_0001.pdf | ||
| Sol_140F0121R0016_Amd_0001.pdf | ||
| Contractor Sign-In_0001.pdf | ||
| Revised Proposal Form-Schedule of Prices_0001.xlsx | XLSX spreadsheet | |
| Statement of Work.docx | DOCX document | |
| Proposal Form-Schedule of Prices.xlsx | XLSX spreadsheet | |
| Davis-Bacon Act Wage Determination.pdf | ||
| Pre-Offer Meeting. Site Visit Information.docx | DOCX document | |
| Project Narrative.pdf | ||
| Sol_140F0121R0016.pdf | ||
| General and Technical Specifications.pdf | ||
| PRV Locations.pdf | ||
| 100 Percent Design Drawings.pdf | ||
| Technical Requirements.doc | DOC document | |
| Subcontract List and List of Named Equipment_Material Manufacturers Form.pdf |
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Text version
DOH 331-121-Fb (Revised 07/13)
GROUP B CONSTRUCTION COMPLETION
REPORT FORM
In accordance with WAC 246-291-120 (5), a Construction Completion Report is required for all new or expanding Group B projects. Purveyors must submit a Construction Completion Report to the Office of Drinking Water (ODW) within sixty (60) days of completion and before use of any water system facility.
Please type or print legibly in ink:
DOH System ID No.:
Name of Water System
DOH Project No.:
Name of Purveyor (Owner or System Contact)
Date Group B Design Report Workbook Approved by DOH
Mailing Address
City State Zip
PROJECT NAME AND DESCRIPTIVE TITLE:
PROFESSIONAL ENGINEER’S ACKNOWLEDGMENT (Complete items below–Attach additional sheets as needed)
The undersigned professional engineer (PE), or their authorized agent, has inspected the above-described project which, as to layout, size, type of pipe, valves, materials, reservoir, and other designed physical facilities, has been constructed and is substantially completed in accordance with the Group B Design Workbook approved by ODW. In the opinion of the undersigned engineer, the installation, physical testing procedures, water quality tests, and disinfection practices were carried out in accordance with state regulations and principles of standard engineering practice.
Date Signed
Name of Engineering Firm
Name of PE Acknowledging Construction Completion
Mailing Address
City State Zip
Engineer’s Signature
Please return completed form to the Office of Drinking Water regional office checked below.
NWRO Drinking Water SWRO Drinking Water ERO Drinking Water
Department of Health Department of Health Department of Health 20425 72nd Ave. S, Suite 310 PO Box 47823 16201 E. Indiana Ave., Suite 1500 Kent, WA 98032-2358 Olympia, WA 98504-7823 Spokane Valley, WA 99216 253-395-6750 360-236-3030 509-329-2100
If you need this form in an alternate format, call 800-525-0127. For TTY/TDD, call 800-833-6388.
P.E.’s Seal zspruell Text Box The Contractor's Professional Engineer under Subcontract to the Contractor, shall Sign, Stamp, and Seal this Construction Completion Report Form after the A-E Company Professional Engineer has Performed Site Observation and Inspection of the Contractor's On-Site Work. After Completing this Form, the Contractor's Professional Engineer shall return a completed copy to the Office of Drinking Water (WADOH).
| 291.3. 001 – Water System Modification Conditional Approval Letter |
| 331-121-Fb – Group B Construction Completion Report Form |
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