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Usace Eng Form 4025-r

This document is a transmittal form used to submit shop drawings, equipment data, material samples, or manufacturer's certificates of compliance for approval. It includes sections for the contractor to list the items submitted along with references and remarks. The approving authority will then review and provide an action code for each item to indicate if it is approved, needs resubmission, or is disapproved. The form provides instructions for its use and defines submittal types and action codes.

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3K views

Usace Eng Form 4025-r

This document is a transmittal form used to submit shop drawings, equipment data, material samples, or manufacturer's certificates of compliance for approval. It includes sections for the contractor to list the items submitted along with references and remarks. The approving authority will then review and provide an action code for each item to indicate if it is approved, needs resubmission, or is disapproved. The form provides instructions for its use and defines submittal types and action codes.

Uploaded by

bashiri
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL SAMPLES, OR

MANUFACTURER'S CERTIFICATES OF COMPLIANCE

DATE

TRANSMITTAL NO.

For use of this form, see ER 415-1-10; the proponent agency is CECW-CE.
SECTION I - REQUEST FOR APPROVAL OF 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 SEC. NO. (Cover only one section with each transmittal)

PROJECT TITLE AND LOCATION

THIS TRANSMITTAL IS FOR: (Check one)


FIO

ITEM
NO.
(See
Note 3)
a.

DESCRIPTION OF SUBMITTAL ITEM


(Type size, model number/etc.)

SUBMITTAL
TYPE CODE
(See Note 8)

NO.
OF
COPIES

b.

c.

d.

REMARKS

GA

CONTRACT DOCUMENT
REFERENCE
SPEC.
PARA. NO.

DRAWING
SHEET NO.

e.

f.

DA

CR

DA/CR

DA/GA

CONTRACTOR
REVIEW
CODE

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

USACE
ACTION
CODE
(Note 9)

g.

h.

i.

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.

NAME OF CONTRACTOR

SIGNATURE OF CONTRACTOR

SECTION II - APPROVAL ACTION


ENCLOSURES RETURNED (List by item No.)

ENG FORM 4025-R, MAR 2012

NAME AND TITLE OF APPROVING AUTHORITY

SIGNATURE OF APPROVING AUTHORITY

REPLACES EDITION OF MAR 95, WHICH IS OBSOLETE.

DATE

Page 1 of 2

INSTRUCTIONS
1. Section I 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 a sequential number for the submittals under that spec section. If the Transmittal is a resubmittal, then add a decimal point to the end of the
original Transmittal Number and begin numbering the resubmittal 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 ENG Form 4025-R.
5. Items transmitted on each transmittal form will be from the same specification section. Do not combine submittal information from different specification sections in a single
transmittal.
6. If the data submitted are intentionally in variance with the contract requirements, indicate a variation in column h, and enter a statement in the Remarks block describing he
detailed reason for the variation.
7. ENG Form 4025-R 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 I.
Submittal types are the following:
SD-01 - Preconstruction
SD-07 - Certificates

SD-02 - Shop Drawings

SD-03 - Product Data

SD-08 - Manufacturer's Instructions

SD-04 - Samples

SD-05 - Design Data

SD-09 - Manufacturer's Field Reports

SD-10 - O&M Data

SD-06 - Test Reports


SD-11 - Closeout

9. For each submittal item, the Contractor will assign Submittal Action Codes in column g of Section I. The U.S. Army Corps of Engineers approving authority will assign Submittal
Action Codes in column i of Section I. The Submittal Action Codes are:
A -- Approved as submitted.

F --

Receipt acknowledged.

B -- Approved, except as noted on drawings. Resubmission not required.

X --

Receipt acknowledged, does not comply with contract requirements, as noted.

C -- Approved, except as noted on drawings. Refer to attached comments.

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)

Resubmission required.
D -- Will be returned by separate correspondence.
E -- Disapproved. Refer to attached comments.

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

ENG FORM 4025-R, MAR 2012

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