MATERIAL APPROVAL SUBMITTAL
FORM APPROVED
OMB NO. 9000-0062
Expires Apr.30 1993
(See Instructions on Reverse)
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TO: ( Contracting Officer)
FROM: (Contactor)
DATE
Lia Arthofer, SMSgt
Aztec General Contractors, LLC
CONTRACT NUMBER
SUBMISSION NUMBER
W912LC-15-C-5002
SUBMITTAL
001-15140
PREVIOUS SUBMITTAL NUMBER
30-Aug-2016
RESUBMITTAL
NEW
PROJECT NUMBER
Construct Range Control Facility & Fitness Center, Project #: FTAE 12-9002
TO BE COMPLETED BY CONTRACTOR
(line number)
ITEM
NO.
SPECIFICATION SECTION /
PARA NO./DRAWING NO.
FOR GOVERNMENT USE ONLY
DESCRIPTION OF MATERIAL
APPROVED
SEE
REVERSE
DISAPPROVED
INITIAL
(Include Type, Model Number, Catalog, Mfg.,etc.)
1
Para 1.03.B
Domestic Water Piping-Product Data
2
Para 1.03.C
Domestic Water Piping-Water sampling
As per Para 3.13.A
Clean & Disfect Domestic Water Piping
X
X
X
BMcD
NO DATA PROVIDED
will be performed according to the
specifications section, all test samples
& reports will be provided to the COR
upon completion of the installation.
BY COMPLETING THIS FORM, THE UNDERSIGNED CONTRACTOR CERTIFIES THAT
DATE
30-Aug-2016
THE MATERIAL COMPLIES WITH ALL SPECIFICATIONS OF SUBJECT CONTRACT.
TYPE OR PRINT NAME AND TITLE
SIGNATURE
RUSSELL B. LUKER, Submittal Manager
FOR GOVERNMENT USE ONLY
TO: (Base Civil Engineering Officer)
For Evaluation and Action
DATE
TYPE OR PRINT NAME AND GRADE
SIGNATURE
TO: (AF Contracting Office)
RECOMMEND
DATE
26SEP2016
X
APPROVAL
TYPE OR PRINT NAME AND GRADE
DISAPPROVAL AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE
Digitally signed by
SIGNATURE
SMITH.WILLIAM.NATH SMITH.WILLIAM.NATHANTERR.1052248600
DN: c=US, o=U.S. Government, ou=DoD,
ou=USAF,
ANTERR.1052248600 ou=PKI,
cn=SMITH.WILLIAM.NATHANTERR.1052248600
WILLIAM N.T SMITH, LTCOL
TO: (CONTRACTOR)
Date: 2016.09.26 10:50:12 -06'00'
Aztec General Contractors, LLC
X APPROVED
DISAPPROVED AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE SIDE.
REQUEST RESUBMITTAL ON DISAPPROVED ITEMS WITHIN
DATE
20160926
TYPE OR PRINT NAME AND GRADE
LIA ARTHOFER, SMSgt
AF FORM 3000, 19910901 (EF-V2)
PREVIOUS EDITION IS OBSOLETE
_______________ DAYS OF DATE SHOWN BELOW.
signed by ARTHOFER.LIA.MARIE.1133861234
ARTHOFER.LIA.MARIE.11 Digitally
DN: c=US, o=U.S. Government, ou=DoD, ou=PKI,
ou=USAF, cn=ARTHOFER.LIA.MARIE.1133861234
33861234
Date: 2016.09.26 12:05:24 -06'00'
SIGNATURE
010515 Form GCO-16
Submittal No:
001-1540
Date Received:
8/31/16
Project:
Range Control Facility & Fitness Center
Contract No:
FTAE 12-9002
Owner/Client:
CO Air National Guard
Project No:
73681
Contractor:
Aztec General Contractors, LLC
Date Returned:
9/6/16
Engineer’s Action (See Contract Documents)
A – Recommend Approval
B – Recommend Approval with comments (no resubmittal)
C – Recommend Disapproval, Revise and Resubmit
D – Recommend Rejection
Submittal No.
001-15140
Submittal Description
Domestic Water Piping
ACTION
A
Submittal Comments:
1. Recommend approval of the Domestic water piping and water meter
BURNS & McDONNELL
By
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