Contractor Name and Logo
- Project name
- Owner
- Contractor
- Print set or design reference
- Print revision
- Area, route or segment
- Prepared by
- Date
Before You Submit
- Every line matches an item or unit code on the prints
- Installed quantities come from field records and redlines, not from the design
- Every difference between design and installed quantity is explained in the notes
- Material returned to stock or to the owner is listed
- Quantities match the as-builts submitted for the same area
| Item or Unit Code | Description | Unit of Measure | Design Quantity | Installed Quantity | Difference | Location or Station | Notes |
|---|---|---|---|---|---|---|---|
Sign-Off
Contractor Project Manager
- Name
- Signature
- Date
Owner Representative
- Name
- Signature
- Date
