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

(Read instructions on the reverse side prior to initiating this form)

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

DATE TRANSMITTAL NO.

TO: FROM: CONTRACT NO. CHECK ONE:THIS IS A NEW TRANSMITTALTHIS IS A RESUBMITTAL OFTRANSMITTAL ___________

SPECIFICATION SEC. NO. (Cover only one section with eachtransmittal)

PROJECT TITLE AND LOCATION 01-Main Register CHECK ONE: THIS TRANSMITTAL ISFOR FIO GA DA CR

ITEMNO.

a.

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

b.

MFG OR CONTR.CAT., CURVEDRAWING OR

BROCHURE NO.(See instruction no. 8)

c.

NO.OF

COPIES

d.

CONTRACT REFERENCEDOCUMENT

SPEC.PARA. NO.

e.

DRAWINGSHEET NO.

f.

FORCONTRACTOR

USE CODE

g.

VARIATION(See

InstructionNo. 6)

h.

FORCE

USECODE

i.

REMARKS I certify that the above submitted items have been reviewedin detail and are correct and in the strict conformance with thecontract drawings and specifications except as otherwisestated.

NAME AND SIGNATURE OF CONTRACTOR

SECTION II - APPROVAL ACTIONENCLOSURES RETURNED (List by item No.) NAME, TITLE AND SIGNATURE OF APPROVING AUTHORITY DATE

ENG FORM 4025, MAR 95 (ER 415-1-10) EDITION OF SEP 93 IS OBSOLETE. (Proponent: CEMP-CE)

04/06/2011 01015-4

01015

W5J9LE-11-C-0007 NA

Shindand Resident Office ARAO FELLGOUP JV

,

Dsgn/Const 9th Commando Kandak for Af Na Herat Provinces

X

X

7 Concrete Masonry Unite (CMU) SAMPLES 1 4.4.1 A N B

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