SUBMITTAL CERTIFICATION FORM
PROJECT: CONTRACTOR'S PROJ. NO:
CONTRACTOR: ENGINEER'S PROJ. NO:
ENGINEER:
SHOP -
DRAWING SPECIFICATION SECTION SEQUENTIAL NUMBER
NUMBER: OR DRAWING NO: (& ALPHA SUFFIX FOR
RESUBMITTAL)
DESCRIPTION:
MANUFACTURER:
The above referenced submittal has been reviewed by the undersigned and I/we certify that the
material and/or equipment meets or exceeds the project specification requirements with
[.] NO DEVIATIONS
or
[] ACOMPLETE LIST OF DEVIATIONS AS FOLLOWS?:
By: By:
Contractor?
Manufacturer
Date: Date:
4 Any deviations not brought to the attention of the Engineer for review and concurrence shall be the
responsibility of the Contractor to correct, if so directed.
b Required on all submittals
© When required by specifications Page of
General Contractor's Stamp
13089K
