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| U.S. Department of Transportation Federal Highway Administration California Division Damage Assesssment Form (DAF) Title 23, Federal-Aid Highways |
Report No. _______________ | |||
|---|---|---|---|---|
| Sheet No. _____ of ______ | ||||
| Applicant ____________________________________ |
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| Quantity | Unit | Labor, Materials, and Equipment | Unit Price | Cost |
FHWA DA Form (CA Rev 11/21/05)
 California Division | U.S. Department of Transportation Federal Highway Administration |