Appendix G (continued)

Construction Program Management and Inspection Guide

DIVISION OFFICE
FINAL ACCEPTANCE CHECKLIST
FOR FEDERAL-AID "N" PROJECTS

PROJECT INFORMATION
EA No.	Federal-aid No.
Project Description
District/County/Route/KP
Date Awarded	Approval Date
Time Started	Work Started
Contract Days	Final No. Working Day
Original Completion Date	State Acceptance Date
Liquidated Damages (no. of days and total $ amount)
SUBMITTALS	SUBMITTED?			DATE
Material Certification (CM 6-1.1)	Yes	No	N/A
Form FHWA-47M	Yes	No	N/A
Proposed Final Estimate	Yes	No	N/A
Last Statement of Working Days	Yes	No	N/A
Contractor's Written Statement of Claims (Submitted Separately)	Yes	No	N/A
List of CCOs	Yes	No	N/A
(Approved and Pending)	Yes	No	N/A
(Participating/Non-Participating)	Yes	No	N/A
List of Time Extensions	Yes	No	N/A
(FHWA Approved/Not Approved)	Yes	No	N/A
Form CEM-2402 (F) Final Report	Yes	No	N/A
Utilization of DBE	Yes	No	N/A
Environmental Commitments Completed	Yes	No	N/A
ADDITIONAL INFORMATION
Labor Compliance Problems
Any Other Changes

(ORIGINAL: PROJECT FILE; CC: FHWA, WITH PROPOSED FINAL ESTIMATE)

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Updated: 04/04/2011