TO: FROM:

Islands Mechanical Contractor X3070 Blanding Blvd

PROJECT TITLE AND LOCATION

SPEC. PARA. NO.

DRAWING SHEET NO.

a. c. d. e. f. h. i.SD-03 1

ENG FORM 4025-R, MAR 2012 PAGE 1 OF 2REPLACES EDITION OF MAR 95, WHICH IS OBSOLETE

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

REMARKS I certify that the above submitted items had been reviewed in detail and are correct and instrict conformance with the contract drawings and specifications except as otherwise stated.

IMC Kevin ClinardNAME OF CONTRACTOR SIGNATURE OF CONTRACTOR

Panels CA, CB, CC

CONTRACTOR REVIEW CODE

VARIATION Enter "Y" if

requesting a variation (See

Note 6)

USACE ACTION CODE

(Note 9)

b. g.PanelBoards

SPECIFICATION SEC. NO. (Cover only one section with each transmittal)

THIS TRANSMITTAL IS FOR: (Check One)

16442 Ocean 500, Boyton Beach, FL.

ITEM NO. (See

Note 3)

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

SUBMITTAL TYPE CODE

(See Note 8)

NO. OF

COPIES

CONTRACT REFERENCE DOCUMENT

THIS IS A RESUBMITTAL OF

Middleburg, FL 32068 TRANSMITTAL

SECTION I - REQUEST FOR APPROVAL OF THE FOLLOWING ITEMS (This section will be initiated by the contractor)CONTRACT NO. CHECK ONE:

LandSouth THIS IS A NEW TRANSMITTAL

TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL SAMPLES, ORDATE: TRANSMITTAL NO.

MANUFACTURER'S CERTIFICATE OF COMPLIANCE 11/10/15 14For use of this form, see ER 415-1-10; the proponent agency is CECW-CE

JDF11/12/15

X

Submittal #058 - DIV 16 - Panelboards - Panels CA, CB, CC Resubmittal - #16442 par.1.3