ࡱ> z|y vKbjbj <~hh 8}}}}lBj`>@@@@@@ }#@]ll@}}}}>>}j|*0+$+$+$L@@+$ : Notification of Project Completion and Materials Certification This certificate must be furnished to the Department of Roads before the project can be closed out. To: Nebraska Department of Roads Urban/Rural Engineer, Local Projects SectionCity/County of  FORMTEXT      , NebraskaProject Name: FORMTEXT      State Project No.: FORMTEXT      State Control No. FORMTEXT      Prime Contractor Name:Final Contract Amount: FORMTEXT      $  FORMTEXT      Subcontractor Name(s):Final Subcontract Amount FORMTEXT      $  FORMTEXT       FORMTEXT      $  FORMTEXT       FORMTEXT      $  FORMTEXT       FORMTEXT      $  FORMTEXT       FORMTEXT      $  FORMTEXT       The City/County certifies that all the work on this project is complete and accepted by the City/County as of20 FORMTEXT   , and the project was constructed according to the plans and specifications approved by the Nebraska Department of Roads (NDOR). Materials testing requirements of the contract were met and test reports are on file with the City/County. All required manufacturers certificates of compliance and the manufacturers certified test reports met contract requirements and also are on file with the City/County. Exception(s) to the plans and specifications:  FORMCHECKBOX  Yes  FORMCHECKBOX  No If Yes, attach additional sheet(s) to this form explaining the exception(s). By signing this Notification of Project Completion and Materials Certification form, I,  FORMTEXT      representing the City/Cou"#?       $ ŶŧŘv`G8h,+hCJOJQJaJ0jh,+hCJOJQJUaJmHnHu+jh,+h;CJOJQJUaJh,+hRCJOJQJaJ%jh,+h;CJOJQJUaJh,+htVCJOJQJaJh,+h6CJOJQJaJh,+hCJOJQJaJh,+hz~CJOJQJaJ"hzh 6CJOJQJ]aJhH5CJ OJQJ\h 5CJ OJQJ\?  $ $ *+($If]^a$gd,+ *+($If]gd,+$ *+($Ifa$gd,+ *+$If]gd,+ $xa$gd}$a$gdH$ & B j pX< *+($If]^gd,+ *+($If]gd,+kdv$$Iflre%*% t*644 lalyt,+$ & > B D X Z \ f h j l x ۲șےtt^ștOth,+hCJOJQJaJ+j.h,+h;CJOJQJUaJh,+htVCJOJQJaJh,+hTCJOJQJaJ hzhz0jh,+hCJOJQJUaJmHnHu+j;h,+h;CJOJQJUaJ%jh,+h;CJOJQJUaJh,+hzCJOJQJaJh,+h6CJOJQJaJ hzhz~j l  uV7$ *+($If]^a$gd,+$ *+($If]^a$gd,+ *+($If]^gd,+ *+($If]gd,+Vkd$$Ifl\0y*y/# t*644 lalyt,+     2 4 b d f h j ~ ȯȠ{{t{^ȯȊ{O{h,+hLCJOJQJaJ+jVh,+h;CJOJQJUaJ hzhth,+hn CJOJQJaJh,+htCJOJQJaJ hzhtVh,+htVCJOJQJaJ0jh,+hCJOJQJUaJmHnHu%jh,+h;CJOJQJUaJ+jh,+h;CJOJQJUaJh,+hQ CJOJQJaJ  6 8 f kO0$ *+($If]^a$gd,+ *+($If]^gd,+ *+($If]gd,+|kd$$Ifl\\y#*y[ t*644 lalyt,+f h ~_C *+($If]^gd,+$ *+($If]^a$gd,+ *+($If]gd,+ikd$$Ifl FE* c t*6    44 lalyt,+ " $ & : < > H J P R T h j l v x z | ~ ֽ֮֘{ֽ֘l֘Vֽ֘֘+jh,+h;CJOJQJUaJh,+hLCJOJQJaJ+jhh,+h;CJOJQJUaJ hzhn h,+hn CJOJQJaJ hzhth,+htCJOJQJaJ0jh,+hCJOJQJUaJmHnHu%jh,+h;CJOJQJUaJ+jh,+h;CJOJQJUaJ " ~bC$ *+($If]^a$gd,+ *+($If]^gd,+ *+($If]gd,+ikdB$$IflFE* c  t*6    44 lalyt,+" $ L P z ~_C *+($If]^gd,+$ *+($If]^a$gd,+ *+($If]gd,+ikd$$Ifl FE* c t*6    44 lalyt,+z | ~_C *+($If]^gd,+$ *+($If]^a$gd,+ *+($If]gd,+ikdT$$IflF E* :c  t*6    44 lalyt,+      & ( * , . ֽֽ֮֮֮֮lֽ֮֮Vֽ֮+j h,+h;CJOJQJUaJ+j h,+h;CJOJQJUaJ hzhn +jkh,+h;CJOJQJUaJh,+hLCJOJQJaJh,+hn CJOJQJaJ0jh,+hCJOJQJUaJmHnHu%jh,+h;CJOJQJUaJ+jh,+h;CJOJQJUaJ * ~_C *+($If]^gd,+$ *+($If]^a$gd,+ *+($If]gd,+ikd$$IflF E* :c  t*6    44 lalyt,+* , T X ~_C *+($If]^gd,+$ *+($If]^a$gd,+ *+($If]gd,+ikdn $$IflF E* :c  t*6    44 lalyt,+. 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FORMTEXT      City/County of FORMTEXT       FORMTEXT      LPA Project Construction Manager/EngineerLPA Responsible Charge FORMTEXT   / FORMTEXT   /20 FORMTEXT   Comment(s) by the State Representative/District Engineer:  FORMCHECKBOX  Yes  FORMCHECKBOX  No If Yes, attach additional sheet(s) to this form with comments. This completes all work on this project. I recommend closeout:  FORMCHECKBOX  with audit  FORMCHECKBOX  without audit. I Concur: FORMTEXT       FORMTEXT      NDOR District Project RepresentativeNDOR District Engineer FORMTEXT   / FORMTEXT   /20 FORMTEXT    FORMTEXT   / FORMTEXT   /20 FORMTEXT    FORMTEXT      Local Projects Section Urban/Rural EngineerDR Form 299, Mar 09 FORMTEXT   / FORMTEXT   /20 FORMTEXT        BBBDjDlDDDqkkk$If$($Ifa$gdKm$  $+dx]a$gdS28gkd$$IflF *  t6    44 layt,+XDZD\DfDhDjDlDDDDDDDDDDDDDDֱyjTyyPAhrShrSCJOJQJaJh +jhKmh;CJOJQJUaJhKmhrSCJOJQJaJ%jhKmh;CJOJQJUaJhKmh CJOJQJaJhU]CJOJQJaJh CJOJQJhrSh CJOJQJaJ*jhCJOJQJUaJmHnHu%jhrSh;CJOJQJUaJ+jahrSh;CJOJQJUaJDDDDD~~p$($Ifa$gdKm$IfzkdI$$Ifl4\p*` 44 lalf4ytU]DDDDDDDDDDEE*EE@ElEnEpErEtEvExEֱ|oeVFjh;CJOJQJUaJhKmh1kCJOJQJaJh1kCJOJQJh1k6CJOJQJ]hT6CJOJQJ]h 6CJOJQJ]hU]6CJOJQJ]h CJOJQJh hrSh CJOJQJaJ*jhCJOJQJUaJmHnHu%jhrSh;CJOJQJUaJ+jhrSh;CJOJQJUaJDDDDD$Ifgkd|$$Ifl4Fp* `,    44 lalf4ytU]DD>E@EnE~p$($Ifa$gdG7 ($IfgdG7$($Ifa$gdU]gkd2$$Ifl4Fp*  ,    44 lalf4ytU]nEpErEtEvEEEEEEEEzzzzzz$$If]^a$gdq $$Ifa$ekd$$Ifl4Fp*,    44 lalf4ytU] 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