TRANSMITTAL OF SHOP DRAWINGS, EQUIPMENT DATA, MATERIAL SAMPLES, OR DATE TRANSMITTAL NO.

MANUFACTURER'S CERTIFICATES OF COMPLIANCE 03/15/2010 01525-1

(Read instructions on the reverse side prior to initiating this form)
SECTION I - REQUEST FOR APPROVAL OF THE FOLLOWING ITEMS (This section will be initiated by the contractor)
TO: North-Afghanistan Engr Distric FROM: CONTRACT NO. CHECK ONE:
DORA Construction Company
X THIS IS A NEW TRANSMITTAL
Najara Street OPP Clinic Sector A W5J9JE-10-C-0011 NA THIS IS A RESUBMITTAL OF
Kabul, TRANSMITTAL ___________
SPECIFICATION SEC. NO. (Cover only one section with each PROJECT TITLE AND LOCATION 01-Main Register CHECK ONE: THIS TRANSMITTAL IS
transmittal) 01525 ANA O&M Pol-e Charki Security Upgds 2 PEC, Kabul, Kabul, Afghanistan FOR FIO X GA DA CR
ITEM DESCRIPTION OF ITEM SUBMITTED MFG OR CONTR. NO. CONTRACT REFERENCE FOR VARIATION FOR
NO. (Type size, model number/etc.) CAT., CURVE OF DOCUMENT CONTRACTOR (See CE
DRAWING OR COPIES USE CODE Instruction USE
BROCHURE NO. SPEC. DRAWING No. 6) CODE
(See instruction no. 8) PARA. NO. SHEET NO.
a. b. c. d. e. f. g. h. i.

1 Accident prevention Plan PRECON SUBMTL 4 1.8 A N

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

NAME AND SIGNATURE OF CONTRACTOR

SECTION II - APPROVAL ACTION

ENCLOSURES RETURNED (List by item No.) NAME, TITLE AND SIGNATURE OF APPROVING AUTHORITY DATE

ENG FORM 4025, MAR 95 (ER 415-1-10) EDITION OF SEP 93 IS OBSOLETE. SHEET 1 OF 1 (Proponent: CEMP-CE)