HomeMy WebLinkAboutTPI2008-00029 CONTRACTORS STATEMENT OF RESPONSIBILITY.TIF. . . 0
Contractor's Statement of Responsibility
Appendix A Blank Forms
Each contractor responsible for the construction or fabrication of a system or component designated in the Quality
Assurance Plan must submit a Statement of Responsibility.
Project: b 0,:,,j4 Zv- -j-s r SQ.' S / eoaacf NC
Contractor's Name: e�;,, f tu; /sbp, 7'NT �u {urns , L Je-
Address: 'I" 1,,, 2i - )S,1J,rp C , N c 28+60
License No.:
Description of designated building systems and components included in the Statement of Responsibility:
9 L`F S a tu 61
Contractor's Acknowledgment of Special Requirements
I hereby acknowledge that I have received, read, and understand the Quality Assurance Plan and Special Inspection
program.
hereby acknowledge that control will be exercised to obtain conformance with the construction documents approved
by the Building Official.
Signature
Date
Contractor's Provisions for Quality Control
Procedures for exercising control within the contractor's organization, the method and frequency of reporting and the
distribution of reports is attached to this Statement.
Identification and qualifications of the person(s) exercising such control and their position(s) in the organization are
attached to this Statement.
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• Contractor's Statement of Responsibility •
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