Title Page
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Type of Document
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Project Name
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Purchase Order Number
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Works Completed On
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Location
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Contractor
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Contractor Representative
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Contractor Representative Phone
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Council Project Manager
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Council Project Manager Phone
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Conducted On
Defect Checklist
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Back Filling Satisfactory
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Turf Reinstatement Satisfactory
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Concrete Finish Satisfactory
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Edging and Joints Satisfactory
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Asphalt Adjustment to Gutter Satisfactory
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Asphalt Adjustment to Road Satisfactory
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Concrete/Material Spatter Cleaning Satisfactory
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Sediment Cleared
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Pegs/Timbers Cleared
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Road Base Cleared from Verge
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Loose Stones on Road Surface Cleared
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Dirt/Material on Road Surface Cleared
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Saw Cutting Slurry on Road Surface Cleared
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Barricades Removed
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Traffic Signs Reinstated
Additional Defects
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If project is incomplete, payment will not be released - all listed defects must be completed. Council Officer to list defects for rectification and another inspection will be required.
Defect
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Identify Defect
Sign Off
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Contractor Representative Acknowledges All Defects and Items to be Rectified
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Subsequent Defect Inspection Date
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Subsequent Defect Inspection Date
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Contractor Representative Name and Signature
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Council Project Manager Name and Signature
