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Los Angeles Unified School District F A C I L I T I E S S E R V I C E S D I V I S I O N Facilities Services Division, Policies and Procedures 1 of 8 Rev 2.0 14.21.1 Project Closeout and DSA Certification Manual September 14, 2012 14.21.1 PROJECT CLOSEOUT AND DSA CERTIFICATION MANUAL 1. Introduction Project Closeout and DSA Certification Manual The objective of this Manual is to provide LAUSD Facilities staff with a stand-alone repository notebook for all essential documents required for the timely certification of a construction project which falls under the jurisdiction of the Division of the State Architect (DSA.) While a construction project may have several DSA applications associated with it, the notebook contains the documents related to the certification requirements of a single DSA application. In the event of an OAR staff change, the Manual will serve the transition role for critical information and project history to the succeeding staffs responsible for closeout and DSA certification. Contents and Organization The Manual organizes required documents into eleven categories roughly arranged by construction phase and document type. The Exhibits include a matrix titled “Table of Documents and Responsibilities" which further specifies the documents to be found within each of the eleven chapters. The matrix further describes each document with the assignment of departmental or agency roles and responsibilities for the origination, signatures, distribution, approval, and collection of each document. Expected Outcome The Manual is intended to guide staff in the assembly of a project notebook which holds the essential documents to be collected during each phase of project design and construction. At Substantial Completion few, if any, DSA required documents will be missing; the Manual is a proactive guide. For now, the notebooks will store physical documents. In the future, the notebook may take the form of an electronic file with the exception of a few key documents which must also be saved as original, ''wet signature" documents. This process facilitates a policy of strict document control and clearly assigns responsibility for collection and electronic storage for every key document. Legacy projects, those which were completed prior to this "Manual" procedure, require extensive forensic efforts to locate or execute required documents. In this case, the Manual serves to assist the closeout specialist in identifying documents, their originators, required signatories, and proper distribution. A complete notebook is unlikely and unreasonable to expect for many of the older completed projects. Best efforts must be made to collect as many of the required documents as possible with an absolute minimum being those requested by DSA in their 90-Day and Close of File letters. In either case, a complete Project Closeout and DSA Certification Notebook (Closeout Notebook) should hold copies of every form and substantiating document required to obtain a Certification and Close of File letter from the State Architect for a given DSA application.

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Page 1: 14.21.1 PROJECT CLOSEOUT AND DSA CERTIFICATION MANUAL

Los Angeles Unified School DistrictF A C I L I T I E S S E R V I C E S D I V I S I O N

Facilities Services Division, Policies and Procedures 1 of 8 Rev 2.0 14.21.1 Project Closeout and DSA Certification Manual September 14, 2012

14.21.1 PROJECT CLOSEOUT AND DSA CERTIFICATION

MANUAL

1. Introduction

Project Closeout and DSA Certification Manual

The objective of this Manual is to provide LAUSD Facilities staff with a stand-alone repository notebook for all essential documents required for the timely certification of a construction project which falls under the jurisdiction of the Division of the State Architect (DSA.) While a construction project may have several DSA applications associated with it, the notebook contains the documents related to the certification requirements of a single DSA application. In the event of an OAR staff change, the Manual will serve the transition role for critical information and project history to the succeeding staffs responsible for closeout and DSA certification.

Contents and Organization

The Manual organizes required documents into eleven categories roughly arranged by construction phase and document type. The Exhibits include a matrix titled “Table of Documents and Responsibilities" which further specifies the documents to be found within each of the eleven chapters. The matrix further describes each document with the assignment of departmental or agency roles and responsibilities for the origination, signatures, distribution, approval, and collection of each document.

Expected Outcome

The Manual is intended to guide staff in the assembly of a project notebook which holds the essential documents to be collected during each phase of project design and construction. At Substantial Completion few, if any, DSA required documents will be missing; the Manual is a proactive guide. For now, the notebooks will store physical documents. In the future, the notebook may take the form of an electronic file with the exception of a few key documents which must also be saved as original, ''wet signature" documents. This process facilitates a policy of strict document control and clearly assigns responsibility for collection and electronic storage for every key document.

Legacy projects, those which were completed prior to this "Manual" procedure, require extensive forensic efforts to locate or execute required documents. In this case, the Manual serves to assist the closeout specialist in identifying documents, their originators, required signatories, and proper distribution. A complete notebook is unlikely and unreasonable to expect for many of the older completed projects. Best efforts must be made to collect as many of the required documents as possible with an absolute minimum being those requested by DSA in their 90-Day and Close of File letters.

In either case, a complete Project Closeout and DSA Certification Notebook (Closeout Notebook) should hold copies of every form and substantiating document required to obtain a Certification and Close of File letter from the State Architect for a given DSA application.

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2. Purpose

This Manual is to provide direction to the Owners Authorized Representatives (OAR) as to the procedures and coordination required to obtain Division of the State Architect (DSA) Certification and project closure. It is designed to be project specific and is a supplement to Los Angeles Unified School District (LAUSD) Policy and Procedure 14.21 Contract Closeout.

Project closure includes securing all deliverables from the Construction Contractor and Design Agent for both on-site and off-site work and fiscal closure of all agreements between the District and others related to the project. This Manual is organized in the chronological sequence of a project.

3. Document Control

Document control is the key to successfully managing the certification and closure process. It begins with the Design Manager and continues through certification and closure. The originals of the following documents are to be filed in accordance with the project file plan included in the current version of LAUSD Policy and Procedure 14.11. Copies of these documents are to be maintained by the OAR in a Project Closeout and DSA Certification Notebook on site, readily available for review and use by District Management and the field team. The index for the Closeout Notebook is included in this Manual. A digital copy of all final documents shall be posted on the LAUSD Facilities Services website.

4. Transition Phase

The following approval documents are to be provided to the OAR by the Design Manager when the project is turned over for the bidding process. Content and preparation of these documents are detailed in the “DSA Project Certification Guide.”

DSA-1 Application for Approval of Plans

This document is the application submitted to DSA who will issue a unique application number that will be used for the life of the project. This form identifies the person in General Responsible Charge, Project Architect (Architect of Record {AOR}), Structural Engineer, Mechanical Engineer, Electrical Engineer, and Geotechnical Engineer. On larger projects, there may be multiple names for each discipline. Only the persons named on this form have signatory authority for Revisions, Addenda, Construction Change Documents and RFC’s.

DSA-108 Delegation of Responsibility

In the event that any of the professionals listed on the DSA-1 (see 3.1 above) are replaced or additional professionals are added prior to project certification, they must be identified on a DSA-108 Form. This formal approval is required prior to their serving as a design agent on the project.

DSA Plan Approval Letter

DSA issues an "Approval of Plan(s) Letter" upon completion of the plan review process to inform the school district that code requirements pertaining to the design and review of documents have been completed. The California Education Code requires that this letter be issued prior to entering into any construction contract and/or prior to the start of any construction. The deferred approval requirements, if any, for the project are listed on the last page of this letter.

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Revisions

Revisions are changes to approved plans made prior to bid. They are to be signed and stamped only by the Architect or Engineer(s) of Record preparing and submitting them. Copies of DSA approval of any revision are to be provided to the construction OAR.

DSA-103 Structural Tests and Inspections (T&I Sheets)

A list of all required tests of materials and of all required special inspections shall be prepared and submitted by the architect, structural engineer, or civil engineer in general responsible charge of the project at the time the plans and specifications are stamped for identification by DSA. The OAR is responsible to transmit the approved DSA-103 Form to the Inspector of Record (IOR) prior to the start of work. All tests and inspections identified on this form must be either completed and a Form-291, 292, or 293 provided certifying that the tests were done and the results are in compliance with the DSA approved documents, or removed by the person in General Responsible via a letter. The IOR is required to maintain copies of these approvals in his or her job file and is to provide copies to the OAR upon request.

Off-Site Permit

Should the project require off-site construction in the public right-of-way an approved design sanctioned by the municipality having jurisdiction is to be included with the approved construction drawings. Within the City of Los Angeles, this is referred to as a Building Design (BD) Permit. The BD Permit Drawings and Specifications are included in the Bid Documents for the construction contract. The actual construction permit is referred to as a Building Construction (BC) Permit. The BC Permit is taken out by the General Contractor. Permit fees may be included in the Allowances for the contract. For temporary permits in the public right-of-way (valve boxes in the sidewalk, roof overhangs over the property line, etc.) a revocable permit may be required.

5. Bid Cycle

Addenda

Changes or alterations to the approved plans or specifications, including Divisions 00 and 01, prior to letting a construction contract for the work involved, shall be made by means of addenda which shall be submitted to and approved by DSA prior to distribution to contractors. Original copies of all addenda shall be stamped and signed by the architect or engineer in general responsible charge of preparation of the plans and specifications and by the architect or registered engineer delegated responsibility for the portion affected by the addenda. One copy of each addendum is required for the files of DSA and one signed and approved copy of the DSA Approval Form shall be kept in the Closeout Notebook.

6. Award of Construction Contract

DSA-102 Contract Information

This document is submitted to DSA by the LAUSD Inspection Department. The IOR is required to maintain a copy of this form in his job file. This form contains the project name, DSA Application Number, initial contract amount (awarded value), contractor’s name, scope of the contract, and signature of the LAUSD Chief Construction Inspector.

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DSA-5 Approval of Inspector (IOR)

For each K-12 school project utilizing public funds, the District must provide a DSA Certified Inspector. This Inspector must also be acceptable to the Architect of Record or Engineer Responsible for the design of the project. The DSA-5 is the approval document for the IOR and must be submitted to DSA within 10 days of Notice to Proceed (NTP) being issued to the Construction Contractor. An approved copy is to be maintained in the IOR’s Job File on site. This document, though necessary for construction, is not required for final certification (See the DSA Certification Guide).

DSA-5 Approval of Special Inspectors (SIOR)

As needed during the construction process, special inspection by inspectors specially approved by DSA may be required. The requirements for these inspections are noted on the DSA-103 “Testing and Inspection Requirements”. The IOR is required to maintain copies of these approvals in his job file and is to provide copies to the OAR.

DSA Form 5A Approval of Assistant Inspectors (AIOR)

In the event the scopes of work or special elements of the construction require an assistant inspector, the assistant inspector is approved by DSA and the Architect of Record on a DSA-5A. There may be multiple assistant inspectors. The IOR is required to maintain copies of these approvals in his job file and is to provide copies to the OAR upon request.

7. Mobilization

The initial closeout meeting is to be scheduled by the OAR and is to occur within thirty days of the issuance of the Notice to Proceed (NTP). This meeting is to acquaint all construction team members with the overall closeout procedures that will be used on the project. Attendees aside from the OAR and IOR may include: District Senior Project Manager, General Contractor Project Manager, AOR, and the Regional Closeout Manager (RCM). At this point, the OAR should create a binder entitled “Project Closeout and DSA Certification Notebook” hereinafter referred to as the “Closeout Notebook.”

Project DSA Closeout and Certification Notebook

At the initial closeout meeting, the OAR will prepare the Closeout Notebook to insure that all of the above required documents are included. The OAR will also identify, using the T&I

sheet and DSA E-Tracker (www.apps.dgs.ca.gov/tracker/Appno.aspx), all of the required

documents necessary for DSA certification. This list will be used by the project team to ensure collection of necessary documents.

Submission of Deferred Approvals

The status of the required deferred approval document, noted on the DSA plan approval letter, will be reviewed during this meeting. It is the responsibility of the General Contractor to prepare all required drawings, specifications, calculations and supporting data for submittal of Deferred Approval design to DSA. The Deferred Approval status will be updated by the OAR weekly in the weekly project meeting minutes.

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DSA Project Certification Guide

The Guide, published by the Department of the State Architect, describes the process necessary to achieve DSA Certification for a project. The Guide (PDF-3.31MB) revised 03/24/10, may be found on the DSA Publications web site (www.dgs.ca.gov/dsa/Resources/pubs.aspx).

What is DSA Project Closeout

Project closeout is the process that DSA uses to determine that the constructed project complies with the codes and regulations governing school construction (the codes and regulations being those used for the original design). Project closeout consists of examination of specific project files for documents required to be submitted before, during and after construction, and to determine if outstanding issues have been resolved. After the file is examined, the project file is closed either with certification or without certification. After the project is closed, the files are sent to State Archives.

What is DSA Project Certification

Project certification is a letter issued by DSA certifying that the building project has been completed in accordance with the requirements as to the safety of design and construction pursuant to Education Code Sections 17280-17316 and 81130-81147

8. Weekly Meetings Minutes

The closeout of a project starts at the beginning of a project. Good record keeping and closure of open items will greatly assist the project certification. Weekly project meetings shall track the status of DSA Approval of Revisions, Addenda and Deferred Approvals. The meeting minutes shall track the approval of FCDs and closure of all FTNs. Additionally, the IOR shall update the status on the required Verified Reports.

Off-Site Construction

Although not generally required for DSA Certification, closure of the off-site permit work is required to close the construction and design contracts. Once construction is completed the Contractor is to request a final inspection from the municipality or agency that issued the permit and the Architect of Record is to update the agency plans and specifications as necessary. NOTE: LAUSD projects may be sited in any of several municipalities or within areas governed by the County of Los Angeles. Permit closeout procedures may vary from jurisdiction to jurisdiction.

Construction Change Documents

All Change Order Proposals (COPs) are to be submitted to the District Prior to Notice of Completion which is issued ten days after the Certification of Substantial Completion. The status of change orders shall be monitored during the OAR’s weekly progress meetings.

9. Substantial Completion

Closeout Progress Meeting Requirements

At Substantial Completion, closeout progress meetings should be held periodically with attendance by the OAR, AOR, General Contractor, Project Manager, and IOR. (Optional attendees are the same as noted in paragraph 7 above). The agenda for these meetings shall be determined in advance by the OAR and made available to all attendees. The focus

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of the meetings will shift from completing the work of construction to providing final certifications and deliverables for both the Construction Contractor and the Architect of Record, completing the corrective work, processing of all remaining construction change documents, and meeting the requirements for occupancy of the facilities. The meetings will be discontinued at Final Completion.

Corrective Work

Prior to Substantial Completion (SC), the Inspector of Record will issue a Non-Conformance Items List (NCIL) for the project. This is the working list of non-compliant items that need resolution. The incomplete items will eventually be transferred to the SC Punch List.

Within five days of Substantial Completion, the Inspector of Record will issue a corrective items list (punch list) for the project. This list will be inclusive of all Special Inspector, Architect, DSA Field Trip Notes (FTN) and District agency comments (i.e. OEHS, FTPMG, etc.). This is the only punch list to be issued for the project after Substantial Completion.

1. Contractor Corrective Work: Contractual work requiring correction or adjustment is to be completed by the Contractor prior to Final Completion and final application for payment. The OAR is to determine the appropriate time to be given to the Contractor for the completion of the punch list; however the duration may NOT exceed 60 days past the SC issuance date.

2. Design Corrective Work: All DSA required Construction Change Documents, are to be submitted to DSA for review and approval. DSA approval is critical to obtaining a Form 6 100%.

3. Not In Contract Code Required Corrections or Changes: It is not a requirement of the Contractor to complete California Building Code requirements identified during construction that are separate from the contractual scope identified in the approved plans and specifications. They must, however, be completed prior to requesting DSA Certification if identified within the application but separate from present contract. If identified prior to Substantial Completion, they are to be addressed with a Construction Change Document to the Contractor. If identified after Substantial Completion, other contracts, or by Maintenance and Operations forces, other means may be used to complete this type of required scope. A new DSA Form-102 will be issued to DSA by Inspection to capture the additional cost and contractor information for these contracts and will show that 100% of the Application scope is contracted. NOTE: Any changes to the DSA approved design must also be DSA approved. Obtaining DSA approval is critical to obtaining the DSA-6 Form from the IOR and AOR.

4. Unfinished Punch List items: All items identified on the punch list must be resolved. The following are solution strategies that can be used to accomplish this goal:

Contractor to complete the Punch List: The punch list is resolved/completed by the original contractor.

OAR Acceptance Letter: OAR can accept the non-scope, non-code regulated and non-safety punch list items.

Submit a Change Order or FCD Removing the item: The punch list code-regulated item shall be cleared by a DSA approved Change Order or FCD.

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Complete the item by other means: As provided for within the General Conditions of the Construction Agreement, the OAR may elect to complete remaining items by issuing an additional contract (JOC, M&O, or A/B Letter).

10. Final Completion

Schedule

OARs should be aware that for Final Completion and Contract Closeout, time is of the essence. Closeout must be accomplished within 30, 60 or 90-days of the date of Substantial Completion, as specified in the Contract.

For the General Contractor

Final Completion is the point at which all of the work of construction has been completed, including all corrective work, off site work, and that all change documents have been submitted to DSA for review and all contractual deliverables, including certifications, warrantees, guarantees, and operations manuals have been received by the District. At this time, the Contractor may submit a final application for payment.

1. General Contractor Final Verified Report: At final completion the District will expect a Verified Report (DSA-6) from the Contractor stating that construction is complete. Any unapproved Change Documents are to be noted on the Verified Report. Upon approval of all Change Orders, the General Contractor shall issue a DSA-6 form noting any remaining Change Orders unapproved.

For the Architect of Record

Final Completion is that point at which the Record Documents have been submitted to the District and accepted by the Plan Vault, all Construction Change Documents have been approved by DSA, all off-site permits have been closed by the issuing agencies, and the Verified Report (DSA-6A/E) has been submitted to the District reflecting that the project is 100% complete and in conformance with the DSA approved documents. Any unapproved Change Documents are to be noted on the Verified Report. Upon approval of all Change Orders, the A/E shall update and reissue a DSA-6 form.

For the Inspector of Record

Final Completion is that point at which the work of construction is complete, including all corrective work, and all Change Documents have been approved by DSA. The Inspector of Record will issue a Verified Report (DSA-6) indicating that the work is 100% complete and in conformance with the DSA approved plans and specifications. Any unapproved Change Documents are to be noted on the Verified Report. Upon approval of all Change Orders, the Inspector shall update and reissue issue a DSA-6 form.

DSA Final Construction Certification

DSA submittal for final certification should be accomplished within 180-days of the date of Substantial Completion, or 90-days after the last Change Order has been approved by DSA, whichever is the latest.

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11. Project Closeout and DSA Certification Notebook:

The required documents for DSA Certification of construction are unique to each project. Specific project information may be located on DSA “Tracker” at (https://www.apps.dgs.ca.gov/Tracker/Appno.aspx). All of these documents are described in detail in the “DGS Project Certification Guide” and are grouped on DSA Tracker. The forms that may be required for closeout and certification are listed below. A project specific checklist has been prepared for convenience, and is attached as an Exhibit B to this Manual’s List of Documents. The OAR shall organize the Closeout Notebook as indicated below:

Tab 1 Application Documents

Tab 2 Revisions Tab 3 Addenda Tab 4 Deferred ApprovalsTab 5 Form 5s Tab 6 Form 6s Tab 7 Test and Inspection DocumentsTab 8 Field Trip NotesTab 9 Invoices and Copies of WarrantsTab 10 Closeout DocumentsTab 11 Other Documents

EXHIBITS

Note: DSA Forms and Publications are available on the DSA website at (www.dgs.ca.gov/dsa/Forms.aspx)

Exhibit A—Project Closeout Checklist

Exhibit B—List of Documents Required for Closeout and DSA Certification

Exhibit C—Construction Department DSA Closeout Notebook / Table of Documents and Responsibilities

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PROJECT CLOSEOUT CHECKLIST

School: __________________________________________________________________ Region: ______________________________IFS:

Project: PIC:

OAR: Contract #:

DOCUMENTS REQUIRED FOR CLOSEOUT Document Origination

Certificate of Substantial Completion OAR

Notice of Completion OAR/ laschools.org

Receipt of All Warranties and Manuals OAR

Final “As Built” Record Submittal Acceptance by Vault OAR

All Punch-List Items Have Been Resolved (Notice from Inspection) OAR

Release of Retention Authorization IFS

Signed off B Permits for Offsite Work OAR

Fire Alarm Completion Notice-NFPA-72-Signed by the IOR (Fire Alarm Projects Only) OAR

Release of Withhold Authorization OAS

All Change Orders are Board Approved (Include PIC Change Order Log) PIC

De-encumbrance and Close of All Job Tickets (M&O, Inspection, Design, Etc…) IFS

All Outstanding Invoices Have Been Paid IFS

Financial Closeout - Project Finalization Form OAR/EAC tool

Contractor Performance & Safety Evaluation OAR

A/E Performance Evaluation OAR

ADDITIONAL DOCUMENTS REQUIRED FOR DSA PROJECTS

If issued, copy of DSA "Close of File Letter". If not issued, copy of DSA "90-Day Letter". If none, state N/A LAUSD Facilities Document System

Current print-out of "Documents Required List" from DSA Tracker. Verify complete. Date printed: ______

DSA-6 @ 100% (Contractor, A/E, IOR) Include the forms for all contracts related to the DSA Application. OAR

T&I Sheets and Lab Affidavits Form 291's, 292's and 293's and/or Waiver Letters OAR

All FCD's approved (FCD Log) OAR

All Change Orders are DSA Approved (PIC Report) PIC

Approved Addenda and Deferred Approvals (tracker updated to reflect) OAR

Close all Field Trip Notes as noted in DSA 90-Day letter, Close of File Letter or DSA Tracker OAR

DSA Contract Reconciliation Form for Multiple Projects i.e. JOC, B letter (see comment below) OAR

DSA Form 168 Statement of Final Actual Project Costs OAR

OAR, "Signature Verifies All Above Documents are Included in the Project Closeout Package Submitted" Date

<Insert name>, Sr PM or Regional Closeout Lead; <Insert Region> Date

<Insert name>, Regional Construction Director; <Insert Region> Date

Rev. date 5/30/12

EXHIBIT A

DSA #: 03-

For multi-contract projects, especially where informal B-Letter, JOC Mod, A-Letter, or M&O Contacts are used to complete portions of the work, and in particular, when such contracts are not notified to Inspection by FCC, there is a need for a DSA Contract Reconciliation Document to be provided to Inspection so that Inspection can notify DSA of the correct revised DSA 102 (i.e. contract award amount) and also to have all information to provide the correct final construction amount on the AE and IOR Form 6’s (i.e. the sum total of all contract amounts and all change orders for all formal contracts).

The DSA Contract Reconciliation Form is not sent to DSA by Inspection, but it is used by Inspection to know what the right amount should be reported to DSA and reported on the IOR and AE Form 6, documents which capture all contracts and all application scope and associated costs.  

DSA Tracker

9/28/2012

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LIST OF DOCUMENTS REQUIRED FOR CLOSEOUT and DSA CERTIFICATION

School: Contract #: _______________ IFS: _______________

Project: DSA No.: _______________ PIC: _______________

Doc Ref # Document Name Applicable Complete

Tab 1 Application Documents1 DSA-1 "Application for Approval of Plans and Specifications"

2 DSA-1.DEL "Delegation of Responsibility" (designation of alternate-supplement to DSA-1)

3 DSA-1.INC "Definition of Scope of Increments"

4 DSA-108 "Change of Responsibility" (to replace personnel)

5 DSA-403 "Energy Compliance Checklist"

6 DSA-2 "Application for Evaluation of Existing School Building"

7 DSA-3 "Project Submittal Checklist"

8 DSA Letter - "Notice of Progress"

9 DSA-145 "Record of Set Handling Instructions" (transmittal information)

10 DSA Letter - "Approval of Plans" (Critical document)

11 LAUSD Letter Requesting Extension of Approval

12 DSA Revised "Approval of Plans" showing Extension of Time (Critical document)

13 DSA-102 "Contract Information" (for each contract and any revisions) (Critical document)

14 LAUSD Letters - Any correspondence altering conditions of the application

15 DSA-103 "Structural Tests and Inspections" (Critical document)

16 LAUSD "Structural Tests and Inspections" Sheet (DM Contracts Lab)

17 DSA-121 "Checklist for Site Inspection of Relocatable Buildings"

18 LAUSD Letter - "Cancellation of Application"

19 DSA Letter - "Void after 4-Year Rule"

20 DSA Letter - "Cancellation"

21 DSA-111 "Start of Project Report"

Tab 2 Revisions22 Copies of DSA Stamped cover sheet and transmittal (Critical document)

Tab 3 Addenda23 Copies of DSA Stamped cover sheet and transmittal (Critical document)

Tab 4 Deferred Approvals24 Copies of DSA Stamped cover sheet and transmittal (Critical document)

Tab 5 Form 5s25 DSA-5 "Project Inspector Qualification Record" (As applicable for each IOR)

25a DSA-5 "Project Inspector Qualification Record" Welding (as applicable)

25b DSA-5 "Project Inspector Qualification Record" Masonry (as applicable)

25c DSA-5 "Project Inspector Qualification Record" Concrete (as applicable)

26 DSA-5A "Assistant Inspector Qualification Record" (as applicable, all disciplines)

Tab 6 Form 6s27 DSA-6 "Verified Report" for Inspectors

28 DSA-6 "Verified Report" for Contractors

29 DSA-6A/E "Verified Report" for Architects and Engineers

______________________________________________________ Region: __________________

__________________________________________ OAR: ________________________________

Comments

EXHIBIT B Project: ______________________________ 9/28/2012

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LIST OF DOCUMENTS REQUIRED FOR CLOSEOUT and DSA CERTIFICATION

Tab 7 Test and Inspection Documents30 DSA-130 "Certificate of Compliance - Approved Bleacher Grandstand Fabricator"

31 DSA-131 "Bleacher Grandstand Material Certification - Unapproved Fabricator"

32 DSA-201 "Soil Compaction"

33 DSA-202 "Sieve Analysis"

34 DSA-203 "Tension/Bend"

35 DSA-204 "Compression"

36 DSA-205 "Concrete Masonry"

37 DSA-206 "Anchor Load"

38 DSA-207 "Masonry Core Shear/Compression"

39 DSA-208 "High Strength Bolt"

40 DSA-209 "Fireproffing Density"

41 DSA-210 "Ultrasonic (NDT)"

42 DSA-250 "Special Inspection"

43 DSA-291 "Laboratory Verified Report" (formerly "Lab Affidavit") (Critical document)

44 DSA-292 "Special Inspection Verified Report" (for ongoing work) (Critical document)

45 DSA-293 "Geotechnical Verified Report" (Critical document)

46 DSA-190 "Certification of Exessive Flow Automatic Gas Shutoff Valve" (triggers DSA-250)

47 DSA-191 "Certification of Seismic Automatic Gas Shutoff Valve" (triggers DSA-250)

48 DSA-999 "inspection Verified Report for Projects Exempt from DSA Approval"

Tab 8 Field Trip Notes49 DSA Field Trip Notes

50 LAUSD Responses/Resolutions to Field Trip Notes (FTNs)

Tab 9 Invoices and Copies of Warrants51 DSA Invoices

52 LAUSD Warrant Requests

53 LAUSD Copy of Warrant with DSA Stamp of Receipt

Tab 10 Closeout Documents54 LAUSD Certificate of Substantial Completion (Critical document)

55 LAUSD JOC Certificate of Substantial Completion (Critical document)

56 LAUSD Notice of Completion (NOC) (for each contract) to FCC (Critical document)

57 LAUSD PIC Change Order and/or CDA Log(s)

58 LAUSD FCD Cover Letters with DSA Approval Stamp

59 LAUSD CO/CDA Cover Letters with DSA Approval Stamp

60 DSA-112 "Close of Project Report"

61 DSA-122 "SB 1469 Inspector's Report"

62 DSA-123 "SB 1469 Certification of Compliance"

63 DSA Letter - "90-Day Letter (including any modified or revised letters) (Critical document)

64 DSA Letter - "Close of File without Certification" due to Deficiencies or Exceptions (Critical document)

65 LAUSD Generated Correspondence in Response to Closeout Cocuments, ex: Waivers

66 DSA Letter - "Certification and Close of File" (Critical document)

Tab 11 Other Documents67 BC Permit (Off-Site Work)

68 DSA-168 Statement of Final Actual Costs

69

EXHIBIT B Project: ______________________________ 9/28/2012

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