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STATE OF CALIFORNIA VAKLY STATEMENT <br /> DEPARTMENT OF TRANSPOIZTA11ON OF WORKING DAYS 3 S I AMP File Index No. 27 <br /> FoRm -4;. - .. 10-SJ-4-R17 . 4 <br /> 15(REV <br /> 9-let TT 1 0"A5 l4 REPORT No—a. <br /> ItEV � .•,. � � ' <br /> TO 0. H. Materials Contractor <br /> The following statement shows the number of working days charged to your contract for the week ending Januar 24 , 19 $5 <br /> Working Days <br /> Non-Working No Work <br /> Dote Do Weather,Weather Conditions or Working Days Done on <br /> Day Other ConditionsNote 1 <br /> ( ) Day Caused 6y Controlling <br /> Weather Operation <br /> (Note 2) <br /> Jan. 2n Mon. <br /> Holiday <br /> 21 Tue. <br /> 22 Wed. <br /> 23 Thur. It <br /> 94 Fri. rt <br /> Days this week--------------- _ -- -- -----------------------------_ _.. ——- -- —_-- — <br /> Days previously reported.—------------ -- ------------_---------------__— --— --------------— -------------- <br /> Total days to date......- --......------------------------------------ _ -- — --- - <br /> CCO Numbers Dari Approved <br /> TIME EXTENSIONS (Note 3) <br /> GCO Other <br /> Days this report_.............. ......... - --•------- <br /> Days previously reported_-_--------------•-.-..... - ----------------------------------------------- -- - <br /> Totaldays to dote--- -------- ------------- -- .................----------------------- _ — - ------------- ------------------ <br /> COMPUTATION OF EXTENDED DATE FOR COMPLETION Number Numbered Day Date <br /> of Days (Note 5) <br /> 1. Date Contract approved by Attorney <br /> 2. Working days specified in contract__—_---______ 40 <br /> . COMPUTED GATE FOR COMPLETION (if all days specified an workable)._...—_. — <br /> 4. Total time extension d approved to date (CCO plus other _-------- <br /> -----------___— t <br /> 5. Total non-working days o date (Note L) --_—_ ) —_—_ c # } Y} <br /> b. Sub Total Line 4 -- - 7 7 <br /> { plus Line 5) <br /> 7. EXPENDED DATE FOR COMPLETION (Line 3 plus Line 6}�—___._•—_—__._—_ <br /> B. Revised working days for contract (Line 2 plus Line 4) —_— ______W--___ 45 <br /> i s� <br /> 9. Total working days to date_„ _--__-•- y <br /> 10. WORKING DAYS REMAINING (Line 8 minus Line 9).___—___.._.________----------------_____._.__.,....----_----- 1 A <br /> Controlling Operations) --Soil tests, backfill <br /> REMARKS: (Note Li) (Continue on reverse) <br /> The Contractor will be allowed f cen (15) days in which to protest in writing the correct- R. R• Le S an <br /> nese of the statement; otherwise the statement shall be deemed to hay* been accepted by Resident Engineer <br /> the Contractor as correct. NOTE: All footnotes ore on reverse side, <br /> 84 89199 <br />