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F±BROWNAND Attachment D <br /> LDWELL Notice of Unsafe Conditions <br /> tContractor Date <br /> Project Name Project Number <br /> THIS NOTICE <br /> This notice is to advise you, the Prime Contractor on the above-named Contract, that this <br /> Representative of the Owner of the above-mentioned Project has observed (on the date shown above) <br /> an unsafe condition on the Project <br /> _ These conditions are listed as follows <br />' ITEM CONDITION <br /> By this Notice, the Owner or its Representatives shall not assume any responsibility under the GENERAL CONDITIONS or <br /> assume any liability for the existence or correction thereof, for the unsafe conditions, or any others that may have been <br /> unnoticed <br /> These conditions shall be remedied as soon as possible within a safe working period If these corrections are not made, the <br />' Owner will be forced to remove all field staff from the fob No payment shall be made for any work installed after this date <br /> without first examination of work in accordance with the GENERAL CONDITIONS <br /> Signature of Owner's Representative Title Date <br /> Received by(Signature of Contractor's Representative) Title Date <br /> NOTE: Place a copy of completed form in project file. HS--19 REV 06198 <br />