CERTIFICATE OF COMPLETION

CONTRACT NO :

TITLE :

EMPLOYER :

CONSULTANT :

CONTRACTOR :

INSPECTION : :
DATE OF INSPECTION
REPORT NO

EFFECTIVE DATE OF : DATE OF END OF DEFECTS :

CERTIFICATE LIABILITY PERIOD

IT IS HEREBY CERTIFIED IN TERMS OF CLAUSE 54(4) OF THE GENERAL CONDITIONS OF

CONTRACT THAT THE WORKS ON ABOVE CONTRACT IS COMPLETE, HAS BEEN INSPECTED AND
HAS PASSED ALL QUALITY CONTROL TESTS.

OUTSTANDING, UNACCEPTABLE AND EXTRA WORK APPLICABLE

NOT APPLICABLE

Attached:

 Addendum A is a list of items which are either incomplete or unacceptable and should, in accordance with GCC
Clause 54(4), be completed or rectified in accordance with the specifications, drawings and relevant instructions not
later than the date stated in the Addendum.

 Addendum B lists extra items that are required to be completed by the stated date. If these items are not complete
or have not been rectified by the aforementioned date, the effective date of this certificate shall be extended by the
amount of additional time taken by the Contractor to complete the work specified.

ENGINEER FOR: ROADS AND STORMWATER FOR: CONTRACTOR

DIVISION

Date Date Date

597442865.doc
 ADDENDUM A
INCOMPLETE AND/OR UNACCEPTABLE ITEMS
Snag Action by Completion
Date Action by
No date date

597442865.doc
 ADDENDUM B
EXTRA WORK
Snag Action by Completion
Date Action by
No date date

597442865.doc