CDOT Form 249 "Manufacturer's Certification of Compliance for Concrete Pipe" - Colorado

What Is CDOT Form 249?

This is a legal form that was released by the Colorado Department of Transportation - a government authority operating within Colorado. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 1998;
  • The latest edition provided by the Colorado Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of CDOT Form 249 by clicking the link below or browse more documents and templates provided by the Colorado Department of Transportation.

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Download CDOT Form 249 "Manufacturer's Certification of Compliance for Concrete Pipe" - Colorado

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Project
COLORADO DEPARTMENT OF TRANSPORTATION
MANUFACTURER'S CERTIFICATION OF
Location
COMPLIANCE FOR CONCRETE PIPE
Date shipped
Manufacturer instructions:
1) Complete this form and make two copies.
2) Send two copies with the truck load and have the contractor representative sign all three copies and,
a) retain one copy for your records.
b) give one copy to the contractor representative.
Contractor Representative instructions:
1) Retain one copy for your records.
2) Transmit one copy to the Colorado Department of Transportations Project Engineer.
Project Engineer instructions:
1) Conduct a visual inspection on the pipe listed below for final acceptance.
2) Attach a copy of this form when submitting CDOT Form #157 Field Report for Sample Identification or Materials
Documentation.
(NOTE: Inspection of plant facilites (fabrication process, materials, “D” load tests) are conducted to assure quality. Test
results are on file in the Central Laboratory.)
Manufacture name
Contractor name
Shipment #
Size
Class
Date of mfg.
# of pieces
Length
Total length
Remarks:
Manufacturer certification
I CERTIFY UNDER PENALTY OF PERJURY IN THE SECOND DEGREE AND ANY OTHER APPLICABLE STATE OR FEDERAL
LAWS, THE PIPE LISTED ABOVE HAS BEEN FABRICATED ACCORDING TO THE APPLICABLE AASHTO STANDARDS.
Manufacturer’s representative signature
Date
CDOT Form # 249 5/98
Project
COLORADO DEPARTMENT OF TRANSPORTATION
MANUFACTURER'S CERTIFICATION OF
Location
COMPLIANCE FOR CONCRETE PIPE
Date shipped
Manufacturer instructions:
1) Complete this form and make two copies.
2) Send two copies with the truck load and have the contractor representative sign all three copies and,
a) retain one copy for your records.
b) give one copy to the contractor representative.
Contractor Representative instructions:
1) Retain one copy for your records.
2) Transmit one copy to the Colorado Department of Transportations Project Engineer.
Project Engineer instructions:
1) Conduct a visual inspection on the pipe listed below for final acceptance.
2) Attach a copy of this form when submitting CDOT Form #157 Field Report for Sample Identification or Materials
Documentation.
(NOTE: Inspection of plant facilites (fabrication process, materials, “D” load tests) are conducted to assure quality. Test
results are on file in the Central Laboratory.)
Manufacture name
Contractor name
Shipment #
Size
Class
Date of mfg.
# of pieces
Length
Total length
Remarks:
Manufacturer certification
I CERTIFY UNDER PENALTY OF PERJURY IN THE SECOND DEGREE AND ANY OTHER APPLICABLE STATE OR FEDERAL
LAWS, THE PIPE LISTED ABOVE HAS BEEN FABRICATED ACCORDING TO THE APPLICABLE AASHTO STANDARDS.
Manufacturer’s representative signature
Date
CDOT Form # 249 5/98