Form CEM-4905 "Contractor Authorization for Using Internet Extra Work Bill System" - California

What Is Form CEM-4905?

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

Form Details:

  • Released on January 1, 2009;
  • The latest edition provided by the California 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 fillable version of Form CEM-4905 by clicking the link below or browse more documents and templates provided by the California Department of Transportation.

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Download Form CEM-4905 "Contractor Authorization for Using Internet Extra Work Bill System" - California

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STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
Contractor Authorization for Using Internet Extra Work Bill System
CEM-4905 (NEW 01/2009)
Caltrans Contract Number
Resident Engineer's Name and Location
Contractor Project Number
The contract listed here will not be added to a contractor's account until a resident engineer has been assigned to the contract in the EWB
System and receives a copy of this CEM-4905 form.
Standard
TRO
Select Markup Type:
The markup type will depend on the contract. For TRO, there is an item in the contract for Working Days. The markups will be in the Force
Account Payment section of the special provisions. If there is no item for Working Days, then the contract is a Standard contract.
Enter Markups Below:
Prime Contractor Markups
Subcontractor Markups
Equipment
Equipment
%
%
Material
Material
%
%
Labor
Labor
%
%
Subcontractor
%
Company Name (exactly as listed in incorporation or fictitious name):
Area or Branch Name:
Is contract a Joint Venture?
Yes
No
Project Address
Phone
Fax
Contractor Authorized Personnel (See page 2 of this form)
The prime contractor may request that a subcontractor's personnel be trained and be authorized to create only a report (sub-
entry role) on behalf of the prime contractor. A prime contractor's representative may create and send (contractor role) reports.
See list of available roles on the next page.
The following personnel are authorized to create and send Daily Extra Work Reports via the Internet or File Transfer Protocol
(FTP) on the above project. The contractor understands that the following personnel must have received associated training and
have an account to access the system.
Note: A user or FTP account, assigned by Caltrans, and password used by the personnel listed are deemed to meet the
signature requirement in Section 9-1.03C of the Standard Specifications: "Daily extra work shall be signed by the contractor or the contractor's
authorized representative."
Page 1 of 2
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
Contractor Authorization for Using Internet Extra Work Bill System
CEM-4905 (NEW 01/2009)
Caltrans Contract Number
Resident Engineer's Name and Location
Contractor Project Number
The contract listed here will not be added to a contractor's account until a resident engineer has been assigned to the contract in the EWB
System and receives a copy of this CEM-4905 form.
Standard
TRO
Select Markup Type:
The markup type will depend on the contract. For TRO, there is an item in the contract for Working Days. The markups will be in the Force
Account Payment section of the special provisions. If there is no item for Working Days, then the contract is a Standard contract.
Enter Markups Below:
Prime Contractor Markups
Subcontractor Markups
Equipment
Equipment
%
%
Material
Material
%
%
Labor
Labor
%
%
Subcontractor
%
Company Name (exactly as listed in incorporation or fictitious name):
Area or Branch Name:
Is contract a Joint Venture?
Yes
No
Project Address
Phone
Fax
Contractor Authorized Personnel (See page 2 of this form)
The prime contractor may request that a subcontractor's personnel be trained and be authorized to create only a report (sub-
entry role) on behalf of the prime contractor. A prime contractor's representative may create and send (contractor role) reports.
See list of available roles on the next page.
The following personnel are authorized to create and send Daily Extra Work Reports via the Internet or File Transfer Protocol
(FTP) on the above project. The contractor understands that the following personnel must have received associated training and
have an account to access the system.
Note: A user or FTP account, assigned by Caltrans, and password used by the personnel listed are deemed to meet the
signature requirement in Section 9-1.03C of the Standard Specifications: "Daily extra work shall be signed by the contractor or the contractor's
authorized representative."
Page 1 of 2
STATE OF CALIFORNIA • DEPARTMENT OF TRANSPORTATION
Contractor Authorization for Using Internet Extra Work Bill System
CEM-4905 (NEW 01/2009)
Internet Method - Check one
Data Entry: for contractors who wish to enter bills over the Internet on a screen similar to the paper-based format; or
File Transfer Protocol: for contractors who have an electronic billing system in which reports can be sent to Caltrans via
the server. Caltrans will provide a file specification/format and a secure directory.
Once the authorization form is submitted and the contract is in the EWB system, then this contract may be added to any
subsequent user by writing to the EWB administrator to add this contract to the account, providing the user has been trained.
Please indicate whether Prime Contractor (PC) or Subcontractor (SC).
If a subcontractor, who hired the
Role*
Name and Title
Phone Number
subcontractor?
(See below)
*ROLE ASSIGNMENTS
ROLE
ACTIONS ALLOWED
Contractor
Create, save, send, view, print, and revise EWBs.
Create, save, view, print, and revise EWBs, but can only view and revise bills they entered.
EWB Entry
Cannot send EWBs for Review and Approval. To be used by the prime contractor's staff and
non-managing partners of a joint venture
Create, save, print, view, and revise USER's EWBs
Sub Entry
(Can only view and revise EWBs; cannot send EWB for review and approval)
automatically puts sub-markup flag to Y
Read only (print and view) Can see ALL bills for contract
Staff
The prime contractor, by completing and signing this form, agrees that the above personnel are authorized to use the electronic
EWB system for the contract listed. The EWB administrator should be notified in writing promptly if any user is no longer assigned
to work on this contract or with the Organization (contractor).
Signed:
Authorized Contractor Representative per Standard Specifications
Title
Print Name
Organization Name
Date
cc: Resident Engineer
Dist. EWB Administrator
Page 2 of 2
For individuals with sensory disabilities, this document is available in alternate formats. For information, call (916) 445-1233,
ADA Notice
TTY 711, or write to Records and Forms Management, 1120 N Street, MS-89, Sacramento, CA 95814.
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