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' EXHIBIT A <br /> Substitution Request Form <br /> (One Item per each Form) <br /> FYZ <br /> Project: Date: <br /> Substitution Requestor: <br /> Contractor: <br /> Specification Section No: Paragraph No.(i.e.2.1.A.1.c): Specified Item: <br /> Proposed Substitution: <br /> Provide Product Data Sheets,Manufacturers written installation instructions,drawings,diagrams,or any <br /> other information as an attached to this Form that will demonstrate the proposed substitution is an Approved Equal. <br /> In the lines provided state differences between proposed substitutions and specified item. Differences include but are not limited to interrelationship with other items; <br /> materials,equipment,function,utility,life cycle costs,applied finished,appearances,and quality. <br /> I <br /> In the lines provided demonstrate how the proposed substitution is compatible with or modifies other systems,parts,equipment or components of the Project and Work <br /> under the Contract <br /> In the lines provided,describe what effect the proposed substitution has on dimensions indicated on the Drawings and previously reviewed Shop Drawings? <br /> In the lines provided,describe what effect the proposed substitution has on the Construction Schedule and Contract Time. <br /> In the lines provided,describe what effect the proposed substitution has on the Contract Price. This includes all direct,indirect,impact and delay costs. <br /> I <br /> Manufacturer's guarantees of the proposed and specified items are: <br /> ❑ Same ❑ Different(explain on attachment) <br /> ' The undersigned contractor state's that the function,utility,life cycle costs,applied finishes,appearance and <br /> quality of the proposed substitution are equal or superior to those of the specified item. <br /> (Contractor's Signature) <br /> (Contractor's Firm) <br /> (Date) (Finns Address) <br /> (Telephone) <br /> For use by Project Representative: <br /> ❑ Accepted ❑ Accepted as Noted <br /> (Engineer's Signature) <br /> ❑ Not Accepted ElReceived Too Late <br /> (Owner's Signature) <br /> ' (Date) <br /> Comments: <br /> Copyright 2014 HDR Engineering,Inc. <br /> 10023829 City of Everett Public Works July 2018 <br /> WPCF FEN Chlorination Building Upgrade Work Order 3614 <br /> PRODUCT SUBSTITUTIONS <br /> 01 25 13-1 Issue for Bid <br />