Wash. Admin. Code § 468-16-210 - [Effective 12/22/2023] Prime contractor performance report

(1) The evaluation of contractor performance shall be made on a form substantially in the format as illustrated herein.
(2) A Prime Contractor Performance Report Manual provides detailed instructions for preparation of the prime contractor performance report.

Prime Contractor Performance Report Instructions

The Prime Contractor Performance Report, DOT Form 421-010, consists of two parts - page 1 and page 2. Page 1 consists of Sections I, II, and III. Page 2 consists of Sections IV and V. The electronic form is optimized for use with Adobe Acrobat. Do not use Adobe Sign to complete or route the form for signature.

1. PE completes Sections I - IV in strict conformance with the Prime Contractor Performance Report Manual (M41-40)
2. PE Send to Contractor and discuss.
3. PE sign electronically and transmit to Region. It is recommended to use Adobe Acrobat for signing. Do not lock the form when signing.
4. Region Operations Engineer review, sign electronically. Do not lock the form when signing. Print and mail to Contractor via Certified Mail. Retain electronic copy for further processing.
5. Wait 20 days. Respond to protests, as necessary. Make adjustments.
a. Adjustments made with strikethrough, adding new text and initials of individual making change.
6. Regional Administrator Sign electronically. Do not lock the form when signing. The form must be unlocked for headquarters use.
7. Transmit to Contract Ad and Award electronically. Distribute copies to PE, RA, and Contractor.

DOT Form 421-010 Distribution: Original - Prequalification Branch Copy - Region Administrator Copy - Project Engineer Copy-Contractor Revised 07/2022

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Notes

Wash. Admin. Code § 468-16-210
Amended by WSR 15-01-170, Filed 12/23/2014, effective 1/23/2015 Amended by WSR 23-23-165, Filed 11/21/2023, effective 12/22/2023

Statutory Authority: RCW 47.01.101, 47.28.030 and 47.28.070. 94-05-004, § 468-16-210, filed 2/2/94, effective 3/5/94; 91-04-014 (Order 128), § 468-16-210, filed 1/28/91, effective 2/28/91.

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