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   GENERAL: This form is part of the product or material substitution requirements as specified in Specifications Section 15308: Plumbing General Provisions. Refer to Specifications Section 15308: Plumbing General Provisions for procedure process and specific requirements for filing this product or material substitution request form. The specific requirements as listed under Specifications Section 15308: Plumbing General Provisions shall be followed correctly or the product substitution request form is subject to rejection, in part or whole.

   Project Title:

   Date and Time Received

   To:

    or

    Post Office Box

    Nashville, Tennessee

   Attn:

   Specified Item:

   Specifications Section Referenced:

    (Title):

    (Paragraph):

    1. Proposed Product or Material Substitution:

    (Include: Complete description; catalog cutsheets; specification data; results of laboratory test(s); pump curve charts; material(s) list; manufacturer's full name, address and telephone numbers including contact persons; complete list of existing installations, addresses, telephone numbers and contact persons (existing installations shall have been installed a minimum of one (1) year); product(s) warranties; materials code compliances and acceptance; fire/smoke spread ratings; UL/FM ratings; and including any other related data or information which will aid in conveying that the proposed product or material substitution(s) is an "equivalent". Attach requested information to this form as required.

    2. What effect will substitution(s) have on dimensions, gauges, weight, required installation space, etc. where indicated under the Contract Documents? Be specific:

    .

    3. What effect will substitution(s) have on electrical requirements, wiring, piping layout(s), ductwork, etc. where indicated under the Contract Documents? Be specific:

    .

    4. What effect will substitution(s) have on other trades? Be specific:

    .

    5. Will substitution(s) have any effect on the construction schedule? If yes, why and how long?:

    .

    6. List all differences in quality and performance between the proposed substituted product(s) or materials, and the specified product(s) or materials. Be specific, as all items shall be verified:

    .

    7. Manufacturer's warranties and guarantees of the specified product(s) or material, and the proposed substituted product(s) or material are: Same: _______ Different: _________ (Explain in Detail)

    .

    8. List (on a separate sheet or sheets) the quick availability of maintenance service and replacement materials for the proposed substitute product(s) or material.

    9. List (on a separate sheet or sheets) names of companies, addresses, phone numbers and contact persons of fabricators and/or suppliers for the proposed substituted product(s) or material.

    .

    10. Will there be a total project cost deduct or increase with the use of the proposed substituted product(s) or material?

    Yes: How Much: (Totals) .

    No: Added Cost: (Totals) .

    If yes, explain the reason:

    .

    If no, explain the reason:

    .

    If added cost, explain the reason:

    .

    11. Will, or could there be, any additional license fees, and/or royalties pending on the proposed substituted product(s) or materials?

    Yes: .

    No: .

    If yes, explain in detail:

    .

    12. Could there be, or will there be any increase or decrease in operational cost associated with use of the proposed substituted product(s) or materials, including energy consumption such as electrical power, fuel oil, and maintenance?

    Yes: . Increase: .

    No: . Decrease: .

    If yes, explain in detail giving the approximate increase or decrease cost per month:

    .

    13. Will the proposed substituted product(s) or material look/appear similar to the specified product(s) or materials? (Include finishes, etc.)

    Yes: .

    No: .

    If no, explain in detail:

    .

    14. By the submission of, and signing of this proposed product(s) or material substitution request form, the undersigned has agreed to pay, in full, for any additional studies, investigations, submittals, re-submittals, required redesign of systems or spaces, and/or analysis by the Engineer, or the Engineer's independent chosen third party, caused by the proposed requested substitution(s) of products or materials.

    Submitted By: (Manufacturer, Manufacturer's Representative, Supplier, or Contractor)

    Firm Name: .

    Contact Person: .

    Address: .

    .

    Telephone Number: .

    Fax Number: .

    Signature: . Date: .

    15. Reviewed and Approved By Contractor For Subcontractor:

    Firm Name: .

    Contact Person: .

    Address: .

    .

    Telephone Number: .

    Fax Number: .

    Signature: . Date: .

    16. Engineer's Review Comments:

    Accepted as Submitted: . Date: .

    Accepted as Noted: . Date: .

    Rejected/Not Accepted: . Date: .

    Received Too Late: . Date: .

    Rejected Due to Incomplete

    Form and/or Submittal: . Date: .

    Comments:

    .

    17. Special Notes:

    A. If proposed substituted product(s) or material is acceptable for proposed installation or use, an official written addendum shall be issued to the bidding contractors, with sufficient time allowed to include into the bidding process.

    B. No verbal response, or responses, will be given, and any and all telephone calls or fax tramissions shall be refused, which are requesting any verbal response from the Engineer.

    END OF SECTION/FORM