City of Chicago

Department of Transportation

Project Specific Quality Control (QC) Addendum for Concrete Production

Submittal Type: OriginalProposed Change

Submittal Date:

County:

Section:

Route:

District:

CDOT Contract No.:

CDOT Job No.:

CDOT Project No.:

General Contractor:

P.O. Box:

Street Address:

City/State/ZIP Code:

Phone No.:

  1. Contractor Responsibilities

This Quality Control Addendum to the Annual Quality Control Plan further explains how the General Contractor(GC) proposes to control the equipment, ingredient materials, and production methods to ensure the specified products are obtained. All requirements in the QC/QA Special Provisions, the Annual QC Plan(s), and this QC Addendum will be binding.

Under all circumstances, whether the project is a joint venture or not, with will be the Project Quality Control Manager and will be ultimately responsible for the Quality Control on this Contract. At all times the Project Quality Control Manager will be available by mobile phone at .

  1. Quality Control Personnel:

The Project Quality Control Manager will have overall responsibility and authority for quality control on the project. At a minimum a Level I PCC Technician will be responsible for jobsite mixture control and adjustments. Inspectors certified as PCC Testers will only be responsible for performing tests which will be under the supervision of a PCC Level I Technician. A list of all QC Personnel anticipated for use on this project including QC Personnel with any Sub-Contractors are included in Attachments A through C.

  1. Applicable Laboratory and Equipment Information

If for any reason field or laboratory equipment fails to function as required,calibrated and approved replacement equipment satisfactory to CDOT QA will be supplied. Ifreplacement equipment is notavailable, any activities requiring the use of such equipment willcease immediately and not resume until replacement equipment satisfactory to CDOT QA has been provided.

  1. Mix Plant/Production

Mixtures on this project will only be produced by suppliers that have been certified by CDOT and approved by IDOT. At no time will material be supplied by two different plants to a single placement location concurrently. Should there be a change in plant from the previous day, any additional testing or required start-up procedures will be performed at no additional cost to the City. Construction items that require a uniformity in color or source of ingredient material will not switch plants without permission of CDOT QA. All required QC Testing performed at the plant will be handled by the supplier and as detailed in their IDOT approved Annual QC Plan.

If at any time a plant is not meeting the requirements as determined by the Commissioner, then the plant may be de-certified and removed from the CDOT approved list. A substitute plant certified by CDOT and approved by IDOT will be selected at no additional cost to the City.

  1. Mix Designs

All PCC designs supplied to the project will be IDOT and/or CDOT approved and will be for the current construction season. Current PCC design sheets from IDOT signed by one of their supervisors shall be posted in the QC Laboratory located at each plant and will be available for review at all times. Attachments A through C include information pertaining to the various items of construction for this project with the pertinent PCC mixture information assigned to each of these items. Any changes to a mixture type or application for any PCC construction item shall be addressed in a “Proposed Change” QC Addendum submittal. The use and application of specialty items and/or mixtures, if any, are addressed in Section L with all necessary supporting documentation attached.

  1. Producer Annual Plan Information

All plants utilized on this project will have Annual Quality Control Plans that are current and IDOT approved. Prior to utilizing a new plant on this project the status of their Annual Plan will be verified for compliance with CDOT QA. If acceptable, it is understood that the entire plan and its contents become part of this Job Specific QC Plan. Use of a new plant indicates acceptance of their Annual Plan which shall be binding under this project.

  1. Field Sampling and Testing

Jobsite sampling frequencywill be in accordance with Schedule B of the “Quality Control/Quality Assurance of Concrete Mixtures” check sheetincluded in the contract. All testing will be performed according to the current version of IDOT’s “Manual of Test Procedures for Materials”.

moldssized,made of , will be used to cast strength specimens. The molds will be covered with to prevent the loss of moisture during field curing. During this initial field cure, temperature of the specimens will be maintained within the required range according to the applicable portions of the current “Manual of Test Procedures for Materials”by means of . The specimens will be transported after 24 hours for standard curing. For instanceswhere only flexural strength specimens are permitted according to the specification, beams shall be cast,unlessan equivalent compressive strength process has been approved by the Engineer.

All strength specimens will be transported to for standard curing and testing. Strength specimens will be laboratory stored and cured according to the applicable portions of the current“Manual of Test Procedures for Materials” manual.

  1. Communication

All QC personnel will have exclusive use of a mobile telephone for the purpose of maintaining a line of communication with the entire QC staff for this project. Every QC inspector referenced in attachment A through C has anassigned mobile phone number listed.

  1. Failing Tests and Defective Work

In the event of failing test and/or observations of defective work activities at the jobsite, the Level I PCC Technician will be responsible for notifying the Superintendent and the Project Quality Control Manager. The Project Quality Control Manager will be responsible for notifying the Resident Engineer.

Failing tests in the field and observations of defective work will be addressed by the Project Quality Control Manager with appropriate corrective actions taken immediately. Failing tests at the plant will be addressed by the plant Level II PCC Technician with appropriate corrective actions taken immediately. All failing tests and corrective actions will be properly documented and recorded on the appropriate test reports and/or diary.

  1. Documentation

Documentation of all field test results, corrective actions, and miscellaneous information pertaining to the control of material on this project will be completed prior to the start of production the following day with copies (format per current CDOT requirements) sent to the Resident Engineer and CDOT QAwithin 48 hours. Original reports signed in blue ink will be transmitted to Cindy Williams’ attention at CDOTon a weekly basis. Strength reports will be submitted the working day following the completion of the last break result. Intermediate reports for early strength results will be transmitted as requested or necessary to meet the requirements of the specification.

A bound hardback field book will be used for all documentation on the jobsite and will be submitted for inclusion into the project file upon completion.

  1. Pre-Pour Meetings

A pre-pour meeting will be scheduled 10days prior toany bridge deck pour; and if required by the Engineer 5 days prior to a pour for any other class of concrete. The meetings will discuss mix design, concrete delivery, concrete placement, finishing equipment and requirements, labor issues, deficiencies, curing, weather conditions (i.e. temperature, humidity, wind, etc.), coordination between QC and QA activities, and any other pertinent issues necessary to ensure compliance with the contract documents.

  1. Special Material Issues (if any)
  1. Supplier Acknowledgement of Addendum

The Supplier’s Information for the General Contractor and each Sub-Contractor (if applicable) is listed in attachments A through C. Each attachment includes the signature of the Supplier’s Quality Control Manager to confirm the receipt of this document and the acknowledgement of the supplier’s responsibilities required under this Project Specific Quality Control Addendum.

Schedule of Attachments Completed

(Check One)

Scenario / Attachment
GC Placing All PCC Mixtures / Only A
GC and One Sub-Contractor Placing All PCC Mixtures / A and B
GC and Two Sub-Contractors Placing All PCC Mixtures / A, B, and C
One Sub-Contractor Placing All PCC Mixtures / Only B
Two Sub-Contractors Placing All PCC Mixtures / B and C
  1. General Contractor Acknowledgement of Addendum Submittal

This Project Specific Quality Control Addendum submittal has been reviewed and determined to be complete and accurate. The Project Quality Control Manager is aware of the responsibilities associated under this addendum and is capable of perfoming them as detailed. The General Contractor Project Manager is aware of the requirements of this addendum and has authorized the Project Quality Control Manager to have complete control over the Quality Control of the concrete materials on this project and to make necessary changes as needed to meet the requirements of this addendum and the governing specifications as detailed in the project contract documents.

Project Quality Control ManagerDate

Signature Required (Blue Ink Only)

(Printed name)

General Contractor Project ManagerDate

Signature Required (Blue Ink Only)

(Printed name)

Attachment A – General Contractor Information

QC Personnel List

Name / PCC QC Training / Firm / Mobile Phone Number
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III

Note: Any company contracted to provide personnel with equipment on behalf of a contractor must attach their current annual equipment/laboratory approval letter from the Illinois Department of Transportation, District One office or show evidence of a currently completed CDOT QA Inspection.

General Contractor Laboratory Information

On-Site Field Laboratory

Not Applicable Inspection Documentation Attached

Laboratory Name:

Laboratory Location:

Inspection by: on

Off-Site Laboratory

Not Applicable Inspection Documentation Attached

Laboratory Name:

Laboratory Location:

Inspection by: on

Attachment A – General Contractor Information (cont’d)

PCC Design Information

Pay Item Description / Class of Concrete / Strength Requirement at Specified Age
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs

The Supplier’s Quality Control Manager signature below confirms the receipt of this documentation and the acknowledgement of the supplier’s responsibilities required under this Project Specific Quality Control Addendum.

ConcreteSupplier

Supplier Quality Control ManagerDate

Signature Required (Blue Ink Only)

(Printed name)

Attachment B – Sub-Contractor 1 Information

QC Personnel List

Name / PCC QC Training / Firm / Mobile Phone Number
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III

Note: Any company contracted to provide personnel with equipment on behalf of a contractor must attach their current annual equipment/laboratory approval letter from the Illinois Department of Transportation, District One office or show evidence of a currently completed CDOT QA Inspection.

Sub-Contractor 1 Laboratory Information

On-Site Field Laboratory

Not Applicable Inspection Documentation Attached

Laboratory Name:

Laboratory Location:

Inspection by: on

Off-Site Laboratory

Not Applicable Inspection Documentation Attached

Laboratory Name:

Laboratory Location:

Inspection by: on

Attachment B – Sub-Contractor 1 Information (cont’d)

PCC Design Information

Pay Item Description / Class of Concrete / Strength Requirement at Specified Age
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs

The Supplier’s Quality Control Manager signature below confirms the receipt of this documentation and the acknowledgement of the supplier’s responsibilities required under this Project Specific Quality Control Addendum.

Sub-Contractor 1

Sub-Contractor 1 Project Manager

Printed Name

Sub-Contractor 1 Concrete Supplier

Supplier Quality Control ManagerDate

Signature Required (Blue Ink Only)

(Printed name)

Attachment C – Sub-Contractor 2 Information

QC Personnel List

Name / PCC QC Training / Firm / Mobile Phone Number
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III
Level ILevel I, IILevel I, II, III

Note: Any company contracted to provide personnel with equipment on behalf of a contractor must attach their current annual equipment/laboratory approval letter from the Illinois Department of Transportation, District One office or show evidence of a currently completed CDOT QA Inspection.

Sub-Contractor 2 Laboratory Information

On-Site Field Laboratory

Not Applicable Inspection Documentation Attached

Laboratory Name:

Laboratory Location:

Inspection by: on

Off-Site Laboratory

Not Applicable Inspection Documentation Attached

Laboratory Name:

Laboratory Location:

Inspection by: on

Attachment C – Sub-Contractor 2 Information (cont’d)

PCC Design Information

Pay Item Description / Class of Concrete / Strength Requirement at Specified Age
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs
SIPVBSPPDSMSSCPCPSOther / psi @kpa @123712142124284856120180OtherDaysHrs

The Supplier’s Quality Control Manager signature below confirms the receipt of this documentation and the acknowledgement of the supplier’s responsibilities required under this Project Specific Quality Control Addendum.

Sub-Contractor 2

Sub-Contractor 2 Project Manager

Printed Name

Sub-Contractor 2Concrete Supplier

Supplier Quality Control ManagerDate

Signature Required (Blue Ink Only)

(Printed name)

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