Version 3 – Nov 2015 TAA Ref No Name of Structure DEPARTMENT FOR REGIONAL DEVELOPMENT - TRANSPORTNI TECHNICAL APPROVAL OF HIGHWAY AND ASSOCIATED STRUCTURES PRIVATE DEVELOPMENT - CONSTRUCTION COMPLIANCE CERTIFICATE Name of Project Division Name of Structure TAA Ref No Structure ref No DIV Ref No Design Organisation DC Ref No On Behalf of Plan’ Ref No 1. We certify that: Name of Structure i. 1 Has been constructed, commissioned and tested in accordance with: a) . The Approval in Principle: (ref & date) b) . The Design/Check Certificate(s): (ref & date) c) . The Specification for Highway Works: (edition & date) ii. The construction of the works has been accurately translated into As Constructed drawings. The unique numbers of these drawings are: Drawing No. Date Drawing No. Date Signed Contractor’s Representative Name 1 Version 3 – Nov 2015 TAA Ref No Name of Structure 2 Engineering Qualifications ________________________________ Date _______________________ Signed ________________________________ Name Principal/Partner/Director (Contractor or organisation responsible for construction) Position held Name of organisation Date 2. We certify that reasonable professional skill and care has been used in examining the construction of: Name of Structure and that: i. 1 It has been constructed, commissioned and tested in accordance with: a) The Approval in Principle: (ref & date) b) The Design/Check Certificates : (ref & date) c) The Specification for Highway Works: (edition & date) ii. The construction of the works has been accurately translated into As Constructed drawings scheduled in 1.ii. iii The Health and Safety File and Maintenance Manual are complete and have been passed to TransportNI ………………..Division. Signed Name Position held Name of organisation Principal/Partner/Director (Design Consultant/Works Examiner) Date 3. This certificate is received by TransportNI …………………… Division: 2 Version 3 – Nov 2015 TAA Ref No Name of Structure Signed Name Divisional Manager TransportNI Date Notes: 1. 2. Delete as required. Appropriate Engineering Qualifications e.g. CEng, MICE, MIStructE.. 3