Version 4 – Nov 2015 2012 Name of Structure TAA Ref No DEPARTMENT FOR REGIONAL DEVELOPMENT – TRANSPORTNI TECHNICAL APPROVAL OF HIGHWAY AND ASSOCIATED STRUCTURES DESIGN AND CHECK CERTIFICATE – CATEGORY 1 STRUCTURES Name of Project Division Name of Structure TAA Ref No Structure Ref No DIV Ref No Design Organisation On Behalf of 1. We certify that reasonable professional skill and care has been used in the preparation of the 1 design/assessment and check of the above named structure with a view to securing that: i. 1 2 It has been designed/assessed in accordance with: The Approval in Principle No: Dated: 3 Including the following: ii. It has been independently checked for compliance with the relevant Standards in i. iii. It has been accurately translated into construction drawings and bar bending schedules (all of which have been independently checked). The unique numbers of these drawings and schedules are: 1 or 4 The assessed capacity of the structure is as follows: Drawing No. Date Drawing No. Date Schedule No. Date Schedule No. Date 1 Version 4 – Nov 2015 2012 Name of Structure iv. TAA Ref No The revised estimated cost is: £ Signed 1 Design/Assessment and Check Team Leader Name 5 Engineering Qualifications Signed Name Head of DCS – (TransportNI Designs) or Principal/Partner/Director (Consultant/other Designs) Position held Name of organisation Date 2. The Departures and additional criteria given in paragraph 1 are agreed. 3. The certificate is accepted by the TAA: 6 Signed Director of Engineering, TransportNI Name Date Notes: 1. Delete as appropriate. 2. Insert AIP reference No and date of agreement of the AIP by the TAA, including the dates of any addenda. Note the AIP is valid for three years after the date of agreement by the TAA, ref BD 2. 3. List any Departures (including TransportNI ref. no) and additional methods, criteria or specification clauses. Departures are not generally permitted for Category 1 unless the TAA considers that they have little or no structural implication. 4. Used for assessments only. 5. CEng, MICE, MIStructE or equivalent. 6. Delete as appropriate. Note Departures are not generally permitted for Category 1, see note 3 above. 2