Revised 10/3/06

Asphalt Cement Price Adjustment Guidelines for Completing the Inspector’s Report

(627-39)

This document provides guidelines and instructions for properly completing the Inspector’s Report (627-39) for Asphalt Cement Price Adjustment (ACPA); the adjustment only applies to “let” contracts let since October 2005 that contain the Special Provision - Asphalt Cement Price Adjustment (unless added or changed by SA). This only applies to projects with HMA (Hot Mix Asphalt) and goes into effect either:

After 180 days from the Letting Date for contracts that have the special provision with the 50% maximum adjustment or

Goes into effect at beginning of project for contract that have the special provision with the 75% maximum adjustment

****Verify type of adjustment in the contract before paying on adjustment****

Only the approved electronic version of the form “Asphalt Cement Price Adjustment (ACPA) Inspector Report, 627-39” shall be used. No other version of this form shall be used and will not be accepted by the Contract Auditor for payment and project record documentation. The 627-39 (ACPA) contains three pages; the first page is the main sheet this is where all the information for the month will be documented. The second and third sheets are identical; these sheets will be used to make corrections or adjustments to previous reports, as needed.

The instructions below are for completing the 627-39 form for the Asphalt Price Adjustment.

(Only applies to contracts containing 50% adjustment) An ACPA Inspector’s Report shall be completed early on in the project to determine the “begin adjustment date”. Place the letting date on the appropriate line and the date the report is done, once done this will give the date the Price Adjustment starts. The remainder of the form does not need to be completed. Print and place in the LIN folder for this item. Once the adjustment date has been reached, monthly ACPA inspector’s reports shall be done monthly when asphalt is placed whether an adjustment is required or not. This shall be done monthly to keep accurate records of the index numbers for project documentation purposes. The ACPA (627-39) form is a generic form; it can be used for English or Metric projects. The index numbers will be either English ($/ton) or Metric ($/MG) and will be listed on OMR’s website for the index number (link on the form). The adjustment LIN should already be on the Construction Report when you receive CR # 1. It should appear before all the Asphalt Mix Items unless the contract has both 400 (virgin) and 402 (rap) mixes in the contract then there will be two LIN one before the 400 items and one before the 402 items. When completing the report it will be necessary to complete both depending on the type of mix being placed during the month. Combining the 400 and 402 items on one adjustment report will not be allowed, it must be separated. If the adjustment line(s) are not shown on the Construction Report in CSI, contact Samone McNeil-Chapman @ (404) 656-5325 to have the item(s) added. Do not add the LIN by add-on sheet unless instructed to do so by someone from the Office of Contract Administration - payment section.

REQUIRED DOCUMENTATION TO BE INCLUDED WITH THE MONTHLY INSPECTOR’S REPORT: The following shall be included when completing the 627, (other documentation may be required by the auditor).

1) A copy of the price index from OMR’s website shall be printed monthly and attached to the report.

The only differences between the 50% and 75% forms are as follows:

1. Contract let between October 2005 and August 2006 possibly contains the 50% max adjustment provided the project duration was more than 6 months.

2. Adjustment on 50% contracts begins after 180 days form the date of letting. 3. Contracts let after August 2006 possibly contain the 75% max adjustment provided the project has duration of

more than 366 days. 4. Adjustment on 75% contracts begins at start of project (there is no waiting period) 5% rule still applies.

Page 2

GUIDELINES TO THE FORM (1st page:)

(Form at end of guide) A. Today’s Date:

Date the report is being completed or the end of the month date can be placed (if this is the monthly report the 180 days comes into effect, only that asphalt placed after the 180 day time requirement shall be adjusted.)

B. Enter Letting Date: Date on which the project was let, this can be found on the cover of the contract. C. Days Used:

Automatically calculates the number of days between Letting Date (B) and Today’s Date (A) once they are filled in.

D. Price Adjustment Date Begins: (Only for 50% Adjustment Project) Gives the date adjustment will come into effect (181

st day), the date automatically populates once Letting Date (B)

placed. E. Enter APL: The Monthly Asphalt Cement Price for the month in which the project was let; this can be found on OMR’s webpage (link on inspector’s report). The Monthly Asphalt Cement Price will be posted the Friday following the monthly Letting Date. APL is determined based on the month of letting and will never change for that contract. F. Enter APM:

The Monthly Asphalt Cement Price for the month the asphalt is placed; this can be found on OMR’s webpage (link on inspector’s report). The Monthly Asphalt Cement Price will be posted the Friday following the monthly Letting Date.

G. Monthly Asphalt Cement Price Index Link: This is a link to the “Monthly Asphalt Cement Price Index” on the Office of Materials and Research webpage. The Index shall be printed monthly and attached to the inspectors report. H. Information Line: This gives important information depending on index numbers and dates places.

- STOP TIME REQUIREMENT NOT MET - NO ADJUSTMENT: WITHIN 5% NO ADJUSTMENT REQUIRED - EXCEEDS 50% MAX LIMIT INCREASE ADJUSTMENT AT 50% - +/- (x) % INCREASE/DECREASE ADJUSTMENT

I. L.I.N.: Enter Line Item Number as shown on construction report for asphalt mix. (xxxx). J. Mix Type:

Type of Asphalt mix placed (dropdown list). If leveling, show type of mix used for the leveling; may have to show on multiple lines if more than one type of mix is being used for leveling. Asphalt tickets need to show type of mix being used for leveling, if not on tickets get Asphalt Contractor to place on tickets. Show “leveling” in the Remarks Line on rt. side of inspector’s sheet. Generic mix types have been included (i.e.: 9.5 mm, 12.5 mm, 19 mm, 25 mm) incase the specific type is not in the dropdown list.

K. HMA (HOT MIX ASPHALT):

The amount of each type of mix (Ton/MG) used during the month. Only asphalt placed during the month (and only once requirements have been met), any asphalt being paid during the month that was placed from a previous months will need to be shown on the attachment sheets.

L. JMF (%):

The % of asphalt cement for each mix type is based on the amount of asphalt cement content (AC %) on the approved Job Mix Formula (JMF) for the project. Show as % (example: 4.5, 5.0)

Page 3 M. AC: Automatically calculates amount of AC in tons (MG) from (HMA x JMF AC %). N. Remarks:

Area to place comments or remarks needed to help describe what has been done (keep brief due to small space). If more information is needed then space available place remarks on a separate sheet and attach to the 627, place reference in the remarks block. Information can be typed-in or written-in after printing.

O. TMT: Total Monthly Tonnage of asphalt cement computed based on the Hot Mix Asphalt Concrete of the various types per ton (megagram) certified for payment. P. Monthly Price Adjustments ($):

Gives the total adjustment amount ($) for the area above; it will give informational messages if adjustment requirements are not met.

Q. Audit Corrections or Adjustments:

Places amounts from attachment sheets, this is done automatically from information placed on attachment sheets. Attachment sheets only need to be filled-in if audit corrections or adjustment are required. Only print if used.

R. Total:

Automatically adds the Monthly Price Adjustment ($) line and the Audit Corrections or Adjustment line together and gives the total of all the sheets. If no adjustment is required it will give informational messages.

S. Remarks:

Area to place comments or remarks needed to help describe what has been done. If more information is needed then space available place remarks on a separate sheet and attach to the 627, place reference in the remarks block. Information can be typed-in or written-in after printing.

T. Report Total: Automatically gives the amount that needs to be placed on the Construction Report in CSI. GENERAL NOTES:

If placing asphalt at night and it’s the last day of the month the tickets must be marked and separated once the time reaches 12:01 a.m. for the new month; only applies to asphalt that is in-place, not from the batch time on the tickets. Since this asphalt is placed during a new month it will be adjusted at a different APM even if it was placed with mix from the previous month. The asphalt should be paid for normally but the AC adjustment cannot be made until the end of the month.

Page 4 GUIDELINES TO THE FORM

(2nd and 3rd pages): Audit corrections or adjustment sheet

(Form at the end of the guide)

The following gives guidance and instructions on completing the 2nd

and 3rd

pages on the 627. The 2nd

and 3rd

page are identical and are included incase of audit corrections or adjustments such as a correction from a monthly audit report. The Audit corrections or adjustment sheets will only be required if a correction or adjustment is needed. The 2

nd and 3

rd page

do not need to be completed or printed monthly unless a correction was done. Once completed attached to the 1st page

along with all the required supplemental documentation. The audit correction or adjustment sheet is to be done by project personnel not by the auditor.

While most of the form is comparable to the main sheet there are some differences that need to be explained.

Sections I, II, III and IV are individual sections that can have different APM numbers incase multiple months need to be corrected or adjusted.

The section (j) Other Adjustments or Corrections is to be used for deducting errors or adding corrections from previous months (example: if the wrong APM was applied the previous month, the paid $ amount would need to be removed this month then the correct APM could be applied in Sections I – IV to correctly place the adjustment.)

a. Enter APL: The Monthly Asphalt Cement Price for the month in which the project was let this can be found on OMR’s webpage (link on inspector’s report). The Monthly Asphalt Cement Price will be posted the Friday following the monthly Letting Date. APL is determined based on the month of letting and will never change for that contract. b. Enter APM:

The Monthly Asphalt Cement Price for the month the asphalt is placed; this can be found on OMR’s webpage (link on inspector’s report). The Monthly Asphalt Cement Price will be posted the Friday following the monthly Letting Date.

c. Month Adjusted: Enter the month that applies to the section (month/yr) d. L.I.N.: Enter Line Item Number as shown on construction report for asphalt mix. (xxxx). e. Mix Type:

Type of Asphalt mix placed. If leveling, show type of mix used for the leveling; may have to show on multiple lines if more than one type of mix is being used for leveling. Asphalt tickets need to show type of mix being used for leveling, if not on tickets get Asphalt Contractor to place on tickets. Show “leveling” in the Remarks Line on rt. side of inspector’s sheet.

f. HMA (HOT MIX ASPHALT):

The amount of each type of mix (Ton/MG) used during the month.

g. JMF (%): The % of asphalt cement for each mix type is based on the amount of asphalt cement content (AC %) on the approved Job Mix Formula (JMF) for the project. Show as % (example: 4.5, 5.0)

h. AC: Automatically calculates amount of AC in tons (MG) from (HMA x JMF AC %). i. Comment:

Area to place comments or remarks needed to help describe what has been done (keep brief due to small space). If more information is needed then space available place remarks on a separate sheet and attach to the 627, place reference in the comment block. Information can be typed-in or written-in after printing.

Page 5 j. Other Adjustments or Corrections:

Area to place remarks needed to help describe what has been done (keep brief due to small space). If more information is needed then space available place remarks on a separate sheet and attach to the 627, place reference in the remarks block. Information can be typed-in or written-in after printing.

k. Amount:

The total dollar amount ($) that needs to be deducted or added to correct errors or make adjustments. If deducting make sure (-) is placed in front of the amount

l. TMT: Total Monthly Tonnage of asphalt cement computed based on the Hot Mix Asphalt Concrete of the various types per ton (megagram) certified for payment. m. Remarks:

Area to place comments or remarks needed to help describe what has been done (keep brief due to small space). If more information is needed then space available place remarks on a separate sheet and attach to the 627, place reference in the remarks block. Information can be typed-in or written-in after printing.

NOTES: