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This document serves as a certificate of compliance for daily asphalt mixtures shipped, ensuring the material meets the specifications outlined by the Pennsylvania Department of Transportation. It details relevant data such as plant location, job mix formula, material class, ESALs, binder grade, tons shipped, test results, and payment factors based on compliance with specifications.
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How to fill out cs-4171b certificate of compliance

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Obtain the cs-4171b certificate of compliance form from the relevant authority or website.
02
Fill in the applicant's name and contact information at the top of the form.
03
Specify the type of product or service for which compliance is being certified.
04
Include details of the regulatory standards or codes the product or service meets.
05
Provide any required documentation or evidence of compliance attached with the form.
06
Sign and date the form to validate the information provided.
07
Submit the completed form to the appropriate regulatory body or agency.

Who needs cs-4171b certificate of compliance?

01
Manufacturers of products seeking to demonstrate compliance with regulatory standards.
02
Service providers that need to verify adherence to safety or quality standards.
03
Businesses involved in import/export that require certification to meet legal obligations.
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The CS-4171B Certificate of Compliance is a form used to certify that an entity is in compliance with certain regulations or standards as required by the issuing authority.
Entities or individuals who are subject to the regulatory requirements outlined in the governing documents pertaining to the CS-4171B must file this certificate.
To fill out the CS-4171B, individuals should provide the required identification information, detail the compliance with applicable regulations, and sign the document as verification of the accuracy of the information provided.
The purpose of the CS-4171B Certificate of Compliance is to formally document and affirm that an entity meets all necessary compliance standards set forth by regulatory agencies.
Information required on the CS-4171B includes the entity's name, address, identification number, details of the compliance standards being met, and the signature of the authorized representative.
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Relevant keywords

asphalt mix certificate of compliance PennDOT daily mixtures material specifications payment factor quality control test results job mix formula construction materials

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