DELIVERABLE ACCEPTANCE DOCUMENT (DAD)

CONTRACTOR NAME:

CONTRACT NUMBER: DED NUMBER:

DELIVERABLE TITLE:

DELIVERABLE COMPLETION DATE:

DESCRIPTION OF DELIVERABLE (Should summarize DED and refer, as appropriate):

STATE ACCEPTANCE/REJECTION STATEMENT: (For deficiencies that are not material, indicate Conditions of Acceptance, as applicable)

Upon approval, this deliverable is mutually agreed to and hereby incorporated into the contract.

AUTHORIZED AND APPROVED BY

CONTRACTOR PROJECT MANAGER / DATE:

STATE PROJECT MANAGER/ DATE:

Note: All invoices must be accompanied by an approved DAD. Invoices submitted without an approved DAD will not be processed until the DAD is received.

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