Pay Item Worksheet-Standard or Metric



Pay Item WorksheetStandard or MetricProject DescriptionExisting S.N. FORMTEXT ?????County FORMTEXT ?????Proposed S.N. FORMTEXT ?????Route FORMTEXT ?????Contract Number FORMTEXT ?????Section FORMTEXT ?????Proposed Letting FORMTEXT ?????Designer FORMTEXT ?????Deck / Superstructure RemovalExisting Superstructure Description: FORMTEXT ?????The existing structure is: FORMCHECKBOX Composite FORMCHECKBOX Non Composite FORMCHECKBOX Other FORMTEXT ?????Concrete in existing deck to be removed: FORMTEXT ????? FORMCHECKBOX Cu Yd. FORMCHECKBOX Cu. m.PPC Deck Beams to be removed: FORMTEXT ????? FORMCHECKBOX Sq. Ft. FORMCHECKBOX Sq. m.PPC I-Beams to be removed: FORMTEXT ????? FORMCHECKBOX Ft. FORMCHECKBOX m.Weight of existing structural steel to be removed: FORMTEXT ????? FORMCHECKBOX Lb. FORMCHECKBOX kg.Wearing surface to be removed (thickness FORMTEXT ????? FORMCHECKBOX in. FORMCHECKBOX mm.): FORMTEXT ????? FORMCHECKBOX Cu. Yd. FORMCHECKBOX Cu. m.Other items not listed above: (List items, Quantities and Units) FORMTEXT ?????Substructure Removal(Substructure removal according to Standard Specifications Article 501)Existing Substructure Description: FORMTEXT ?????Total existing substructure concrete: FORMTEXT ????? FORMCHECKBOX Cu. Yd. FORMCHECKBOX Cu. m.Concrete in existing substructure to be removed: FORMTEXT ????? FORMCHECKBOX Cu. Yd. FORMCHECKBOX Cu. m.Percent removal: FORMTEXT ?????Box Culvert Removal(Culvert removal according to Standard Specifications Article 501)Existing Box Culvert Description: FORMTEXT ?????Fill Height: FORMTEXT ????? FORMCHECKBOX Ft. FORMCHECKBOX m.Total Existing Box Culvert Concrete Volume FORMTEXT ????? FORMCHECKBOX Cu. Yd. FORMCHECKBOX Cu. m.Concrete in existing Box Culvert to be removed: FORMTEXT ????? FORMCHECKBOX Cu. Yd. FORMCHECKBOX Cu. m.m.Percent removal: FORMTEXT ?????BBS 2546 (9/02)Page 1 of 2(ProposedSN FORMTEXT ?????)Temporary Support System / Temporary Shoring or BracingTemporary Support, Shoring, or Bracing System Description: FORMTEXT ?????Struts, Wales, etc. total weight (if applicable): FORMTEXT ????? FORMCHECKBOX Lb. FORMCHECKBOX kg.Concrete (if applicable): FORMTEXT ????? FORMCHECKBOX Cu. Yd. FORMCHECKBOX Cu. m.Reinforcement Bars (if applicable): FORMTEXT ????? FORMCHECKBOX Lb. FORMCHECKBOX kg.Sheet Piling (if applicable): FORMTEXT ????? FORMCHECKBOX Sq. Ft. FORMCHECKBOX Sq. m.Cofferdam / Underwater Structure Excavation ProtectionCofferdam / Structure Excavation Protection Description: FORMTEXT ?????Cofferdam Top Elevation: FORMTEXT ?????Bottom of cofferdam excavation elevation: FORMTEXT ?????Total Cofferdam / Structure Excavation Protection Sheeting Area: FORMTEXT ????? FORMCHECKBOX Sq. Ft. FORMCHECKBOX Sq. m.Struts, Wales, etc. Total Weight (if applicable): FORMTEXT ????? FORMCHECKBOX Lb. FORMCHECKBOX kg.Cleaning and Painting Existing Steel StructuresTotal Surface Area of Steel FORMTEXT ????? FORMCHECKBOX Sq. Ft. FORMCHECKBOX Sq. m.Area to be Blast Cleaned per SSPC-SP 10 FORMTEXT ????? FORMCHECKBOX Sq. Ft. FORMCHECKBOX Sq. m.Area to be Power Tool Cleaned per SSPC-SP 3 (Mod) FORMTEXT ????? FORMCHECKBOX Sq. Ft. FORMCHECKBOX Sq. m.Area to be Power Tool Cleaned per SSPC-SP 15 FORMTEXT ????? FORMCHECKBOX Sq. Ft. FORMCHECKBOX Sq. m.Feature(s) Crossed FORMCHECKBOX Waterway FORMCHECKBOX Roadway FORMCHECKBOX Railroad FORMCHECKBOX Other FORMTEXT ?????Drainage SystemApproximate Length of Drainage System FORMTEXT ????? FORMCHECKBOX Ft. FORMCHECKBOX mOther Major Lump Sum Items and/or Each Major Item(Be sure to include any pertinent information needed to estimate the Lump Sum or Each Item not listed above.) FORMTEXT ?????BBS 2546 (9/02)Page 2 of 2 ................
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