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Field Measurement Verification Form Project Information: Project Name: Hastings Family YMCA Project Address: 1430 W 16th St Hastings, NE 68901 Client/Owner: ________________________________________ Date of Verification: 9/21 Subcontractor Information: Subcontractor Name: _________________________________ Subcontractor Contact: _______________________________ Subcontractor Phone: _________________________________ Subcontractor Email: _________________________________ Scope of Work: The subcontractor is responsible for performing field measurements and verification of the following rooms/spaces within the specified project: Room 1: ________________________ Room 2: ________________________ Room 3: ________________________ Room 4: ________________________ Additional Rooms/Spaces: ________________________ Measurement Details: Measurement Method: [ ] Laser Distance Measurement [ ] Tape Measure [ ] Other (Specify): ________________________ Compensation Attach Invoice and select payment method below [ ] ACH: Routing #______________________ Account # ______________________ [ ] Zelle: Username ________________________ [ ] Paypal: Username ________________________ [ ] Billpay/Check: Address ________________________________________________ Instructions to Subcontractor: The subcontractor is responsible for accurately measuring and verifying the dimensions and details of the specified rooms/spaces. Ensure that all measurements are taken from fixed reference points (e.g., walls, corners) and accurately recorded. Pay attention to critical details, such as door and window placements, ceiling height, and any irregularities in the space. Use appropriate tools and equipment for measurements to ensure accuracy. Take clear photographs of the rooms/spaces for reference. Reporting: The subcontractor shall provide a detailed report to Am-Finn upon completion of the field measurements. The report should include: Photographs of the rooms/spaces. Drawing of rooms/spaces with corresponding measurements. Any notes or observations regarding the measurements. Completion and Submission: The subcontractor agrees to complete the field measurement verification and submit the report to Am-Finn no later than 9/22. Acknowledgment: I, the undersigned subcontractor, acknowledge and agree to the terms and responsibilities outlined in this Field Measurement Verification Form. I understand the importance of accuracy and thoroughness in performing these measurements and verifying the dimensions of the specified rooms/spaces. Subcontractor Signature: ________________________ Date: _______________ Am-Finn By: ______________________________________ Cameron Horsburgh, Project Manager Date: 9/2/2023