''No further benefits may be paid out under this program unless this report is completed and filed as required by existing law and regulations (7 U.S. C. 901 et seq.). ''

PROJECT DESIGNATION

SHEET OF SHEETS

CONTRACT NO. CONTRACT DATED

U. S. DEPARTMENT OF AGRICULTURE

RURAL UTILITIES SERVICE

FINAL INVENTORY NAME OF OWNER

NAME OF CONTRACTOR

TELEPHONE CONSTRUCTION CONTRACT 

(Labor and Materials)

INSTRUCTIONS - See reverse side of form.

CERTIFICATE OF COMPLETION

1, the undersigned Engineer of the above-designated Rural Utilities Service Project do hereby certify that:

1. The construction provided for pursuant to the above Construction Contract, including all approved amendments, (hereand is in all respects in strict inafter called the ''Project'') has been completed as of 20

compliance with the provisions of the Loan Contract and the Construction Contract, including all plans, specifications, maps, and all 

modifications thereof.

2. Payment in full has been made to all persons who have furnished labor for the Project.

 3. The Contractor has obtained valid releases of lien from all persons, firms and/or corporations furnishing materials, supplies, 

and appliances which were employed by the Contractor in the performance of the Construction Contract, and that such releases have been 

delivered by the Contractor to the Owner.

 4. The Project consists of facilities shown on the Statement of Construction (RUS Form 527) which is true and correct and which is 

attached hereto and made a part hereof.

 5. The staking sheets and tabulation of staking sheets, upon which the Final Inventory is based, show the accurate location, number, 

and kind of all units of construction of the project and show all work performed in accordance with the Construction Contract.

6. Acceptance tests have been made and the results were satisfactory.

7. All defects in workmanship and materials reported during the period of construction of the Project have been corrected.

 8. To the best of my knowledge and belief, the attached final inventory of the Project correctly shows the 

total number and character of assembly units installed or removed by the contractor and that the total cost of such 

construction performed is (Grand total column 8, Form 724a plus Grand total column 12,

$ Form 724b)

9. The amount to be deducted for construction materials. furnished by the owner in accordance

with the contract is (Amount from Total column 7, RUS Form 281) $

$ 10. The net contract price is (Item 8 minus Item 9 above)

Dated this day of 20

NAME OF ENGINEER

B y

 We, the undersigned Owner and Contractor, do hereby accept the preceding certification as to costs of the completed Project 

and agree that:

 1. The final payment to the Contractor will be the above net contract price less (a) payments made to date, (b) amounts, if any, due 

to the Owner for liquidated damages, and (c) any other sums which the Owner has the right to retain under the terms of the contract and 

signature by all parties does not preclude the- retention by the Owner of such amounts.

 2. Acceptance of the Project by the Owner shall not be deemed to relieve the contractor of its obligations contained in the

Construction Contract with respect to defective workmanship or materials discovered within one year after the date of completion.

RUS Form 724 (Rev. 10-63)

- -

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control 

number. The valid OMB control number for this information collection is 0572-0059. The time required to complete this information is estimated to average 45 minutes per response, including the time 

for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
 3. The Final Inventory attached hereto and made a part hereof is a complete and accurate summary of all units of 

construction in the Project and of work performed in accordance with the Construction Contract.

NAME OF OWNER

- - By

DATE PRESIDENT

NAME AND ADDRESS OF CONTRACTOR

- - By

DATE SIGNATURE AND TITLE

Reviewed By:

- -

SIGNATURE OF RUS FIELD ENGINEER DATE

INSTRUCTIONS (See RUS Bulletin 381-4)

The Engineer will prepare 6 copies of forms covering all data in Column 1 through Column 12, plus Columns 15 and 16.

Cols. Source of Data The assembly units are to be grouped according to the plant account 

classification. (See applicable system of accounts.) The plant account number 

and title should head each group with the total cost of the units in the group 

inserted in parentheses in column 8 opposite the heading. For the purpose of 

this inventory:

From tabulation of staking sheets 

Leave blank except for units not in contract 

Total unit price from contract *

1 & 2

3 & 4

5

6 & 7 Leave blank

Column 1 multiplied bv Column 5 

From tabulation of staking sheets

8

 1. Assembly units containing pin-type insulators (i.e., 

single groove, double groove transposition, etc.) are to be 

listed under the account determined by the other materials in 

the assembly units.

9

10 From tabulation of staking sheets

From contract, as amended 

Col. 9 multiplied by Col. 11 

From Borrower's records 

Col. 9 multiplied by Col. 13 

Prepared by Engineer 

Prepared by Engineer

From Borrower's record 

From Borrower's record 

Col. 17 multiplied by Col. 18

11

12

13

 2. As a sub-item under ''poles lines,'' list the number

 of pin-type insulators (i.e., single groove, double groove

 transposition, etc.) included in the assembly units in that 

account segregated by type and item cost. (Do not extend total cost).

14

15

16

17

18

19

 The final inventory together with all other final papers will

 then be submitted to RUS for approval to release payment to the 

contractor.

20 From Borrower's record

21 From Borrower's record

* Except for certain assembly units where the system of accounts requires 

material costs to be recorded as ''station apparatus'' and labor costs as 

''station connections''

 Upon approval of the inventory for this purpose by RUS, 

one copy will be returned to the owner by RUS. The owner will

 complete columns 13 & 14 and columns 17 through 21 together

with the calculation of "Net Charge Due to Retirement" below:

CALCULATION OF NET CHARGE DUE TO RETIREMENT:

ORIGINAL COST (Col. 14, Form 724b) $

COST OF REMOVAL (Col. 12, Form 724b)

TOTAL

DEDUCT SALVAGE (Col. 19, Form 724c, plus Col. 21, Form 724c)

NET CHARGE DUE TO RETIREMENT (Grand Total Col. 14, Form 724b plus Grand Total Col. 12, Form 724b

less Grand Total Col. 19, Form 724c less Grand Total Col. 21, Form 724c) $

RUS Form 724 (Rev. 10-63)

$