Features for transmitting the form electronically are
available to those customers with access credentials only. If you would
like to establish online access credentials with USDA, follow the instructions
provided at the USDA eForms web site.
Fld Name / |
Instruction |
1 Day |
Enter the day of the month when the engineering agreement is completed. |
2 Month |
Enter the month when the engineering agreement is completed. |
3 Year |
Enter the year when the engineering agreement is completed. |
4 Name |
Enter the name of the person or organization obtaining engineering services. |
5 Name |
Enter the business name of the engineering firm or the name of the engineer who will provide engineering services. |
6 Description |
Enter description of facility to be built or improved. |
7 County |
Enter the name of the county where the facility is being built. |
8 State |
Enter the name of the state where the facility is being built. |
9 Number of Days |
Enter the number of days for preparation of and delivery of preliminary engineering reports negotiated between the owner and engineer. |
10 Number of Days |
Enter the number of days for completion and delivery of final plans and specifications negotiated between the owner and engineer. |
11 & 12 Amount |
Enter the amount negotiated for compensation of preliminary engineering work in words and numbers. |
13 & 14 Amount |
If the owner and engineer agree on a fixed price for final design and the remaining engineering services, enter the amount in words and numbers. |
15 Number of Days |
Enter the estimated number of days to complete construction of the proposed project. |
16 Amount |
Enter an estimated amount for compensation to complete inspections during construction. |
17 Section D 9 Amount |
Enter the amount negotiated for preparation of the operating and maintenance manual. |
18 Amount |
Enter the maximum amount estimated for the cost of all engineering services covered by Section D. |
19 Interest Rate |
Enter the interest rate negotiated by the owner and engineer for a late payment charge for the owner�s failure to make payments within 60 days. |
20 Owner: by |
Signature of the owner�s authorized representative is required. |
21 Attest |
Signature of person attesting to signature of owner�s representative and verifying the representative is authorized to sign the agreement. |
22 Type name |
Enter the name of the person signing as the owner�s representative. |
23 Title |
Enter the title of the person signing as representative of the owner. |
24 Type name: |
Enter the name of the person attesting to the owner representative�s signature. |
25 Date |
Enter the month, day, and year when the owner�s representative signs the engineering agreement. |
26 Title |
Enter the title of the person attesting to owner representative�s signature. |
27 Engineer: by |
Signature of the engineer�s authorized representative is required. |
28 Attest |
Signature of the person attesting to the signature of engineer representative and verifying the representative is authorized to sign the agreement. |
29 Type name |
Enter the name of person signing as the engineer�s representative. |
30 Title |
Enter the title of the person signing as representative of the engineer. |
31 Type name |
Enter the name of the person attesting to the engineer representative�s signature. |
32 Date |
Enter the month, day, and year when the engineer�s representative signs the engineering agreement. |
33 Title |
Enter the title of the person attesting to engineer representative�s signature. |
34 Rural
Development: by |
Leave blank. |
35 Type name |
Leave blank. |
36 Title |
Leave blank. |
37 Date |
Leave blank. |
Fld Name / |
Instruction |
1 Day |
If used, enter the day of the month when the engineering agreement was completed. |
2 Month |
If used, enter the month when the engineering agreement was completed. |
3 Year |
If used, enter the year when the engineering agreement was completed. |
4 Day |
If used, enter the day of the month when the interim agreement is signed. |
5 Month |
If used, enter the month when the interim agreement is signed. |
6 Year |
If used, enter the year when the interim agreement is signed. |