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Iliinois Department Local Public Agency <br /> of Transportation Construction Inspector <br /> Roger Driskell County MACON <br /> Deputy Director Division of Highways Municipality CITY OF DECATUR <br /> Regional Engineer Section 10-00025-00-SW <br /> Department of Transportation Route FRANKLIN ST <br /> 400 W Wabash <br /> Effingham, Illinois 62401 Contract No. <br /> Job No. C-97-023-14 <br /> Project FRANKLIN STREETSCAPE <br /> I consider the following individual to be qualified as a local public agency construction inspector. In addition, I certify that <br /> adequate instruction has been given this individual concerning the requirements of the contract, specifications and <br /> construction manual which pertain to the work which he/she will inspect. This individual has been instructed on the proper <br /> procedures for any necessary tests. Furthermore, if a consultant, this individual has a valid Documentation of Contract <br /> Quantities certification. <br /> Approved 3/28/2014 <br /> Date Signature and Title of Resident Construction Supervisor <br /> Don Cisco III <br /> Applicants Name(Type or Print) <br /> The following describes the educational background, experience and other qualifications of the named applicant to serve as <br /> an inspector on this project. <br /> For Consultants Employees: Documentation of Contract Quantities certificate number is <br /> Illinois State University 2002-2006 Bachelors of Science in Construction Management <br /> Civil Engineering Technician—City of Decatur, Illinois 2006-Present <br /> I recently oversaw three phases of streetscape enhancement in downtown Decatur. I took over resident engineer duties on <br /> IDOT contract 95574 the Eldorado Streetscape project. I assisted on IDOT contract 95545 the West Main Streetscape project <br /> (Phase I and II). Various other projects I have overseen include road rehabilitation, storm and sanitary sewer repairs, parking <br /> lot beautification, sidewalk rehabilitation, and a city block demolition downtown. <br /> If the Resident from BC-775 is a consultant, the local public agency employee in responsible charge must also approve this <br /> individual. <br /> Approved <br /> Date Signature and Title of In Responsible Charge from BC-775 <br /> Printed 3/28/2014 Page 1 of 2 BC 776(Rev. 1/10/12) <br />