1240BE27Q0007 Attachment 5 Equipment Cleaning Form.pdf

This is an Equipment Cleaning Inspection/Verification Form for federal contract 1240BE27Q0007, Little Missouri National Grassland Road Maintenance. The form serves as a certification document that contractors must complete to verify equipment has been cleaned in accordance with contract requirements.

The form requires the contractor to provide essential documentation including the date, contract number, contract name, contractor representative name, and USFS Contracting Officer's Representative (COR) or Inspector identification. Contractors must document the type of equipment cleaned, the cleaning method used, and the location where cleaning occurred. The form also requires identification of the equipment's location of last operations, including the state, specific federal location, and any non-Federal location where work was performed. The contractor certifies that all equipment has been thoroughly cleaned of soil, seeds, and vegetative material in compliance with the equipment cleaning contract provisions. The form concludes with signature and date lines for the contractor, indicating this is a required certification document for contract compliance and documentation purposes.