14-ATTACHMENT A- DAILY SERVICE REPORT.pdf

PDF 129 KB Posted

Attached to
Ground Storage Tank Inspection, Maintenance and Repair Services
Solicitation number
OPN2130579B1
Issued by
Broward County, Florida

About this file

This document is a Daily Service Report form from Broward County, Florida, designed for vendors to document service work performed for the county. The form provides space for detailed tracking of service activities, including vendor information, purchase order and work order numbers, service date, job description, parts used, and sub-contractors engaged. The form requires comprehensive documentation of work performed, with sections for model and serial numbers, parts used, sub-contractor details including classification and time worked, and designated areas for both contractor and county personnel signatures.

The form is structured to facilitate thorough documentation and payment verification, with fields to capture precise details about the service rendered. It includes provisions for recording parts costs, labor rates, and total expenses, and requires mandatory vendor backup for parts and sub-contractor information. The document allows county personnel to confirm job completion, with checkboxes for job status and a section for final acceptance, ensuring a formal process for service verification and payment authorization. The form is color-coded, with white copies designated for the county and yellow copies for the vendor, supporting clear record-keeping and administrative tracking of service work.

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Text version

VENDOR: PURCHASE ORDER #:

LOCATION: WORK ORDER #

ADDRESS: DATE OF SERVICE: ______________________

PM: SERVICE:

DESCRIPTION OF JOB:

MODEL # SERIAL #

QTY / LINE # PARTS USED / LINE DESCRIPTION (MANDATORY VENDOR BACKUP NEEDED) PRICE $ TOTAL

SUB-CONTRACTORS USED (MANDATORY VENDOR BACKUP NEEDED)

NAME & CLASSIFICATION (Master, Journey, Apprentice, Laborer) TIME IN RATE $ TOTAL

WORK PERFORMED:

CONTRACTOR SIGNATURE_________________________________ BC SIGNATURE_____________________________________

INFORMATION BELOW TO BE COMPLETED BY AUTHORIZED COUNTY PERSONNEL

JOB COMPLETE? YES NO

IF YES, SIGN "FINAL ACCEPTANCE" *AUTHORIZED COUNTY PERSONNEL SIGNATURE________________________________________

*I HAVE THE AUTHORITY TO ORDER WORK OUTLINED ABOVE WHICH HAS BEEN SATISFACTORLY COMPLETED AND AGREE TO PAY ALL PARTS

AND HOURS AS INDICATED ON THIS SERVICE REPORT.

WHITE-BC, YELLOW-Vendor

IF NO, STATUS:

TIME OUT

AGENCY: _____________

DAILY SERVICE REPORT

Attachment "A"

Service Report for WWOD

File details come from the government source that posted it. Updated .