Service Hour Log.pdf
PDF 182 KB Posted
- Attached to
- R699--Reader Services
- Solicitation number
- 36C10D25Q0119
- Issued by
-
Department of Veterans Affairs
About this file
The Service Hour Log is a standardized form used to track and verify contractor service hours for a specific VA contract. The document is divided into two parts: Part 1 to be completed by the contractor (including service type and contract employee name) and Part 2 to be completed jointly by the contractor and VA employee (documenting date, hours, and initials). The form includes a certification statement warning against making false statements, which could result in fines or imprisonment. The log provides spaces for recording contract number, business line, regional office/station, service details, and total hours worked, with designated signature lines for both the contract employee and VA employee to validate the recorded information.
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Other files
| File | Type | Posted |
|---|---|---|
| 36C10D25Q0119 0001.pdf | ||
| 36C10D25Q0119.pdf | ||
| Wage Determination 2015-4727 Rev 26 06MAY2025.pdf |
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Text version
SERVICE HOUR LOG
CONTRACT NUMBER OR PURCHASE ORDER BUSINESS LINE REGIONAL OFFICE/STATION
PART 1 – TO BE COMPLETED BY CONTRACTOR
NAME OR TYPE OF SERVICE BEING PROVIDED.
NAME OF CONTRACT EMPLOYEE NAME AND TITLE OF VA EMPLOYEE VERIFYING TIME
PART 2 – TO BE COMPLETED BY VA EMPLOYEE AND CONTRACTOR
DATE HOURS COMPLETED CONTRACTOR INITIALS VA EMPLOYEE INITIALS
TOTAL HOURS: = __________
I HEREBY CERTIFY THAT ALL THE INFORMATION ON THIS FORM IS TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND I REALIZE THAT MAKING WILLFUL FALSE STATEMENTS IS A PUNISHABLE OFFENSE WHICH MAY RESULT IN A FINE OR IMPRISONMENT
OR BOTH.
CONTRACT EMPLOYEE’S SIGNATURE DATE SIGNED VA EMPLOYEE’S SIGNATURE DATE SIGNED
File details come from the government source that posted it. Updated .