Attachment 6 - Daily Headstone-Marker Raise and Realign Verification Survey.pdf
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- Solicitation number
- 36C78625B0034
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Attachment 6 is a daily verification survey form for headstone and marker raise and realignment work at a national cemetery. The form is designed to be completed by the Cemetery Director, Contracting Officer's Representative (COR), Foreman, Work Leader, or their designee at the end of each workday. The survey requires documentation of completed work sections, identification of any discrepancies or issues, confirmation of issue resolution, and notification of the District Office Director and Contracting Officer about unresolved problems.
The form includes fields for the station number, date, cemetery name, cemetery director, and COR. It mandates a re-verification survey using the original Burial Register Report and Gravesite Layout Map, with a requirement to list specific sections and headstones/markers that were raised and realigned. The form concludes with a certification signature, date, and time of completion, serving as a critical quality control and documentation mechanism for cemetery maintenance work.
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ATTACHMENT 6
DAILY HEADSTONE/MARKER RAISE & REALIGN VERIFICATION SURVEY
Station Number:__________ Date:_____________________
Cemetery: _______________ Cemetery Director: _______________
COR: ___________________
Instructions: Prior to the completion of the workday, the Cemetery Director/COR/Foreman/Work Leader/designee MUST perform a re-verification survey for ALL completed work of headstones/markers included in the scope of work. The Cemetery Director/COR/Foreman/Work Leader/designee will use the original Burial Register Report and Gravesite Layout Map used for the Initial Verification Survey.
List Sections and Headstones/Markers R&R: __________________________________
List discrepancy/issue: ___________________________________________________
All discrepancies/issues resolved: Y/N ______
Cemetery Director/COR/Foreman/ Work Leader/designee informed District Office Director and Contracting Officer of all unresolved discrepancies/issues: Y/N _______
By signing below, I certify the Headstone/Marker re-verification survey was completed.
Daily Headstone Verification:
Date: __________ Time Completed: ______________
COR/Director/Foreman/Work Leader/designee Signature: ________________________
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