726DVR7525 Appendix IV Monthly Acctg Form.xlsx
XLSX spreadsheet 15 KB Posted
- Solicitation number
- IRFP 726DVR7525
- Issued by
- Anchorage Municipality, Alaska
About this file
This is a Monthly Accounting Report form for the Alaska Department of Labor and Workforce Development, Division of Vocational Rehabilitation, Business Enterprise Program (BEP), used to report vending machine commission payments. The form serves as the reporting mechanism for vendors providing vending machine services in state and federal buildings throughout the Juneau area. Vendors must submit monthly reports detailing gross sales, commission percentages, and commission amounts due for each vending machine by location type (federal or non-federal) and product category (snack, cold food, soft drink, juice, coffee, and similar items). The report requires vendor certification under penalty of perjury that all commission calculations are accurate and comply with the vending services agreement terms and conditions. Payment must be received by the 15th day of the month following the reporting period, submitted by mail to the BEP office in Juneau with either a check or money order.
The form may be submitted in computerized format with prior BEP approval, allowing vendors flexibility in reporting methods while maintaining standardized data collection. The monthly accounting structure ensures regular commission remittance to support the state's vending machine program, which provides business opportunities typically operated by individuals with disabilities as part of the vocational rehabilitation initiative. Vendors are responsible for accurate meter readings, sales documentation, and timely payment submission, with the BEP serving as the centralized collection point for all commissions generated through vending operations across designated state and federal facilities in the Juneau area.
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Other files
| File | Type | Posted |
|---|---|---|
| 726DVR7525 IRFP - May 6, 2026.pdf | ||
| 726DVR7525 Appendix VII VendMach Beg-End Meter reads.xlsx | XLSX spreadsheet | |
| 726DVR7525 Appendix III Collect Stock Sched.docx | DOCX document | |
| 726DVR7525 Appendix VI Inventory of Machines.docx | DOCX document | |
| 726DVR7525 Appendix VIII Cost Proposal.xlsx | XLSX spreadsheet | |
| RFP Submittal Forms A-C.docx | DOCX document | |
| Appendix A standard-contract-form-for-goods-non-pro-services.pdf | ||
| 726DVR7525 Appendix II Commission Sched.docx | DOCX document | |
| 726DVR7525 Appendix I List of Juneau Vending Machine Locations, Revised.xlsx | XLSX spreadsheet | |
| 726DVR7525 Appendix V Surety Deposit.docx | DOCX document | |
| 726DVR7525 Appendix IV Quarterly Acctg Form.xlsx | XLSX spreadsheet |
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Text version
Sheet1
APPENDIX IV
| MONTHLY ACCOUNTING REPORT FOR SUBMITTING | |||||||
| VENDING MACHINE COMMISSIONS | |||||||
| Vendor Name:_____________________________ City:_______________________ | |||||||
| Contract #: _____________________ Reporting Period:______Month:______Year_____ | |||||||
| Each Vending Machine | Meter Reading | Machine | Product | Gross Sales | Comm | Comm. | |
| Location | Beg | End | Type | Type | % | Due |
| Total Commissions Submitted | |
| *Indicate the location as federal (F) or non-federal (N) | |
| **Snack, Cold Food, Soft Drink, Juice, Coffee, etc. | |
| UNDER PENALTY OF PERJURY, I DECLARE I HAVE EXAMINED THIS REPORT AND CERTIFY THAT | |
| THE COMMISSIONS SHOWN HEREON ARE CORRECT TO APPLICABLE TERMS AND CONDITIONS | |
| OF THE VENDING SERVICES AGREEMENT. | |
| Signature: ______________________________ | Date: __________________________ |
| Title: ___________________________________ | |
| Payment in full must be postmarked by the 15th day of the month following the end of the month of | |
| reporting period. Please mail this report with your check or money order to: | |
| Department of Labor & Workforce Development | |
| Division of Vocational Rehabilitation | |
| Business Enterprise Program | |
| Attn: Ellen Doig | |
| PO Box 115516 | |
| Juneau, AK 99801-5516 | |
| A computerized form may be used with BEP approval. |
Sheet2
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