726DVR7525 Appendix IV Quarterly Acctg Form.xlsx
XLSX spreadsheet 24 KB Posted
- Solicitation number
- IRFP 726DVR7525
- Issued by
- Anchorage Municipality, Alaska
About this file
This file is a Quarterly Accounting Report form issued by the State of Alaska Department of Labor & Workforce Development, Division of Vocational Rehabilitation, Business Enterprise Program (BEP), for vending machine commission tracking and submission. The form is designed for vendors operating vending machines in state and federal government buildings within the Juneau area to report their gross sales, applicable commission percentages, and commission amounts due on a quarterly basis. Vendors must complete the form by identifying each vending machine location, distinguishing between federal and non-federal sites, specifying product types such as snacks, cold food, soft drinks, juice, or coffee, and recording meter readings for the beginning and ending of each reporting period. The form requires vendor certification under penalty of perjury that all commission calculations are accurate and comply with the vending services agreement terms and conditions.
Payment of commissions must be submitted with the completed form and postmarked by the 15th day of the month following the end of the reporting period, with all documents mailed to the BEP program manager at the Department of Labor & Workforce Development office in Juneau. While a computerized version of the form may be used with BEP approval, vendors must ensure accurate recording of gross sales figures and proper calculation of commissions owed based on contractually established commission percentages. This accounting mechanism ensures regular monitoring of vending machine revenue generated from state and federal property and maintains compliance with the vending services agreement for the ongoing operation of machines throughout 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 IV Monthly Acctg Form.xlsx | XLSX spreadsheet | |
| 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 |
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Text version
Sheet1
APPENDIX IV
| QUARTERLY 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 | |
| 801 West 10th Street, Suite A | |
| Juneau, AK 99801-1894 | |
| A computerized form may be used with BEP approval. |
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