A006 - Floor to Book Report (Portfolio).pdf

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Floor to Book Haphazard 2% Directed Program

F2B Counter Name QBL Verifier Name (Supervisor/Leader)

TPIC M Entry Name (Inventory)

Date Date Date

F2B Counter User ID QBL Verifier User Id

TPIC M Entry User ID

F2B Counter QBL Verifier QBL Verified

Inventory TPIC M Entry

Time of Count

Bldg/Lot # Location NSN Unit of Issue Condition

Code Count in Location

DSS QBL Qty 1st Count/QBL Match (Y or N)

TPIC M Created (Y or N) Inventory Cut-Off Date

Signature Field Signature Field Signature Field

Webb, John F CTR DLA DISTRIBUTION (US)

Floor to Book Haphazard 2% Directed Program

F2B Counter Name

QBL Verifier Name

(Supervisor/Leader)

TPIC M Entry Name

(Inventory)

Date

Date

Date

F2B Counter User ID

QBL Verifier

User Id

TPIC M Entry

User ID

F2B Counter

QBL Verifier

QBL

Verified

Inventory TPIC M

Entry

Time of

Count

Bldg/Lot #

Location

NSN

Unit of Issue

Condition

Code

Count in

Location

DSS QBL Qty st

Count/QBL

Match (Y or N)

TPIC M Created (Y or N)

Inventory Cut-Off Date

Signature Field

Signature Field

Signature Field

DateTimeField1:

TextField2:

DateTimeField2:

TextField5:

F2B Counter:

QBL Verifier:

Inventory TPIC M Entry:

Time of Count_Row_1:

Bldg/Lot #_Row_1:

Location_Row_1:

NSN_Row_1:

Unit of Issue_Row_1:

Condition Code_Row_1:

Count in Location_Row_1:

DSS QBL Qty_Row_1:

1st Count/QBL Match (Y or N)_Row_1:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_1:

Time of Count_Row_2:

Bldg/Lot #_Row_2:

Location_Row_2:

NSN_Row_2:

Unit of Issue_Row_2:

Condition Code_Row_2:

Count in Location_Row_2:

DSS QBL Qty_Row_2:

1st Count/QBL Match (Y or N)_Row_2:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_2:

Time of Count_Row_3:

Bldg/Lot #_Row_3:

Location_Row_3:

NSN_Row_3:

Unit of Issue_Row_3:

Condition Code_Row_3:

Count in Location_Row_3:

DSS QBL Qty_Row_3:

1st Count/QBL Match (Y or N)_Row_3:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_3:

Time of Count_Row_4:

Bldg/Lot #_Row_4:

Location_Row_4:

NSN_Row_4:

Unit of Issue_Row_4:

Condition Code_Row_4:

Count in Location_Row_4:

DSS QBL Qty_Row_4:

1st Count/QBL Match (Y or N)_Row_4:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_4:

Time of Count_Row_5:

Bldg/Lot #_Row_5:

Location_Row_5:

NSN_Row_5:

Unit of Issue_Row_5:

Condition Code_Row_5:

Count in Location_Row_5:

DSS QBL Qty_Row_5:

1st Count/QBL Match (Y or N)_Row_5:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_5:

Time of Count_Row_6:

Bldg/Lot #_Row_6:

Location_Row_6:

NSN_Row_6:

Unit of Issue_Row_6:

Condition Code_Row_6:

Count in Location_Row_6:

DSS QBL Qty_Row_6:

1st Count/QBL Match (Y or N)_Row_6:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_6:

Time of Count_Row_7:

Bldg/Lot #_Row_7:

Location_Row_7:

NSN_Row_7:

Unit of Issue_Row_7:

Condition Code_Row_7:

Count in Location_Row_7:

DSS QBL Qty_Row_7:

1st Count/QBL Match (Y or N)_Row_7:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_7:

Time of Count_Row_8:

Bldg/Lot #_Row_8:

Location_Row_8:

NSN_Row_8:

Unit of Issue_Row_8:

Condition Code_Row_8:

Count in Location_Row_8:

DSS QBL Qty_Row_8:

1st Count/QBL Match (Y or N)_Row_8:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_8:

Time of Count_Row_9:

Bldg/Lot #_Row_9:

Location_Row_9:

NSN_Row_9:

Unit of Issue_Row_9:

Condition Code_Row_9:

Count in Location_Row_9:

DSS QBL Qty_Row_9:

1st Count/QBL Match (Y or N)_Row_9:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_9:

Time of Count_Row_10:

Bldg/Lot #_Row_10:

Location_Row_10:

NSN_Row_10:

Unit of Issue_Row_10:

Condition Code_Row_10:

Count in Location_Row_10:

DSS QBL Qty_Row_10:

1st Count/QBL Match (Y or N)_Row_10:

TPIC M Created (Y or N) Inventory Cut-Off Date_Row_10:

SignatureField1:

SignatureField2:

SignatureField3:

TextField1:

TextField3:

TextField4:

TextField6:

DateTimeField3:

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

Week

Totall F2B Counts Required

(Generated by DLA Distribution J3-OC)

Number of F2B Counts Completed

Total # F2B Counts Matching QBL Balance

Total # F2B Counts w/ Discrepancy Resulting in (TPIC M)

Total # Adjustments resulting from (TPIC

M)

Dollar Value of Adjustments

Attachment 1

DD__ Weekly Floor to Book Status Report Month/Week: ________________

A028 - Attachment 1.pdf

Sheet

ADP4592.tmp

Sheet

1_DATA_ITEM_NO: A006

2_TITLE_OF_DATA_ITEM: Floor to Book Report to Support MIMR Requirements

3_SUBTITLE:

4_AUTHORITY_Data_Acquisit: N/A

5_CONTRACT_REFERENCE: Attachment J.1 PWS

6_REQUIRING_OFFICE: DLA Distribution J-7

7_DID_250_REQ: See Block 16

8_APP_CODE:

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: J-7 Contract Spec draft1:

reg1:

repro1: 1 addressee2: COR draft2:

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total_draft: 0 total_repro: 1

16_REMARKS: Submit electronically.

Submit the information identified in Attachment 1 on a weekly basis as F2Bs are completed and discrepancies and adjustments identified.

Submit the information identified in Attachment 2 on a monthly basis by the 5th calendar day of the month.

Block 7: Inspection and acceptance requirements:

The COR will review and provide acceptance after review and comments.

Block 14: Distribution - Contractor to submit to COR and copy to the Contract Specialist.

Block I - Approved By - Signature of Government official accepting the Contractor's reporting requirement of this CDRL will be the the COR.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE:

1_APPROVED_BY:

J_DATE:

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: X006

B_EXHIBIT:

TDP:

TM:

OTHER:

DSYSTEMITEM:

E_CONTRACTPR_NO:

FCONTRACTOR:

of_pages: 1

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