A00814-616507.pdf
PDF 885 KB Posted
- Solicitation number
- BD-27-1030-0H100-0H002-134134
- Issued by
- Massachusetts
About this file
This is a Daily Force Account Report Form (CSD-123) issued by the Massachusetts Department of Transportation Highway Division for Proposal No. 616507-136968. The form serves as a standardized daily reporting document used to track labor, equipment, materials, and salvage associated with force account work performed on transportation projects in Massachusetts. The document is designed to record detailed information about work performed on specific contract dates, including classifications of labor with hours worked, equipment operations with hours of operation, materials used with quantities and units, and salvage items recovered from the project.
The form requires comprehensive documentation of all resources deployed on a given work day, with specific instructions for designating whether materials are used temporarily or remain permanently in the work, indicating the condition of items as new, fit, or scrap, and noting the disposition of previously installed items that required removal. An authorized employee in charge of force account operations must certify the accuracy of the reported labor, equipment, and materials data. The form includes designated spaces for contractor or utility identification, project location details, contract and agreement numbers, and signature blocks for both the employee submitting the report and receiving supervisory personnel, with corresponding date fields for accountability and record-keeping purposes.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| A00820-616507.pdf | ||
| 616507 - Notice to Contractors.pdf | ||
| 616507 Bid Items.txt | TXT text file | |
| A00810-616507.pdf | ||
| A00801-616507.pdf | ||
| A00875-616507.pdf |
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Text version
Massachusetts Department Of Transportation Highway Division Proposal No. 616507-136968
A00814 - 1
DOCUMENT A00814
DAILY REPORT FORM
FORM CSD-123
Massachusetts Department Of Transportation Highway Division
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THIS PAGE INTENTIONALLY LEFT BLANK
COMMONWEALTH OF MASSACHUSETTS
MASSACHUSETTS DEPARTMENT OF TRANSPORTATION – HIGHWAY DIVISION
DAILY FORCE ACCOUNT REPORT
Contractor/Utility: Project:
Contract No: Agreement No: FAP No:
Contract Date: Agreement Date: Prime: Sub:
Date of Work: Work Item and Description:
LABOR
Classification No. Time Worked No. Hours Line Total to to to to to to to to
EQUIPMENT
Description No. Hours of Op. No. Hours Line Total to to to to to to to to
MATERIALS
Description Quantity Unit
SALVAGE
Description Quantity Unit
Location and Description of Work:
Received: Signed:
(Title) (Title) Massachusetts Department of Transportation
Date:
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M A
T E
R
IA
L U
SE
D
, SA
L
V E
D , E
T C
C harged In C harged O ut
Permanent Work
Temporary Work
Old Items Removed
Q uantity
D ate
Q uan
R ate
A m nt Q uantity D ate Q uan R ate A m nt
N ew
Fit
Fit Scrap
IN
ST
R U
C T
IO
N
S 1.
N ote w hether all m aterial chargeable to the project it is used tem porarily or rem ains perm anently in the w ork
2.
U se the three colum ns on the right to indicate the disposition of the item
, using a check m ark (
) in the proper colum n opposite the referenced item
3.
U se the last colum n to designate those item s w hich are already in use and w ere installed prior to any elim ination w ork but w hich m ust be rem oved due to this w ork. D o not refer to such item s under the colum n “C harged In” but do show a salvage allow ance.
4.
Indicate the quality of the item w ith a check m ark ( ) as “N ew ”, “Fit” or “Scrap, in the appropriate colum n.
I, do hereby certify that I am the em ployee of in charge of force account operations in connection w ith the construction of Project/A greem ent N o: located at and that I am in a position to have full know ledge that the accounts herein show n are a substantially accurate statem ent of labor em ployed, equipm ent operated, and m aterial used and/or salvaged on the project on the D ay of , , R eceived:
Signed:
(Title)
(Title) M assachusetts D epartm ent of Transportation D ate:
D ate:
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| A00814-1 Daily Report Form CSD-123 |
| A00814-2 Daily Report Form CSD-123 |
| DAILY FORCE ACCOUNT REPORT |
| LABOR |
| EQUIPMENT |
| MATERIALS |
| SALVAGE |
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