Attachment F.xls

XLS spreadsheet 21 KB Posted Jun 12, 2009

Attached to: Road and Bridge Maintenance and Construction (IDIQ) Job Order Contract for Region 4
Solicitation number: AG-02NV-S-09-0016
Issued by: Department of Agriculture Forest Service R4-Intermountain Region

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Attachment F

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QC FORM

JOB ORDER QUALITY CONTROL PLAN FORM
	Job Order Contract No:	Job Order Contract No.	As the Site Superintendent I have supervised the work identified within this Job Order and certify that all work has been completed in a workmanlike manner in full accordance with the requirements as identified.

Signed: ____________________________________________________ Site Superintendent Date

		Job Order Number:	Enter Job Order Number
		Ranger District (Community):	Enter Ranger District or Community
		County:	Enter County
		Site Superintendent:	Name of Site Superintendent	Signature:
		Sub-Contractor:	Name of Sub-Contractor
		Sub-Contractor:	Name of Sub-Contractor
		Date Prepared:	Enter Date
		Prepared By:	Name of Preparer
		Job Order Time:	Enter Days
		Job Order Performance Period:	Enter Start Date
Line #	RSMeans Costs	Mean'sItem #	Description	Describe Quality Standard	Inspector	Notify Gov. In Advance	Passed (date)	Failed (date)
1		00000-0000000-
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21	Non-prepriced work	Non-Prepriced
22		Non-Prepriced
23		Non-Prepriced
24		Non-Prepriced
25		Non-Prepriced
26		Non-Prepriced
27		Non-Prepriced

&CAttachment F

Sheet2

File details come from the government source that posted it. Updated Nov 14, 2017.