Appendix J - Forms.pdf
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- Solicitation number
- AEW-0170-0561
- Issued by
- Macomb County, Westland City, Michigan
About this file
Appendix J - Forms is a document from the Directorate of Public Works at the Detroit Arsenal, which contains standardized forms for contractors to complete during project execution. The forms include a Contractor Quality Control Report, Contractor Production Report, and an Equipment Checklist. These forms are designed to track daily work activities, safety compliance, equipment usage, and quality assurance for construction and maintenance projects. The forms require detailed logging of work performed, safety meetings, equipment used, materials received, and any incidents or rework items.
The forms serve as critical documentation tools for monitoring project progress, ensuring contract compliance, and maintaining safety standards. They provide spaces for contractors to record work locations, descriptions of tasks, trade hours, safety actions, equipment details, and warranty information. The standardized format allows for consistent reporting across different projects and enables government quality assurance representatives to review and validate the contractor's daily activities and adherence to project specifications.
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Directorate of Public Works Detroit Arsenal
APPENDIX J
Appendix J - Forms a [lilf:l;Mi]
4296/2 (9/98) SHEET 1 OF 1
CONTRACTOR QUALITY CONTROL REPORT
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
DATE
REPORT
NO
PHASE CONTRACT NO CONTRACT TITLE
PR
EP
A R
A
TO
R Y
WAS PREPARATORY PHASE WORK PREFORMED TODAY? YES NO
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL PREPARATORY PHASE CHECKLIST.
Schedule Activity No.
Definable Feature of Work Index #
IN
IT
IA
L
WAS INITIAL PHASE WORK PREFORMED TODAY? YES NO
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL INITIAL PHASE CHECKLIST.
Schedule
FO
LL
O W
-U P
WORK COMPLIES WITH CONTRACT AS APPROVED DURING INITIAL PHASE? YES NO
WORK COMPLIES WITH SAFETY REQUIREMENTS? YES NO
Schedule Activity No.
Description of Work, Testing Performed & By Whom, Definable Feature of Work, Specification Section, Location and List of Personnel Present
REWORK ITEMS IDENTIFIED TODAY (NOT CORRECTED BY CLOSE OF BUSINESS) REWORK ITEMS CORRECTED TODAY (FROM REWORK ITEMS LIST)
Activity No.
Description Schedule
Description
REMARKS (Also Explain Any Follow-Up Phase Checklist Item From Above That Was Answered "NO"), Manuf. Rep On-Site, etc.
On behalf of the contractor, I certify that this report is complete and correct and equipment and material used and work performed during this reporting period is in compliance with the contract drawings and specifications to the best of my knowledge except as noted in this report. AUTHORIZED QC MANAGER AT SITE DATE
GOVERNMENT QUALITY ASSURANCE REPORT DATE
QUALITY ASSURANCE REPRESENTATIVE'S REMARKS AND/OR EXCEPTIONS TO THE REPORT
Schedule
GOVERNMENT QUALITY ASSURANCE MANAGER DATE
4296/2 (9/98) SHEET 1 OF 1
CONTRACTOR QUALITY CONTROL REPORT
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
DATE
REPORT
NO
PHASE CONTRACT NO CONTRACT TITLE
PR
EP
A R
A
TO
R Y
WAS PREPARATORY PHASE WORK PREFORMED TODAY? YES NO
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL PREPARATORY PHASE CHECKLIST.
Schedule
IN
IT
IA
L
WAS INITIAL PHASE WORK PREFORMED TODAY? YES NO
IF YES, FILL OUT AND ATTACH SUPPLEMENTAL INITIAL PHASE CHECKLIST.
Schedule
FO
LL
O W
-U P
WORK COMPLIES WITH CONTRACT AS APPROVED DURING INITIAL PHASE? YES NO
WORK COMPLIES WITH SAFETY REQUIREMENTS? YES NO
Activity No.
Description of Work, Testing Performed & By Whom, Definable Feature of Work, Specification Section, Location and List of Personnel Present
REWORK ITEMS IDENTIFIED TODAY (NOT CORRECTED BY CLOSE OF BUSINESS) REWORK ITEMS CORRECTED TODAY (FROM REWORK ITEMS LIST)
Activity No.
Description Schedule
REMARKS (Also Explain Any Follow-Up Phase Checklist Item From Above That Was Answered "NO"), Manuf. Rep On-Site, etc.
On behalf of the contractor, I certify that this report is complete and correct and equipment and material used and work performed during this reporting period is in compliance with the contract drawings and specifications to the best of my knowledge except as noted in this report. AUTHORIZED QC MANAGER AT SITE DATE
GOVERNMENT QUALITY ASSURANCE REPORT DATE
QUALITY ASSURANCE REPRESENTATIVE'S REMARKS AND/OR EXCEPTIONS TO THE REPORT
Schedule
GOVERNMENT QUALITY ASSURANCE MANAGER DATE
4296/1 (9/98) SHEET 1 OF 1
CONTRACTOR PRODUCTION REPORT
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
DATE
CONTRACT NO TITLE AND LOCATION
REPORT NO
CONTRACTOR SUPERINTENDENT
AM WEATHER PM WEATHER MAX TEMP (F) MIN TEMP (F)
WORK PERFORMED TODAY
WORK LOCATION AND DESCRIPTION EMPLOYER NUMBER TRADE HRS
JOB
SAFETY
WAS A JOB SAFETY MEETING HELD THIS DATE?
(If YES attach copy of the meeting minutes) YES NO
TOTAL WORK HOURS ON JOB
SITE,
THIS DATE, INCL CON'T SHEETS
WERE THERE ANY LOST TIME ACCIDENTS THIS DATE?
(If YES attach copy of completed OSHA report) YES NO
CUMULATIVE TOTAL OF WORK
HOURS FROM PREVIOUS
REPORT
WAS CRANE/MANLIFT/TRENCHING/SCAFFOLD/HV ELEC/HIGH WORK/ HAZMAT WORK DONE?
(If YES attach statement or checklist showing inspection performed.) YES NO
TOTAL WORK HOURS FROM
START OF CONSTRUCTION
WAS HAZARDOUS MATERIAL/WASTE RELEASED INTO THE ENVIRONMENT?
(If YES attach description of incident and proposed action.) YES NO
Schedule
LIST SAFETY ACTIONS TAKEN TODAY/SAFETY INSPECTIONS CONDUCTED SAFETY REQUIREMENTS HAVE BEEN MET.
EQUIPMENT/MATERIAL RECEIVED TODAY TO BE INCORPORATED IN JOB (INDICATE SCHEDULE ACTIVITY NUMBER)
Submittal # Description of Equipment/Material Received
CONSTRUCTION AND PLANT EQUIPMENT ON JOB SITE TODAY. INDICATE HOURS USED AND SCHEDULE ACTIVITY NUMBER.
Owner Description of Construction Equipment Used Today (incl Make and Model) Hours Used
REMARKS
CONTRACTOR/SUPERINTENDENT DATE
EQUIPMENT CHECKLIST
Contract l\Jumber: _
Facility Number/Location: _
Description of Item: _
Model Number: _
Serial Number:
Capacity: _
Name of Manufacturer:
Address of Manufacturer:
Condition:
Inspected by: _
Warranty Information: _
Expiration Date: ~ _
Warranty POC and Phone Number: _
If this is a replacement item, please complete the following information:
Item Removed: _
Model Number/Serial Number: _
Final Disposition of Equipment: _
Remarks: _
| Pages from Appendix J - Forms |
| Contractor Quality Control Report |
| CONTRACTOR QUALITY CONTROL REPORT |
| GOVERNMENT QUALITY ASSURANCE REPORT |
| Initial Phase Checklist |
| Attachment 6 (1) |
| CONTRACTOR QUALITY CONTROL REPORT |
| GOVERNMENT QUALITY ASSURANCE REPORT |
| Attachment 7 (1) |
| CONTRACTOR PRODUCTION REPORT |
| WORK PERFORMED TODAY |
| JOB |
Attachment 23 (1)
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