Attachment 1 - DHS 700-21.pdf
PDF 587 KB Posted
- Attached to
- BUOY SWIVELS Federal contract opportunity
- Solicitation number
- 70Z08424RWOPLNS03
About this file
This document is a Material Inspection Acceptance and Receiving Report template used by the Department of Homeland Security to record receipt and inspection of contract deliverables. It collects information such as contract number, order number, report number, contractor name, items inspected, quantities received and accepted, inspection dates, remarks, and signatures of the inspecting official. The related federal contract opportunity is a solicitation by the U.S. Coast Guard for buoy swivels. No pricing, response deadline or other requirement details are provided in this template document or opportunity description.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Amendment 0001.pdf | ||
| 70Z08424RWOPLNS03.pdf | ||
| Attachment 3 - TE1 Spec. 508.pdf | ||
| Attachment 2 - PPQ.pdf | ||
| Attachment 4 -TE2 Dwg. 121081-C.pdf |
On GovTribe
Work with this file on GovTribe
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
DATE
1. CONTRACT NO. AND LATEST
MODIFICATION NO.
2. ORDER NO. 3. REPORT NO.
4. MATERIAL AND/OR SERVICES INSPECTED
5. CONTRACTOR
7. MANUFACTURER
8. PLACE OF INSPECTION
DHS Form 700-21 (10/14) Page 1 of 2
PREVIOUS
REPORTS
16. SUBMITTED
17. REJECTED
18. ACCEPTED
19. QUANTITY ON
ORDER
22. REMARKS (Use Continuation Sheet for Additional Entries)
23. INSPECTED BY 24. TITLE AND TELEPHONE NUMBER
The materials and/or services listed herein have been inspected or certified test data has been examined, by me or under my supervision.
The materials and/or services listed above as accepted conform to contract requirements. Those listed as rejected do not conform and may not be delivered, except as authorized under "Remarks."
25. SIGNATURE AND PRINTED NAME 26. TITLE AND TELEPHONE NUMBER 27. DATE
DEPARTMENT OF HOMELAND SECURITY
MATERIAL INSPECTION ACCEPTANCE AND RECEIVING REPORT
CONTRACT LINE
ITEM NO(S)
(If applicable)
9.
15. ACCEPTED14. REJECTED
QUANTITY
13. COMPLETED12. STARTED11. READY10. RECEIVED
INSPECTION DATES
20. ACCEPTED TO
DATE
21. BALANCE
REMAINING
THIS
REPORT
TOTAL
TO DATE
6. LOCATION WHERE ITEMS WERE DELIVERED OR
CONTRACTOR PERFORMED
3. REPORT NO.
DEPARTMENT OF HOMELAND SECURITY
MATERIAL INSPECTION ACCEPTANCE AND RECEIVING REPORT (Continued)
CONTRACT LINE
ITEM NO(S)
(If applicable)
9.
15. ACCEPTED14. REJECTED
QUANTITY
13. COMPLETED12. STARTED11. READY10. RECEIVED
INSPECTION DATES
Page 2 of 2DHS Form 700-21 (10/14)
Material Inspection Acceptance and Receiving Report, December 2003 U.S. Department of Homeland Security, Acquisition Policy and Legislation D:20040317145138- 05'00' D:20051012110539- 04'00'
DATE
1. CONTRACT NO. AND LATEST
MODIFICATION NO.
2. ORDER NO.
3. REPORT NO.
4. MATERIAL AND/OR SERVICES INSPECTED
5. CONTRACTOR
7. MANUFACTURER
8. PLACE OF INSPECTION
DHS Form 700-21 (10/14)
PREVIOUS REPORTS
16. SUBMITTED
17. REJECTED
18. ACCEPTED
19. QUANTITY ON ORDER
22. REMARKS (Use Continuation Sheet for Additional Entries)
23. INSPECTED BY
24. TITLE AND TELEPHONE NUMBER
The materials and/or services listed herein have been inspected or certified test data has been examined, by me or under my supervision. The materials and/or services listed above as accepted conform to contract requirements. Those listed as rejected do not conform and may not be delivered, except as authorized under "Remarks."
The materials and/or services listed herein have been inspected or certified test data has been examined, by me or under my supervision. The materials and/or services listed above as accepted conform to contract requirements. Those listed as rejected do not conform and may not be delivered, except as authorized under Remarks.
25. SIGNATURE AND PRINTED NAME
26. TITLE AND TELEPHONE NUMBER
27. DATE
DEPARTMENT OF HOMELAND SECURITY
MATERIAL INSPECTION ACCEPTANCE AND RECEIVING REPORT
CONTRACT LINE
ITEM NO(S)
(If applicable) 9.
15. ACCEPTED
14. REJECTED
QUANTITY
13. COMPLETED
12. STARTED
11. READY
10. RECEIVED
INSPECTION DATES
20. ACCEPTED TO DATE
21. BALANCE REMAINING
THIS
REPORT
TOTAL
TO DATE
6. LOCATION WHERE ITEMS WERE DELIVERED OR
CONTRACTOR PERFORMED
3. REPORT NO.
DEPARTMENT OF HOMELAND SECURITY
MATERIAL INSPECTION ACCEPTANCE AND RECEIVING REPORT (Continued)
CONTRACT LINE
ITEM NO(S)
(If applicable) 9.
15. ACCEPTED
14. REJECTED
QUANTITY
13. COMPLETED
12. STARTED
11. READY
10. RECEIVED
INSPECTION DATES
DHS Form 700-21 (10/14)
| 9. CONTRACT LINE ITEM NUMBER(S) (If applicable) Line 38 of 38.: |
| 15. Quantity Accepted: |
| 14. Quantity REJECTED: |
| Inspection Dates. 13. Completed Date. Enter 2-digit month, 2-digit day and 4-digit year.: |
| Inspection Dates. 12. Started Date. Enter 2-digit month, 2-digit day and 4-digit year.: |
| Inspection Dates. 11. Ready Date. Enter 2-digit month, 2-digit day and 4-digit year.: |
| Inspection Dates. 10. Received Date. Enter 2-digit month, 2-digit day and 4-digit year.: |
| Date. Enter 2-digit month, 2-digit day and 4-digit year.: |
| 1. Contract Number and Latest Modification Number.: |
| 2. ORDER NUMBER.: |
| 4. MATERIAL AND/OR SERVICES INSPECTED.: |
| 5. CONTRACTOR.: |
| 7. MANUFACTURER: |
| 8. PLACE OF INSPECTION: |
| 16. SUBMITTED. PREVIOUS REPORTS: |
| 16. SUBMITTED. THIS REPORT: |
| 16. SUBMITTED. TOTAL TO DATE: |
| 17. REJECTED. TOTAL TO DATE: |
| 17. REJECTED. THIS REPORT: |
| 17. REJECTED. PREVIOUS REPORTS: |
| 18. ACCEPTED. TOTAL TO DATE: |
| 18. ACCEPTED. THIS REPORT: |
| 18. ACCEPTED. PREVIOUS REPORTS: |
| 22. REMARKS (Use Continuation Sheet for Additional Entries). : |
| 23. INSPECTED BY.: |
| 24. TITLE.: |
| 26. TITLE. : |
| 27. DATE. Enter 2-digit month, 2-digit day and 4-digit year.: |
| 19. QUANTITY ON ORDER: |
| 20. ACCEPTED TO DATE: |
| 21. BALANCE REMAINING: |
| 25. PRINTED NAME.: |
| 3. REPORT NUMBER. : |
| 6. LOCATION WHERE ITEMS WERE DELIVERED OR CONTRACTOR PERFORMED.: |
| 26. Telephone Number. Enter 10 digit telephone number including area code.: |
| 25. SIGNATURE. Digital Signature.: |
File details come from the government source that posted it. Updated .