Attachment 5 - Daily Headstone-Marker Raise n Realign Verification Survey - Copy.pdf
PDF 117 KB Posted
- Attached to
- Golden Gate Shrine 895-NS-FY26-001
- Solicitation number
- 36C78626B0024_1
About this file
This is a Daily Headstone/Marker Raise & Realign Verification Survey form for the Golden Gate National Cemetery National Shrine Project (FY26) located in San Bruno, CA, Project No. 895-NS-FY26-001.
The form serves as a quality control and verification document that must be completed prior to the end of each workday by the Cemetery Director, Contracting Officer's Representative (COR), Foreman, Work Leader, or designee. The document requires the responsible party to conduct a re-verification survey of all completed headstone and marker raise and realign (R&R) work performed that day, utilizing the original Burial Register Report and Gravesite Layout Map from the Initial Verification Survey. The form includes fields to document the station number, date, cemetery name, cemetery director name, COR name, sections and headstones/markers worked on, and any discrepancies or issues identified during the survey. A critical requirement is that all discrepancies must be documented and marked as resolved or unresolved, with unresolved issues requiring notification to the District Office Director and Contracting Officer. The signatory must certify completion of the re-verification survey by providing their signature, title, date, and time completed. This form ensures daily compliance and quality assurance for headstone and marker work performed under the contract.
View the file
Other files
Show all 16
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Golden Gate National Cemetery National Shrine Project – FY26 San Bruno, CA 94066 Project No.: 895-NS-FY26-001
ATTACHMENT 5
DAILY HEADSTONE/MARKER RAISE & REALIGN VERIFICATION SURVEY
Station Number: ________________________ Date: __________________________________
Cemetery: ____________________________ Cemetery Director: _______________________
COR: ________________________________
Instructions: Prior to the completion of the workday, the Cemetery Director/COR/Foreman/Work Leader/designee MUST perform a re-verification survey for ALL completed work of headstones/markers included in the scope of work. The Cemetery Director/COR/Foreman/Work Leader/designee will use the original Burial Register Report and Gravesite Layout Map used for the Initial Verification Survey.
List Sections and Headstones/Markers R&R: _________________________________________
List discrepancy/issue: ___________________________________________________________
All discrepancies/issues resolved: Y/N ________
Cemetery Director/COR/Foreman/ Work Leader/designee informed District Office Director and Contracting Officer of all unresolved discrepancies/issues: Y/N _________
By signing below, I certify the Headstone/Marker re-verification survey was completed.
Daily Headstone Verification:
Date: _____________________ Time Completed: ________________
COR/Director/Foreman/Work Leader/Designee Signature: ________________________
| ATTACHMENT 5 |
| DAILY HEADSTONE/MARKER RAISE & REALIGN VERIFICATION SURVEY |
File details come from the government source that posted it. Updated .