Attachment 5.pdf

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Attached to
Chemical Site Prep IDIQ Federal contract opportunity
Solicitation number
12343420R0007
Issued by
Department of Agriculture Forest Service R9-Eastern Region

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Text version

USDA - Forest Service

CONTRACT DAILY DIARY

(Reference FSH 6309.11)

1. FOREST

Monongahela National Forest

2. CONTRACT NO.

3. PROJECT

Chemical Site Prep

4. CONTRACTOR 5. CONTRACTOR REPRESENTATIVE ON SITE

6. GOVERNMENT OFFICIALS ON SITE

7. DATE 8. DAY OF WEEK 9. TIME ARRIVED 10. TIME DEPARTED 11. WEATHER

12. TEMPERATURE °F. 13. GROUND CONDITION 14. CONTRACT TIME 15. DAYS USED 16. COMPLETION DATE Min. Max.

17. TIME USED (%) 18. WORK COMPLETED (%) 19. WORK ON SCHEDULE 20. CONTRACTOR'S WORK - (X Appropriate Box) YES NO Acceptable Unacceptable - Explain in narrative

21. CHANGE ORDERS/AMENDMENTS ISSUED 22. WORK ORDERS ISSUED (Include SUSPEND/RESUME)

23. MATERIALS FURNISHED TO JOB SITE (Furnished By: G-Govt.; C-Cont.; S-Subcont.) 24. LIST EQUIPMENT ON SITE (Furnished by G-Govt.; C-Cont.; S-Subcont.)

Type Contract Item Number and Location of Use Hours Used

25. LIST CONTRACT PAYMENTS, REPORTS, CORRESPONDENCE, ETC. 26. WORKERS ON SITE Number

Item Prep Submit Classification PRIME SUB

27. GOVERNMENT PROVIDED SERVICES ADEQUATELY AND TIMELY

YES NO - Explain in narrative

28. NARRATIVE REPORT

29. SIGNATURE 30. TITLE 31. ADDTL SPACE NEEDED

(continued on 6300-21) Distribution: Original - CO (weekly); COR, SO, PROJ ENG Previous editions of this form are obsolete.

FS-6300-20 (12/85)

File details come from the government source that posted it. Updated .