Attachment 5 - Service Order Form.xlsx
XLSX spreadsheet 33 KB Posted
- Solicitation number
- W91QF426RA010
About this file
This is a Service Order Form template designed for Electronic Security System (ESS) maintenance and service work at Fort Leavenworth, Kansas. The form serves as an administrative and cost tracking document for documenting service orders issued under the contract W91QF426RA010 with the Department of the Army Materiel Command Mission and Installation Contracting Command Fort Eustis.
The form is divided into four main sections: Part I captures service order information including contractor details, facility location, task order and service call dates, service type (Routine, Emergency, or Inspection), and a detailed Statement of Work with completion schedules and safety verification requirements through the Accident Prevention Plan. Part II provides a comprehensive cost summary with separate line items for labor (organized by classification including Project Manager, Security System Engineer, Maintenance Supervisor, Sr. Electronic Technician, and CAD Operator), travel expenses (flights, per diem, rental cars), parts/materials/supplies, and subcontracts. The cost section includes fields for calculating material shipping, taxes, material handling, G&A markups, and profit margins, with specific notes regarding micro-purchase thresholds requiring competitive quotes for items over $10,000 and subcontractor quotes over $2,500. Part III requires authorization signatures from the On-Site Representative, Engineering, and Contracting Officer. Part IV contains certification language requiring signatures from both the contractor and Government Quality Assurance Evaluator confirming satisfactory service completion. This is a blank template with no specific service orders populated.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Attachment 11- Historic ESS Maintenance Tracker.xlsx | XLSX spreadsheet | |
| Attachment 3_Sterilized Combined Equipment List (Updated 20260318).xlsx | XLSX spreadsheet | |
| Atachment 12- System ID Serial Numbers (20260318).xlsx | XLSX spreadsheet | |
| Solicitation Amendment W91QF426RA0100001 SF 30.pdf | ||
| ESS MS Ft. Leavenworth_QA.xlsx | XLSX spreadsheet | |
| Solicitation - W91QF426RA010.pdf | ||
| Attachment 1 - Performance Requirements Summary (PRS) ESS.xlsx | XLSX spreadsheet | |
| Attachment 3- Sterilized Combined Equipment List.xlsx | XLSX spreadsheet | |
| Attachment 8 Draft DD 254 ESS Maintenance.pdf | ||
| Attachment 7 - TRADOC_928-R_Submittal_Form.pdf | ||
| Attachment 9-PPQ-ESS.pdf | ||
| Attachment 10- SCA Wage Determination.pdf | ||
| Attachment 4 - Service Log.xlsx | XLSX spreadsheet | |
| Attachment 2 - Combined Deliverables and Project Schedule Requirements.xlsx | XLSX spreadsheet | |
| Attachment 6 - UFGS 28 10 05 - IDS.pdf |
Show all 15
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
Sheet1 (2)
| SERVICE ORDER FORM | ||
| PART I - SERVICE ORDER INFORMATION | ||
| CONTRACTOR & AUTHOR: | CONTRACT NO.: | |
| FACILITY NAME: | TASK ORDER NO.: | |
| FACILITY LOC.(Building #, Room #): | CLIN NO.: | |
| SO REQUEST NO: | SERVICE CALL DATE:(DDMMMYY) | |
| SERVICE ORDER DATE: (DDMMMYY) | SERVICE TICKET NO.: if different | |
| INITIATOR: | TYPE: Routine, Emergency, Inspection. | |
| SOW (include location; attach additional sheets as required): | SCHEDULE OF COMPLETION (DDMMYY) |
| Safety Verification to be completed by Contractor | CEHNC Safety Initial | |
| One of these boxes must be checked: | Contractor confirms there is an AHA associated with the work being performed in this SO included in the Accident Prevention Plan (APP) | NA |
| Contractor acknowledges there is NOT an AHA associated with the work being performed in this SO included in the APP. AHA is attached for review with the SO. | ||
| Check if applicable: | Contractor acknowledges there is an activity associated with the SO that requires an additional plan or program that will be included in an APP addendum. |
| PART II - COST SUMMARY | ||||||
| LABOR UTILIZED | ||||||
| Labor Classification | Reg Labor Hours | Reg Labor Rate | Reg Labor Amount | OT Hours | OT Rate | OT Amount |
| Project Manager | $0.00 | $0.00 | ||||
| Sr. Security System Engineer | $0.00 | $0.00 | ||||
| Security System Engineer | $0.00 | $0.00 | ||||
| Maintenance Supervisor | $0.00 | $0.00 | ||||
| Sr. Electronic Technician | $0.00 | $0.00 | ||||
| CAD Operator | $0.00 | $0.00 | ||||
| Travel to/from site | $0.00 | $0.00 | ||||
| TRAVEL | ||||||
| Traveler | Flight Total | Days | Per Diem / Day | Rental Car Total | Extended Total | Total |
| Technician | $ - 0 | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Project Manager | $ - 0 | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Other | $ - 0 | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Other | $ - 0 | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| Other | $ - 0 | 0 | $ - 0 | $ - 0 | $ - 0 | $ - 0 |
| PARTS/MATERIALS/SUPPLIES |
Michael Bailey: Consult the KO or SOA for guidance for Micro-Purchase Threshold (MPT) requirements. Single items over $10,000 require 3 competitive quotes or proprietary justification.
| Description | Qty | Unit | Unit Price | Amount | |
| $ - 0 | $ - 0 | $ - 0 | |||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| $ - 0 | $ - 0 | ||||
| SUBCONTRACTS | |||||
| Michael Bailey: Consult the KO or SOA for guidance for Micro-Purchase Threshold (MPT) requirements. Subcontractor quotes over $2,500 require 3 competitive quotes or Sole Source Justification. | Sub Total Parts/Materials/Supplies | $0.00 | |||
| Description | Unit Price | Material Shipping Cost | 0.00% | $0.00 | |
| $ - 0 | Tax | 0.00% | $0.00 | ||
| $ - 0 | Material Handling | 0.00% | $0.00 | ||
| $ - 0 | Total Parts/Materials/Supplies Cost | $0.00 | |||
| $ - 0 | Travel G&A | 0.00% | $0.00 | ||
| $ - 0 | Total Travel Cost | $0.00 | |||
| $ - 0 | Total Subcontractor Cost | $0.00 | |||
| $ - 0 | Total Overtime Labor | $0.00 | |||
| $ - 0 | Total Non-Reimbursable Labor | $0.00 | |||
| $ - 0 | Profit (not on Travel) | 0.00% | $0.00 |
Michael Bailey: Doesn't include profit on Subcontractor.
| Michael Bailey: Consult the KO or SOA for guidance for Micro-Purchase Threshold (MPT) requirements. Single items over $10,000 require 3 competitive quotes or proprietary justification. | Subtotal Subcontracts | $0.00 | Bond (DBA only) | $0.00 | ||
| Subcontractor Handling Charge | 0.00% | $0.00 | Total Service Order Cost | $0.00 | ||
| TOTAL TO BE INVOICED | $0.00 | |||||
| PART III - AUTHORIZATION | ||||||
| On Site Representative (OSR) Concurrence: | ||||||
| If the OSR is not the SOA, concurrence of the SOW | DATE | |||||
| Engineering Concurrence: | ||||||
| DATE | ||||||
| Contracting Officer Signature: | DATE | |||||
| PART IV - CERTIFICATION OF SERVICES | ||||||
| I certify that the services under the above Service Order have been satisfactorily completed. | ||||||
| Contractor Signature & Printed Name: | DATE | |||||
| Government Quality Assurance Evaluator Signature & Printed Name: | DATE |
File details come from the government source that posted it. Updated .