Attachment 6 - Daily Headstone-Marker Raise and Realign Verification Survey.pdf
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- Solicitation number
- 36C78626B0015
About this file
This is a verification survey template for daily quality control inspections of headstone and marker raise and realign work at cemeteries.
The form requires the Cemetery Director, Contracting Officer Representative (COR), Foreman, Work Leader, or designated representative to conduct a re-verification survey of all completed headstone and marker work prior to end of workday. The survey must reference the original Burial Register Report and Gravesite Layout Map from the initial verification survey. The form captures the station number, date, cemetery name, and cemetery director information. Completion requires documentation of all sections and headstones/markers raised and realigned, identification of any discrepancies or issues encountered, and certification that all discrepancies have been resolved or, if unresolved, that the District Office Director and Contracting Officer have been notified. The authorized official must sign and date the form, including the time work verification was completed. This template serves as the daily quality assurance documentation mechanism for cemetery headstone and marker work under a federal contract.
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ATTACHMENT 6
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: ________________________
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