Attachment 6 Daily Headstone Marker Raise Realign Verification Survey.pdf

This is a verification survey form template used for quality control purposes on federal cemetery maintenance contracts. The Daily Headstone/Marker Raise & Realign Verification Survey (Attachment 6) documents the completion and inspection of headstone and marker repositioning work within cemetery grounds.

The form requires designated personnel—including the Cemetery Director, Contracting Officer's Representative (COR), Foreman, Work Leader, or designee—to conduct a re-verification survey of all completed headstone/marker raise and realign work prior to the end of each 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, cemetery director name, and COR information. Specific sections require documentation of which sections and headstones/markers were raised and realigned, identification of any discrepancies or issues encountered, confirmation of whether all discrepancies were resolved, and notification status to the District Office Director and Contracting Officer regarding any unresolved issues. The certifying official must record the verification completion date, time completed, and provide a signature. This template serves as evidence that daily quality assurance procedures were performed in accordance with contract requirements.