Attachment D - Appendix B - Transfer of GF Headstones-Markers-NC.pdf
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- Solicitation number
- 36C78626Q0060
About this file
This document is an appendix form used for tracking the transfer of blank government-furnished headstones, markers, and niche covers from Veterans Affairs (VA) cemetery personnel to VA contractors providing on-site inscription services under contract 36C78626Q0060.
The form serves as a certification document requiring cemetery personnel to document the transfer of blank monuments by material type and quantity. Transferable items include Memorial Wall Markers in both marble and granite, Niche Covers in granite and marble, and Upright Headstones in granite, marble, or combined marble-granite configurations. The form includes a section for documenting rejected items with type and quantity specifications. The VA contractor must verify receipt of all transferred items and certify that quantities have been verified. Both cemetery personnel and the VA contractor must sign and date the document to establish accountability for the government-furnished materials being transferred for inscription services.
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Attachment D – On-Site Inscription Services – 36C78626Q0060
APPENDIX B - TRANSFER OF BLANK GOVERNMENT-FURNISHED HEADSTONES,
MARKERS, OR NICHE COVERS
I certify that the blank headstones, markers, or niche covers specified below were transferred to the VA contractor listed at the bottom of the form.
Printed Name of Cemetery Personnel:
Signature: ____________________________________ Date: _________________________
Check the appropriate box and insert the quantity for the type of headstone, marker or niche cover being transferred to the on-site contractor.
(A1) Memorial Wall Marker, Marble, Blank Quantity: ______
(C1) Memorial Wall Marker, Granite, Blank Quantity: ______
(H1) Niche Cover, Granite, Blank Quantity: ______
(I1) Niche Cover, Marble, Blank Quantity: ______
(W1) Headstone, Upright, Granite, Blank Quantity: ______
(U1) Headstone, Upright, Marble, Blank Quantity: ______
(V1) Headstone, Upright, Marble, Granite, Blank Quantity: ______
(W1) Niche Cover, Granite, Blank Quantity: ______
List any rejects below, include type and quantity:
I certify that the headstones, markers, or niche covers specified above were received by me and the quantity of items has been verified.
Printed Name of VA Contractor:
Signature: _______________________________________________ Date: _______________
File details come from the government source that posted it. Updated .