Attachment D - Appendix B - Transfer of GF Headstones-Markers-NC.pdf

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L099--36C78626Q0061 - Onsite Inscription Services for Georgia National Cemetery
Solicitation number
36C78626Q0061
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This is an appendix template for documenting the transfer of blank government-furnished headstones, markers, and niche covers to VA contractors providing on-site inscription services under contract 36C78626Q0060.

The form serves as a receipt and verification document with two certification sections. The upper section requires cemetery personnel to certify the transfer of blank items by providing their printed name, signature, and date. The lower section requires the VA contractor to certify receipt and verify the quantity of items received, also with printed name, signature, and date. The form includes checkboxes for eight types of blank items with quantity fields: Memorial Wall Marker in Marble (A1) and Granite (C1); Niche Cover in Granite (H1) and Marble (I1); Headstone Upright in Granite (W1), Marble (U1), and Marble/Granite combination (V1); and a duplicate Niche Cover Granite entry (W1). A separate section allows documentation of rejected items by type and quantity. This template establishes accountability and chain of custody for government property transferred between cemetery operations and the on-site inscription contractor.

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Other files

File Type Posted
Attachment I - CDR.pdf PDF
Attachment B - SOW - On-Site Inscription Services - Georgia.pdf PDF
Attachment F - Drawings.pdf PDF
Attachment K - Past Performance Questionnaire.docx DOCX document
Attachment A - Price-Cost Schedule - On-Site Inscription Services - Georgia.xlsx XLSX spreadsheet
Attachment J Sample Review Forms.pdf PDF
Attachment C - Appendix A - Cemetery Site Specific Info and Maps.pdf PDF
Attachment H - Weekly Status Report Sample.pdf PDF
Attachment G - WD 2015-4471 Rev 35 - 13 May 2026.pdf PDF
36C78626Q0061.docx DOCX document
Attachment E - Appendix C - Completion of Inscription Services.pdf PDF
Combined Synopsis Solicitaton - On-Site Inscription Services - Georgia NC.docx DOCX document
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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 .