Attachment D - Appendix B - Transfer of GF Headstones-Markers-NC.pdf
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About this file
This is a transfer form used for the Department of Veterans Affairs on-site inscription services contract, specifically Appendix B of Attachment D.
The form documents the transfer of blank government-furnished headstones, markers, and niche covers from cemetery personnel to a VA contractor. It requires the transferring cemetery personnel to provide their printed name, signature, and date, then specify quantities of blank items being transferred by type. The transferable items include ten distinct product categories: Memorial Wall Markers in both marble and granite; Markers in marble; Niche Covers in both granite and marble; Thin Flat Markers in granite; Small Flat Markers in granite; and Headstones in upright marble (two variants) and upright granite. The form includes a section for documenting any rejected items with their type and quantity. The receiving VA contractor must certify receipt of the items by providing their printed name, signature, and date, along with a verification that quantities have been confirmed. This form serves as an accountability document for government property transfer related to headstone and marker inscription services at VA cemeteries.
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Attachment D – On-Site Inscription Services
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: ______
(F1) Marker, Marble, Blank Quantity: ______
(H1) Niche Cover, Granite, Blank Quantity: ______
(I1) Niche Cover, Marble, Blank Quantity: ______
(J1) Thin Flat Marker, Granite, Blank Quantity: ______
(L1) Small Flat Marker, Granite, Blank Quantity: ______
(U1) Headstone, Upright, Marble, Blank Quantity: ______
(V1) Headstone, Upright, Marble, Blank Quantity: ______
(W1) Headstone, Upright, 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 .