Attachment D - Appendix B - Transfer of GF Headstones-Markers-NC.pdf
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About this file
This is an appendix to a Veterans Affairs contract document for on-site inscription services, specifically a transfer form for blank government-furnished headstones, markers, and niche covers.
The form documents the transfer of blank inventory items from VA cemetery personnel to the VA contractor performing inscription services. Cemetery personnel certify the transfer by providing their printed name, signature, and date. The form requires itemization of ten different product types being transferred, each with a corresponding quantity field: Memorial Wall Markers in marble (A1) and granite (C1), marble markers (F1), granite and marble niche covers (H1 and I1), thin flat markers in granite (J1), small flat markers in granite (L1), and upright headstones in marble (U1 and V1) and granite (W1). The form includes a section for documenting any rejected items by type and quantity. The VA contractor receiving the inventory items must certify receipt by providing their printed name, signature, and date, confirming that all quantities have been verified. This form serves as a critical accountability document for tracking government-furnished materials transferred to the contractor for inscription and installation services.
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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: _______________
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