Attachment I - Monthly Summary Report.xls
XLS spreadsheet 58 KB Posted
- Solicitation number
- ITN-01380
- Issued by
- Leon County, Florida
About this file
This document is a monthly summary report related to a state and local contract opportunity for elevator preventative maintenance, repair, inspection, and testing services issued by the State of Florida, Department of Management Services (DMS), Division of Real Estate Development and Management (REDM). The contract is for services at facilities throughout the state, including in Leon County and the city of Tallahassee. Questions and answers as well as an addendum have been posted on July 11, 2022. The contract term and any renewal options are not specified.
The pricing terms, set asides, incumbents, funding requirements and sources, and other salient information are not provided in this summary report document.
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Other files
| File | Type | Posted |
|---|---|---|
| Addendum No. 1 w Attachments.pdf | ||
| Attachment A - Scope of Work.pdf | ||
| Attachment C - Facility List.xls | XLS spreadsheet | |
| Attachment K - Quarterly Condition Report.xlsx | XLSX spreadsheet | |
| DMS-2122-198 ITN.pdf | ||
| Attachment D - Regional Map.pdf | ||
| Attachment F - Site Visits.xls | XLS spreadsheet | |
| Attachment G - Price Sheet.xlsx | XLSX spreadsheet | |
| REVISED Attachment J - List of Elevators.pdf | ||
| Attachment B - Draft Contract.pdf | ||
| Attachment E - PSGs.xlsx | XLSX spreadsheet | |
| Attachment H - Eval Criteria.pdf |
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Text version
Attachment I - Monthly Summary
| Attachment I - Monthly Summary Report | ||
| Elevator Preventative Maintenance, Repair, Inspection, and Testing Services | ||
| ITN No. DMS-21/22-198 | ||
| (Must be submitted with Monthly Invoice) | ||
| Vendor: | ||
| Monthly Summary Report for the Month of: | ||
| Facility: | ||
| Invoice Date: | ||
| Invoice Amount: | ||
| Requirements | ||
| Contract Requirements | Date | FM Initials or Comments |
| Logbook completed with all required information (Y/N): | ||
| All Service Ticket(s) for the month signed & attached (Y/N): | ||
| Reference Library Maintained (Y/N): | ||
| Condition Report (Quarterly) - completed and submitted (Y/N): | ||
| Services Provided Information | Fill In Information | FM Initials or Comments |
| Date of Previous Monthly Service: | ||
| Number of Service Calls: | ||
| Hours Spent on Service Calls (Provide total hours and hours per call): | ||
| Monthly Scheduled Service Visit for Preventative Maintenance (date): | ||
| Hours Spent on Scheduled Preventative Maintenance by the Contractor: | ||
| Equipment Cleaned by the Contractor (list details below): | ||
| Debris Removed after Service (Y/N): | ||
| List any Inspections During the Service Period: | ||
| Equipment Painted by the Contractor (list details below): | ||
| Monthly Equipment Inspection (provide information below): | ||
| Were all Entrapments discussed (Y/N): | ||
| Please use Comments Section below to provide details of problems, solutions, and comments. | ||
| Car(s) Out of Service | Date | Task or Reason |
| Elevator Number: | ||
| Reason: | ||
| Time Out of Service: | ||
| Time Back in Service: | ||
| Total Days Out of Service: | ||
| Tasks Performed: | ||
| Resolution of Problems: | ||
| List of All Equipment Cleaned (include Elevator Number & Room): | Date Cleaned | Part(s) Cleaned |
| List of All Equipment Painted (include Elevator Number & Room): | Date Painted | Part(s) Painted |
| Detail of Services Listed in Logbook (I.e., oil or fluid added, bulbs changed): | Date | Task or Reason |
| Credits to Be Issued: | Reason | Amount |
| Please use Comments Section below to provide details of problems, solutions, and comments. | ||
| Certification Information | Date Inspected | Signature |
| Safety Certification Letter (Annual) | ||
| Certificates of Competency (Section 399.01, Florida Statutes) | ||
| Electric Traction Elevator Safety Test (Annual) | ||
| Hydraulic or Traction Elevator Safety Test (Annual) | ||
| Three-Year Hydraulic Safety Test Date (hydraulic elevators) | ||
| Five-Year Full Load Safety Test Date | ||
| Required Signatures: | Name | Signature |
| Assigned Contractor Technician: | ||
| Inspection by Senior Representative: | ||
| Facility Manager's or Designee's Signature: | ||
| Senior Representative's Signature: | ||
| Monthly Inspection Issues: | Dates | |
| Repair Plan for any Issues: | Dates | |
| Labor and Material Costs, Estimated Time to Obtain Parts, Time to Repair: | Dates | |
| Comments and Explanations: | Dates |
&L&10Contract No: DMS-21/22-198 Elevator Preventive Maintenance, Repair, Inspection, and Testing Services&R&10Page &P of &N
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