Attachment%20J%20P2Inter-AgencyVoucherReq.pdf
PDF 138 KB Posted
- Attached to
- Facility Protection Services - UPDATED State and local contract opportunity
- Solicitation number
- RFP 32110-22726
- Issued by
- Davidson County, Tennessee
About this file
This is an Inter-Agency Journal Voucher Request Form issued by the Tennessee Department of General Services (DGS) Facilities Management division, designed to facilitate cost allocation and authorization for facility-related projects requested by state agencies. The form serves as a mechanism for tenant agencies to request DGS services, with the scope of work to be completed defined by the requesting agency and submitted to the DGS Coordinator. Upon submission, DGS estimates the labor and material costs required to complete the described work, returns the form to the tenant agency for approval of the estimated costs, and proceeds with the project only after receiving the authorized signature from the tenant's Fiscal Representative and the DGS STREAM Director of Facility Administration. The form requires identification of relevant accounting information including the organization number, speed chart number, and location chartfield, and includes signature lines for both the tenant and DGS leadership to authorize the charges against the tenant's budget.
The voucher request form does not establish pricing terms, set-asides, or incumbent contractors. Instead, it functions as an internal authorization document within Tennessee's state procurement system, enabling individual agencies to request and pay for facility services on a cost-reimbursement basis. No funding amounts, contract terms, or renewal options are specified in this form, as it is a transactional tool rather than a comprehensive service contract. The form is designed for flexibility, accommodating various types of facility requests while maintaining fiscal control through required signatures and cost estimates before work commences.
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Text version
Date:
Tennessee Department of General Services Facilities Management Inter-Agency Journal Voucher Request
To (DGS Coordinator):
From (Agency):
Complex:
Organization #:
Speed Chart #:
Location Chartfield #:
Building, Address
Example: 3210101000
Example: GS00000062
AKA Cost Center, Legacy #
Scope of Work:
Signature: Tenant Date
Above signature authorizes tenant to be charged with all costs associated with estimating this request.
For Tenant Requests Projects: This form will be returned to the tenant for signature after estimated project costs have been determined.
Estimated cost for Labor and Material to complete the above described scope of work: $
If this cost meets with your approval, please digitally sign and return as soon as possible. Project will proceed upon receipt of authorized signature.
Tenant’s Authorized Fiscal Rep Signature
STREAM Director of Facility Admin. Signature Date
DGS Internal Agency Journal Voucher Request Form (02-2017)
RDA SW-25
GS-1128
| undefined: |
| To DGS Coordinator 1: |
| To DGS Coordinator 2: |
| Building Address: |
| Example 3210101000: |
| Example GS00000062: |
| AKA Cost Center Legacy: |
| Date: |
| Date_2: |
| Text12: |
| Text14: |
File details come from the government source that posted it. Updated .