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 Facilities Management division for processing internal cost allocations related to facility projects. The form serves as an authorization document enabling the Department of General Services to charge tenant agencies for estimated labor and material costs associated with specific facility work scopes. The document requires completion of project details including building location, cost center information, scope of work description, and estimated project costs. Authorization signatures from both the requesting tenant agency's fiscal representative and the Department of General Services' Stream Director of Facility Administration are required before project work proceeds. The form includes fields for routing to multiple DGS coordinators and captures key administrative data such as organization numbers, speed charts, and chartfield locations to ensure proper cost allocation within the state's accounting system.

This voucher request form represents the internal financial processing mechanism used by Tennessee state agencies to facilitate inter-departmental billing and cost recovery for facility management services. The form template, dated February 2017 and identified as form RDA SW-25 GS-1128, establishes a standardized procedure for agencies requesting facility improvements or maintenance work to receive cost estimates and authorize expenditures prior to project commencement. The document functions within the broader context of state facility management operations and supports the administrative infrastructure necessary for the Department of General Services to manage statewide facility protection services, maintenance, and improvement initiatives across multiple state-owned and state-leased properties throughout Tennessee.

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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 .