CTPHC Outside Vendor Tool Inventory Form (4).pdf

PDF 223 KB Posted

Attached to
Fitness Equipment for Hospital Patients
Solicitation number
BPM053882
Issued by
Maryland

About this file

This is a Tools and Equipment Inventory Control Form for the Clifton T. Perkins Hospital Center (CTPHC) in Maryland, used to track tools and equipment provided to outside vendors working on hospital projects. The form documents the check-in and check-out of tools and equipment by recording inventory counts, quantities used, items damaged or discarded, quantities lost, and changes for consumables. The inventory tracking includes common tools such as hammers, screwdrivers, pliers, wrenches, tape measures, levels, utility knives, power drills, flashlights, wire strippers, voltage testers, and consumable items such as nails and screws. The form requires completion by both the contractor and the security inspector, with signatures and timestamps documenting the time tools are issued and returned.

The form serves as an accountability mechanism to ensure proper management and return of hospital property loaned to outside vendors. Each line item includes columns for check-in quantity, check-out quantity, quantity used, items damaged or properly discarded, quantity lost, and changes for consumables, with a note that certain discrepancies require a Maintenance Variance Report (MVR). This inventory control process protects hospital assets while maintaining clear documentation of tool usage and condition throughout contractor work periods at the facility.

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Text version

TOOLS AND EQUIPMENT INVENTORY CONTROL FORM

OUTSIDE VENDOR COMPANY:

Time In: Time Out:

Hammer Phillips Head Screw Drivers Flat Head Screw Drivers Slip Joint Pliers Needle-nose Pliers Adjustable Wrenches Open Ended Wrenches Pipe Wrenches Tape Measures Levels Utility Knives Chisels Hand Saws Power Drill / Drivers Stud Finder Caulk Gun Caulk Flashlight Pipe Cutters Soldering Torches Wire strippers Voltage testers Conduit Benders Nails Screws

Inventory Date:

Contractor Name: Check In Sec. Insp. Name:

Contractor Signature: Check Out Sec. Insp. Name:

🗹 if Present Item Description

Check in Quantity on Hand

Check Out QuantityQuantity

Used

Damaged / Properly

Discarded

Quantity Lost

Changes for Consumables Quantity

*Requires

MVR

🗹 if Present Item Description

Check in Quantity on Hand

Check Out QuantityQuantity

Used

Damaged / Properly

Discarded

Quantity Lost

Changes for Consumables Quantity

*Requires

MVR

File details come from the government source that posted it. Updated .