CTPHC Outside Vendor Tool Inventory Form (7).pdf

PDF 223 KB Posted

Attached to
Temporary Dental Services at Clifton T. Perkins Hospital Center
Solicitation number
BPM058246
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, designed to track tools and equipment managed by outside vendors providing services at the facility. The form documents the check-in and check-out of various hand tools, power tools, and consumable items including hammers, screwdrivers, pliers, wrenches, tape measures, levels, utility knives, power drills, caulk guns, flashlights, pipe cutters, soldering torches, wire strippers, voltage testers, conduit benders, nails, and screws. The inventory control process requires contractor sign-off and verification by a security inspector at both check-in and check-out, with designated fields to record inventory dates, quantities on hand, quantities used, damaged or discarded items, quantities lost, and changes for consumables. This form supports the temporary dental services contract opportunity at CTPHC, which seeks contractors to provide dental services coverage during periods when the permanent dentist or dental assistant is unavailable.

The form serves as an accountability mechanism to monitor tool inventory and prevent loss or misuse by outside vendors. Each line item includes columns for documenting the condition and disposition of equipment, with notation that certain damaged items require a Motor Vehicle Report (MVR). The inventory control process involves coordination between the contractor and facility security inspectors to ensure accurate record-keeping and proper management of hospital property used by temporary service providers.

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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 .