CTPHC Outside Vendor Tool Inventory Form (7).pdf

PDF 223 KB Posted

Attached to
Service Repairs for Washing Machines and Dryers
Solicitation number
BPM054876
Issued by
Maryland

About this file

This is a Tools and Equipment Inventory Control Form for outside vendors at Clifton T. Perkins Hospital Center (CTPHC) in Maryland. The form is designed to track the checkout and return of tools and equipment used by contractors performing service work at the facility. The inventory includes a comprehensive list of hand tools, power tools, and consumable items such as hammers, screwdrivers, pliers, wrenches, tape measures, levels, utility knives, chisels, hand saws, power drills, stud finders, caulk guns, flashlights, pipe cutters, soldering torches, wire strippers, voltage testers, conduit benders, nails, and screws. The form requires documentation of check-in and check-out times, inventory dates, contractor names, security inspector signatures, and quantities for each item including those on hand, used, damaged or discarded, lost, and consumables requiring Material Verification Record (MVR) notation.

The form serves as an accountability and control mechanism to ensure proper management of hospital equipment and to track any losses, damage, or consumption of tools during contractor work. By requiring both contractor and security inspector signatures for both check-in and check-out procedures, the form establishes clear documentation of tool custody and condition. This inventory control process is particularly relevant to the hospital's service maintenance contract for washing machines and dryers on twelve patient wards, where contractors would need access to appropriate tools and equipment to complete their work while maintaining accountability for all hospital assets.

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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 .