Exhibit 3 - GSA Elevator Inspection Report.xlsx
XLSX spreadsheet 67 KB Posted
- Attached to
- New England Elevator Inspections
- Solicitation number
- 47PB0123Q0007
About this file
This document contains three elevator inspection reports for buildings owned by the General Services Administration. The reports document the results of semiannual, annual, five-year, and full load tests. They note the condition of ropes, deficiencies found, and corrective actions required of elevator contractors by specified dates. Contractors must sign upon completing repairs and return copies to the GSA building manager.
The related federal contract opportunity is a solicitation for new elevator inspections throughout New England issued by the GSA Public Buildings Service Region 1. The solicitation seeks inspection services but provides no further details on response date, award date, pricing terms, or set-asides.
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Text version
Elev#1
ELEVATOR INSPECTION REPORT BUILDING NAME BUILDING NUMBER
ADDRESS CITY STATE
| INSPECTIONS COMPLETED | ||||||||
| SEMIANNUAL | ANNUAL & NO-LOAD TESTS | 5-YEAR | FIREFIGHTER'S SERVICE | |||||
| FULL LOAD TESTS | ||||||||
| ELEVATOR NO. | MANUFACTURER | MFG. NO. | MAINTENANCE CONTRACTOR | GSA CONTRACTOR NUMBER |
| TYPE (Pass / Freight. .) | INSTALL YEAR | MOD. YEAR | LAST 5 YR | # FLRS/OPNGS | CAP. LBS. | SPEED | DOOR | YES | ||||||
| RESTRICTION | NO | |||||||||||||
| TOP RUNBY (hydro) | BTM CAR RUNBY | CTRWT RUNBY | CAR BUFFER STROKE | CTRWT BFR STROKE | NO LOAD PRESSURE | RELIEF PRESSURE |
| TYPE OF MACHINE (Geared/Traction/ etc.) | TYPE OF CONTROL | TYPE OF OPERATION (SELL. COLL., ETC.) | FLOOD MONITORING / CONTROL | |||
| YES | NO | N/A | ||||
| I HAVE INSPECTED THE ELEVATOR DESCRIBED ABOVE & ITS CONDITION IS AS STATED BELOW & ON AN OVERFLOW SHEET WHERE APPLICABLE. |
INSPECTOR'S NAME Q.E.I. NUMBER DATE OF INSPECTION
| I. CONDITION OF ROPES | ||||||||
| ROPE | ROPING | NUMBER | SIZE | USED LIFE (in months) | EST. ADD. LIFE (in months) | NO. BROKEN WIRES (per lay) | TYPE | |
| ie: 1:1, etc | IRON | STEEL | ||||||
| HOISTING |
GOVERNOR
COMPENSATING
| II. DEFICIENCIES |
| A. THE GSA BUILDING COR WILL ENSURE THAT THE FOLLOWING DEFICIENCIES ARE |
| CORRECTED BY THE ELEVATOR CONTRACTOR BY THE DATE INDICATED |
NOTE: The Semi-Annual/Annual/5year test was performed satisfactorily. CORRECT BY:
B. SERVICE CENTER MANAGEMENT (7PS) WILL ENSURE THE FOLLOWING DEFICIENCIES ARE CORRECTED
| CERTIFICATION: THIS FORM IS PRESCRIBED BY GSA R01 AUTHORITY - ELEVATOR MAINTENANCE, REPAIR AND INSPECTION. WHEN THE WORK DESCRIBED IN II.A ABOVE HAS BEEN COMPLETED, THE BUILDING MANAGER SHALL RETURN A SIGNED & DATED COPY OF THIS FORM TO XXXX. | |||
| ELEVATOR CONTRACTORS SIGNATURE | DATE | BUILDINGS MANAGER SIGNATURE | DATE |
GENERAL SERVICES ADMINISTRATION Revised 3/2012
Elev#2
ELEVATOR INSPECTION REPORT BUILDING NAME BUILDING NUMBER
ADDRESS CITY STATE
| INSPECTIONS COMPLETED | ||||||||
| SEMIANNUAL | ANNUAL & NO-LOAD TESTS | 5-YEAR | FIREFIGHTER'S SERVICE | |||||
| FULL LOAD TESTS | ||||||||
| ELEVATOR NO. | MANUFACTURER | MFG. NO. | MAINTENANCE CONTRACTOR | GSA CONTRACTOR NUMBER |
| TYPE (Pass / Freight. .) | INSTALL YEAR | MOD. YEAR | LAST 5 YR | # FLRS/OPNGS | CAP. LBS. | SPEED | DOOR | YES | ||||||
| RESTRICTION | NO | |||||||||||||
| TOP RUNBY (hydro) | BTM CAR RUNBY | CTRWT RUNBY | CAR BUFFER STROKE | CTRWT BFR STROKE | NO LOAD PRESSURE | RELIEF PRESSURE |
| TYPE OF MACHINE (Geared/Traction/ etc.) | TYPE OF CONTROL | TYPE OF OPERATION (SELL. COLL.,ETC.) | FLOOD MONITORING / CONTROL | |||
| YES | NO | N/A | ||||
| I HAVE INSPECTED THE ELEVATOR DESCRIBED ABOVE & ITS CONDITION IS AS STATED BELOW & ON AN OVERFLOW SHEET WHERE APPLICABLE |
INSPECTOR'S NAME Q.E.I. NUMBER DATE OF INSPECTION
| I. CONDITION OF ROPES | ||||||||
| ROPE | ROPING | NUMBER | SIZE | USED LIFE (in months) | EST. ADD. LIFE (in months) | NO. BROKEN WIRES (per lay) | TYPE | |
| ie: 1:1, etc | IRON | STEEL | ||||||
| HOISTING |
GOVERNOR
COMPENSATING
| II. DEFICIENCIES |
| A. THE GSA BUILDING COR WILL ENSURE THAT THE FOLLOWING DEFICIENCIES ARE |
| CORRECTED BY THE ELEVATOR CONTRACTOR BY THE DATE INDICATED |
NOTE: The Semi-Annual/Annual/5year test was performed satisfactorily. CORRECT BY:
B. SERVICE CENTER MANAGEMENT (XXX) WILL ENSURE THE FOLLOWING DEFICIENCIES ARE CORRECTED
| CERTIFICATION: THIS FORM IS PRESCRIBED BY GSA R01 AUTHORITY - ELEVATOR MAINTENANCE, REPAIR AND INSPECTION. WHEN THE WORK DESCRIBED IN II.A ABOVE HAS BEEN COMPLETED, THE BUILDING MANAGER SHALL RETURN A SIGNED & DATED COPY OF THIS FORM TO XXXX. | |||
| ELEVATOR CONTRACTORS SIGNATURE | DATE | BUILDINGS MANAGER SIGNATURE | DATE |
GENERAL SERVICES ADMINISTRATION Revised 3/2012
Elev#3
ELEVATOR INSPECTION REPORT BUILDING NAME BUILDING NUMBER
ADDRESS CITY STATE
| INSPECTIONS COMPLETED | ||||||||
| SEMIANNUAL | ANNUAL & NO-LOAD TESTS | 5-YEAR | FIREFIGHTER'S SERVICE | |||||
| FULL LOAD TESTS | ||||||||
| ELEVATOR NO. | MANUFACTURER | MFG. NO. | MAINTENANCE CONTRACTOR | GSA CONTRACTOR NUMBER |
| TYPE (Pass / Freight. .) | INSTALL YEAR | MOD. YEAR | LAST 5 YR | # FLRS/OPNGS | CAP. LBS. | SPEED | DOOR | YES | ||||||
| RESTRICTION | NO | |||||||||||||
| TOP RUNBY (hydro) | BTM CAR RUNBY | CTRWT RUNBY | CAR BUFFER STROKE | CTRWT BFR STROKE | NO LOAD PRESSURE | RELIEF PRESSURE |
| TYPE OF MACHINE (Geared/Traction/ etc.) | TYPE OF CONTROL | TYPE OF OPERATION (SELL. COLL., ETC.) | FLOOD MONITORING / CONTROL | |||
| YES | NO | N/A | ||||
| I HAVE INSPECTED THE ELEVATOR DESCRIBED ABOVE & ITS CONDITION IS AS STATED BELOW & ON AN OVERFLOW SHEET WHERE APPLICABLE |
INSPECTOR'S NAME Q.E.I. NUMBER DATE OF INSPECTION
| I. CONDITION OF ROPES | ||||||||
| ROPE | ROPING | NUMBER | SIZE | USED LIFE (in months) | EST. ADD. LIFE (in months) | NO. BROKEN WIRES (per lay) | TYPE | |
| ie: 1:1, etc | IRON | STEEL | ||||||
| HOISTING |
GOVERNOR
COMPENSATING
| II. DEFICIENCIES |
| A. THE GSA BUILDING COR WILL ENSURE THAT THE FOLLOWING DEFICIENCIES ARE |
| CORRECTED BY THE ELEVATOR CONTRACTOR BY THE DATE INDICATED |
NOTE: The SemI-Annual / Annual / 5 year test was performed satisfactorily. CORRECT BY:
B. SERVICE CENTER MANAGEMENT (XXX) WILL ENSURE THE FOLLOWING DEFICIENCIES ARE CORRECTED
| CERTIFICATION: THIS FORM IS PRESCRIBED BY GSA R01 AUTHORITY - ELEVATOR MAINTENANCE, REPAIR AND INSPECTION. WHEN THE WORK DESCRIBED IN II.A ABOVE HAS BEEN COMPLETED, THE BUILDING MANAGER SHALL RETURN A SIGNED & DATED COPY OF THIS FORM TO XXX. | |||
| ELEVATOR CONTRACTORS SIGNATURE | DATE | BUILDINGS MANAGER SIGNATURE | DATE |
GENERAL SERVICES ADMINISTRATION Revised 3/2012
Overflow Sheet
| ELEVATOR INSPECTION REPORT | |||
| OVERFLOW SHEET | BUILDING NAME | BUILDING NUMBER |
| ADDRESS | CITY | STATE | |
| Elevator #: | |||
| II. DEFICIENCIES (Cont.) | |||
| A. THE GSA BUILDING MANAGER WILL ENSURE THAT THE FOLLOWING DEFICIENCIES ARE CORRECTED | |||
| BY THE ELEVATOR CONTRACTOR PRIOR TO THE "CORRECT BY" DATE |
B. MAINTENANCE MANAGEMENT WILL ENSURE THAT THE FOLLOWING DEFICIENCIES ARE CORRECTED
GENERAL SERVICES ADMINISTRATION Revised 3/2012
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