EXHIBIT 5 - SAFETY SHOE AUTHORIZATION FORM - FACILITIES MGMT.pdf
PDF 119 KB Posted
- Attached to
- Safety and Uniform Boots
- Solicitation number
- 70FA5020A00000004
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment C - PRICING SPREADSHEET 2.xlsx | XLSX spreadsheet | |
| EXHIBIT 2 - SAFETY SHOE AUTHORIZATION FORM - SECURITY BRANCH.pdf | ||
| EXHIBIT 4 - SAFETY SHOE AUTHORIZATION FORM - FIRE DEPT.pdf | ||
| EXHIBIT 1 - SAMPLE PURCHASE ORDER.pdf | ||
| EXHIBIT 3 - SAFETY SHOE AUTHORIZATION FORM - POLICE DEPT.pdf | ||
| Attachment C - PRICING SPREADSHEET.xlsx | XLSX spreadsheet | |
| Attachment B - Clauses.docx | DOCX document | |
| Attachment A - Statement of Work.pdf |
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Text version
SAFETY FOOTWEAR AUTHORIZATION FORM
DEPARTMENT OF HOMELAND SECURITY/
FEDERAL EMERGENCY MANAGEMENT AGENCY
19844 BLUE RIDGE MOUNTAIN ROAD
MOUNT WEATHER, VA 20135
DATE:
EMPLOYEE NAME:
The above named employee is entitled to (please circle – one or two) pair of safety footwear. DHS/FEMA will cover the not-to-exceed amount of $200.00 per pair.
Any amount over $200.00 will be the responsibility of the employee named above.
If there are any questions, please call Chris Hall (540) 542-2406, Scheduling Branch, Facilities Management Division.
SUPERVISOR APPROVAL: ___________________________________
AUTHORIZED BY (DIVISION POC): ___________________________
EMPLOYEE SIGNATURE: ____________________________________
STORE AND LOCATION: ___________________________________
SHOE REQUIREMENTS: ASTM F2413-05, MI/75 C/75 EH
SHOE RESTRICTIONS: ______________________________________
NOTE: This authorization is only valid 21 days from the date issued by the authorized division POC. This authorization will be considered null and void if presented after the 21-day period.
Rev. 8/14/2020:sb
EXHIBIT 5
File details come from the government source that posted it. Updated .