Report 1852 PH B110 Replace wet Chem Exting PM 5-17-21.pdf
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- Solicitation number
- FA255024R0003
About this file
This document contains a federal contract opportunity notice and related maintenance report. The contract opportunity notice is for base operations support services at Prospect Harbor Space Force Station in Maine. Key details include that the solicitation is expected to be released in January 2024 for a competitively awarded small business set-aside contract. The contractor will be responsible for operating and maintaining the government-owned facility, including physical security, civil engineering, communications, logistics, and environmental compliance. The maintenance report provides details on replacing a kitchen fire extinguisher at Prospect Harbor Naval Station, including labor hours, materials used, and signatures approving the work.
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Text version
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
YES NO
YES NO
YES NO
MATERIALS USED
MAINTENACE & INSPECTION REPORT
(ONE FOR EACH PIECE OF EQUIPMENT)
WILL MATERIALS NEED TO BE ORDERED? HOW LONG IS THE LEED TIME?
EXPLAIN BELOW
HAVE NOT BEEN MET
(BELOW) FOR ADMINISTRATION USE ONLY
DATE IT WILL BE RECEIVED :
PROPER PPE BEING WORN
YES
CONTRACTOR: TECHNICIANS NAME:
LOCATION WEATHERBUILDING NAME or #
CONTRACTOR/SIGNATURE CCI/ SIGNATURE SITE INSPECTOR/SIGNATURE
CONTRACT # ELIN # REPORT NO.
HAVE BEEN MET
DATE:
General Direct Condition Rating
TYPE OF EQUIPMENT MAKE MODEL
WORK DESCRIPTION & PROBLEMS FOUNDS
TIME TO COMPLETE TASK
IS INSPECTION CHECK LIST ATTACHED?
SAFETY REQUIREMENTS
WAS WORK COMPLETED?
IF NO EXPLAIN BELOW
General Direct Condition Rating Notes ( Explain Conditions found for the Rating given above)
N40085-17-D-7201
NO
HOUSE KEEPING COMPLETE
YES
NO
MAXIMO # Work Order # xxx
(Print) Name of Authorized Buyer
TERMS OF THIS AGREEMENT ARE:
The price for work to be performed under this agreement shall be based on prevailing Dean & Allyn prices for material, labor and related items, in effect at the time supplied under this agreement.
Description of work or material:
Dean & Allyn, Inc. for and in consideration of the prices herein named, proposed to furnish the work and/or materials hereinafter described, subject to the conditions outlined below, and on the reverse side of this order.
Cust. P.O. No.
LOCATION OF WORK TO BE PERFORMED (PLEASE PRINT)
116 Lewiston Road
Gray, Maine 04039
207/657-5646 fax 207/657-5647
Job Name__________________________________________
Street_____________________________________________
City___________________State ________ Zip ___________
BILLING ADDRESS Telephone No. ____________________
SERVICE
WORK ORDER
Customer__________________________________________
Street_____________________________________________
City___________________State ________ Zip ___________
(HEREINAFTER CALLED “BUYER”)
Service Representative Terms
NET TEN (10) DAYS
Customer has inspection contract: with � Yes
� No
Dean & Allyn
Other
A.
B.
C.
The terms of payment for invoices rendered against this order shall be net 10 days from date of invoice. Invoices may be rendered on a “Progress” basis, and the Buyer agrees to pay such progress billing in full, in accordance with the terms of payment.
Travel time will be included in the hours on all time and material orders.
See reverse side of this order for other General Terms and Conditions.
� Time and Material � Lump Sum $______________________________
Any changes to scope and price of the work will be described in a “Field Change Order” and must be acknowledged by the Buyer.
TERMS OF THIS AGREEMENT ARE:
ADDITIONAL TERMS:
BUYER’S ACCEPTANCE:
Title
Signature
Date
No.
DATE _____________________________
DEAN & ALLYN, INC.
FIRE PROTECTION • SPECIAL HAZARD
OFFICE
| DATE: 5/17/2021 |
| TYPE OF EQUIPMENTRow1: Fire extinguisher |
| MAKERow1: Amerex |
| MODELRow1: K class |
| TIME TO COMPLETE TASKRow1: 1 |
| CONTRACTOR: Dean & Allyn, Inc. |
| TECHNICIANS NAME: Barry Prescott |
| LOCATIONRow1: Prospect Harbor |
| BUILDING NAME or Row1: #110 |
| WEATHERRow1: Warm/clear |
| General Direct Condition RatingRow1: Green + |
| General Direct Condition Rating Notes Explain Conditions found for the Rating given aboveRow1: |
| WILL MATERIALS NEED TO BE ORDERED HOW LONG IS THE LEED TIME EXPLAIN BELOW: |
| MATERIALS USEDRow1: 1 - 6 liter K class wet chem fire extinguisher |
| DATE IT WILL BE RECEIVED: |
| CCI SIGNATURERow1: |
| ELIN N4008517D7201: |
| REPORT NON4008517D7201: |
| REPORT NOWork Order: |
| MAXIMO Row1: |
| Work Order Row1: |
| REPORT NORow3: |
| Text2: |
| Check Box4: Off |
| Check Box8: Off |
| Check Box11: Yes |
| Check Box12: Off |
| Check Box13: Yes |
| Check Box14: Off |
| 0: 21593 |
| Text1: Replaced kitchen K class fire extinguisher that was due for service |
| elephone o: |
| ob ame: Prospect Harbor Naval station |
| ustomer: CCI |
| treet: |
| treet_2: |
| ity: Prospect Harbor |
| tate: Maine |
| Zip: |
| ity_2: |
| tate_2: |
| Zip_2: |
| ust o: |
| ervice epresentative: Barry Prescott |
| escription of work or materialRow1: Swapped out a 6 liter K class kitchen extinguisher needing service with a new 6 liter extinguisher. |
Labor and travel - 2 hours
Material 1 - 6 liter K class extinguisher from Fire safe
| Check Box3: Yes |
| Check Box5: Off |
| Check Box6: Yes |
| Check Box7: Off |
| undefined: |
| Check Box9: Yes |
| undefined_2: 643.95 |
| Check Box10: Off |
| uthorized uyer: Derek McCaslin |
| itle: |
| ate: |
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