Reports - check list Sample 3.xls

XLS spreadsheet 214 KB Posted Dec 11, 2008

Attached to: FA5004-09-R-C001 Federal contract opportunity
Solicitation number: FA5004-09-R-C001
Issued by: Department of the Air Force Pacific Air Forces

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PWS ATTCH 3

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Other files for this federal contract opportunity

Other files attached to FA5004-09-R-C001, newest first.
File	Type	Posted
P0008 Amendment 7.pdf	PDF	Jun 2, 2009
JA-7 - ARRA Addenda 1.pdf	PDF	May 5, 2009
P00007 Amendment 6.pdf	PDF	May 5, 2009
P00006 Amendment 5.doc	DOC document	Apr 3, 2009
Notice of Posting Error.doc	DOC document	Apr 1, 2009
Notice of Question Submittal Due Date.2.doc	DOC document	Apr 1, 2009
Specifications	—	Mar 31, 2009
Questions and Responses 004.doc	DOC document	Mar 31, 2009
Questions and Responses 005.doc	DOC document	Mar 31, 2009
Amendment Document.doc	DOC document	Mar 31, 2009
Base Year.xls	XLS spreadsheet	Mar 31, 2009
Option Year 1.xls	XLS spreadsheet	Mar 31, 2009
Notice of Question Submittal Due Date.1.doc	DOC document	Mar 31, 2009
Option Year 2.xls	XLS spreadsheet	Mar 31, 2009
Amendment 3.pdf	PDF	Mar 23, 2009
Questions and Responses 003.doc	DOC document	Mar 12, 2009
Notice of Question Submittal Due Date.doc	DOC document	Mar 11, 2009
Specifications	—	Mar 10, 2009
Questions and Responses 002.doc	DOC document	Mar 10, 2009
Modification Document P0003.doc	DOC document	Mar 10, 2009
Site Visit Attendance Sheet.pdf	PDF	Mar 10, 2009
Amended Solicitation FA5004-09-R-C001-0001.doc	DOC document	Mar 4, 2009
Attachment JA-2 Wage Determination 4 Mar 2009.doc	DOC document	Mar 4, 2009
Option Year 1.xls	XLS spreadsheet	Feb 18, 2009
Base Year.xls	XLS spreadsheet	Feb 18, 2009
Copy of AFForm66.xlsx	XLSX spreadsheet	Feb 18, 2009
Attachment JA-2 Wage Determination.doc	DOC document	Feb 18, 2009
Specifications	—	Feb 18, 2009
Option Year 2.xls	XLS spreadsheet	Feb 18, 2009
JA-4 Financial Reference Sheet.doc	DOC document	Feb 18, 2009
Solicitation 17 Feb 2009.doc	DOC document	Feb 18, 2009
JA-3 Past Performance Questionaire.doc	DOC document	Feb 18, 2009
JA5 Haz Mat Sheet.doc	DOC document	Feb 18, 2009
MFH DBA.doc	DOC document	Dec 11, 2008
FA5004-09-R-C014.pdf	PDF	Dec 11, 2008
Hazardous Material Identification data.docx	DOCX document	Dec 11, 2008
Financial Reference Sheet.docx	DOCX document	Dec 11, 2008
PWS revised 28 Mar 09.docx	DOCX document	Dec 11, 2008
Past Performance Questionnaire.docx	DOCX document	Dec 11, 2008
Water Distribution Map 1.pdf	PDF	Dec 11, 2008
Wage Determination 05-2017 REV 10 17 Mar 2009.doc	DOC document	Dec 11, 2008
Sanitary Sewer Map 2.pdf	PDF	Dec 11, 2008

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Monthly Invoice Summary

INVOICE SUMMARY INFORMATION
Invoice Date
Contract #
CLIN NUMBER	MFH TYPE (Leased-Owned-Unaccompanied)	DESCRIPTION OF CLIN	TOTAL COST PER CLIN NUMBER
5000	Leased/Owned/UnACCOMPANIED	BASIC BID
5001	Leased/Owned/UnACCOMPANIED	REIMBURSABLE
5002	Leased/Owned/UnACCOMPANIED	CARPET
5003	Leased/Owned/UnACCOMPANIED	ETC…
5004		ETC…
5005		ETC…
5006		ETC…
5007		ETC…
5008		ETC…
5009		ETC…
5010
5011
TOTAL AMOUNT FOR THE MONTH OF ____________________________			$0.00

Monthly Line Item Billing

MONTHLY LINE ITEM BILLING
Invoice Date
CONTRACT #
CLIN NUMBER	DATE OF SERVICE	MFH TYPE	JOB ORDER #	MFH FACILITY #	ADDRESS	BRIEF DESCRIPTION OF WORK PERFORMED	QUANITY	MATERIAL/LABOR	TOTAL BILLED	CLIN TOTAL
1	1/2/09	OWNED	XXXX	5101A	743A NORTH STREET	Replaced actuator	1	0.01	0.01
1	1/5/09	owned	XXXX	5207A	672A KODIAK STREET	replaced ceiling fan	1	0.02	0.02
1						recore unit with 2 new keys	1	0.01	0.01
1						replaced kitchen faucet and supply lines	1	0	0
						repair broken pipe in master bedroom	1		0
total for CLIN 1										0.04
2		Leased	xxxxxx			COM	1	1	1
2		Leased				Replaced garbage disposal	1	0.5	0.5
2		Leased				Fixed Dishwasher	1	0.07	0.07
2									0
2									0
total for CLIN 2										1.57
3		Owned	xxxx			carpet	220	3.86	849.2
3		Owned	xxxx			carpet	110	3.86	424.6
3									0
3									0
3									0
total for CLIN 3										1273.8

Monthly Detail Service Call Rep

DETAIL SERVICE CALL LOG

INVOICE DATE

CONTRACT #

Date Request Received

Time Called/Notified

Category (Emergency, Urgent, Routine)

Response Date

Response Time

Work Order #

Facility #

Address

Unit Type

Type of Service

Detail Description of Work Performed/Service

Complete Date

Complete Time

Part Number

Part Description

Quanity of Part

Each Price of Part

Extended Cost

Less Reimbursable Amount

Total Billed Amount

Parts on Order estimated time for new repair

Number of skilled labor hours

Skilled labor cost

Number of unskilled labor hours

Unskilled labor cost

Number of Labor Hours

Date Materials Ordered

Date Materials Received

Heat Inspection

Vacant unit Check

Mechanical Room

Appliance Check

Broken Pipe

Basement Flood

Install Mini Blind

SAMPLE

Monthly Major Repair Report

MONTHLY MAJOR REPAIR REPORT
Type of Unit	Facility #	Address	Location	Carpet	Interior Paint	Exterior Paint	Vinyl	VCT Tile	Ceramic Tile	Asbestos Abatement	Lead Paint Abatement
				(SF)	(SF)	(SF)	(SF)	(SF)	(SF)	(SF)	(SF)

MFH Unit Cost

Facility #

Address

October

November

December

January

February

March

April

COM

Minor Alteration

Job orders

Major Repair

Self Help

Lead Abateent

Asbestos Abateent

COM

Minor Alteration

Job orders

Major Repair

Self Help

Lead Abateent

Asbestos Abateent

COM

Minor Alteration

Job orders

Major Repair

Self Help

Lead Abateent

Asbestos Abateent

COM

Minor Alteration

Job orders

Major Repair

Self Help

Lead Abateent

Asbestos Abateent

COM

Minor Alteration

Job orders

Major Repair

Self Help

Lead Abateent

Asbestos Abateent

COM

Minor Alteration

Job orders

Major Repair

Self Help

Lead Abateent

Asbestos Abateent

COM

Minor Alteration

Job orders

Major Repair

Self Help

Lead Abateent

GOQ REPORT

GOQ REPORT
Invoice Date
CONTRACT #
DATE OF SERVICE	JOB ORDER #	COMPLETION DATE	BRIEF DESCRIPTION OF WORK PERFORMED	TOTAL MATERIALS COST	LABOR COST	NUMBER OF LABOR HOURS	TOTAL BILLED

COM Cost

MONTHLY DETAIL COM

ITIMIZED COST PER MFH FACILITY

Invoice Date

Contract #

Date of COM

MFH FACILITY #

Address

Unit Type

Work Order #

CLIN

Completion Date

DETAIL DESCRIPTION

PART NUMBER

QUANITY OF ITEM

COST OF ITEM

Materials

Labor

Extended Cost

Reimbursable Cost

Non-Reimbursable Cost

ITEMS ON ORDER

Skilled

Unskilled

Hours

Cost

Hours

Cost

Leased FH

Owned FH

GOQ

&C&"-,Bold"&14COM COST REPORT

SAMPLE

Appliances Change Out List

APPLIANCE CHANGE OUT LIST

INOVICE DATE

CONTRACT

Work Order Request Date

Work order #

Date Complete

MFH Type

Facility # (If on base)

Address

Install/Remove

Appliance Type

Manufacturer

Serial #

Model #

Size

Age

Purchase Date

Repairable (Yes/No)

Reason Non-repairable

Disposal Date

Disposal Method

Storage Location

REMOVED

WASHER

Maytag

Green tag

INSTALLED

Kenmore

REMOVED

Red Tag

INSTALLED

&C&"-,Bold"&14SAMPLE APPLIANCE WORK ORDER LOG

SAMPLE

Appliance Master List

MASTER APPLIANCE LIST

Date of Report

CONTRACT #

Date of Report

Facility # (If on base)

Location/ Address

Date Appliance Installed

Appliance Type

Serial Number

Model Number

Manufacturer

Size

Color

Age

Date Purchased

Verified Date

Warranty Date

&C&"-,Bold"&14SAMPLE MASTER APPLIANCE LIST

SAMPLE

Self Help Issue Log

SELF HELP ISSUE REPORT
INVOICE DATE
CONTRACT #
Issue Date	Work Order #	MFH Type	MFH FACILITY #	Address	Occuapnt	Part #	Item Description	QUANITY	Cost of Iten	TOTAL COST

&C&"-,Bold"&14SELF-HELP ISSUE LOG

SAMPLE

Self Help Inventory on Hand

SELF HELP INVENTORY ON HAND
INVOICE DATE
CONTRACT #
DATE OF REPORT	Part #	Item Description	Quantity on Hand	Cost Per Item	Total Extended Cost of Items on Hand	Quantity on Order	Date Ordered	Estimated Arrival Date	VENDOR	Cost Per Item on Order

&C&"-,Bold"&14SELF-HELP INVENTORY LOG

SAMPLE

Recurring Maintenance Report

REACURRING MAINTENANCE

INVOICE DATE

CONTRACT #

Date Request Received

Time Called/Notified

Category (Emergency, Urgent, Routine)

Response Date

Response Time

Work Order #

Facility #

Address

Unit Type

Type of Service

Detail Description of Work Performed/Service

Complete Date

Complete Time

Part Number

Part Description

Quantity of Part

Each Price of Part

Extended Cost

Less Reimbursable Amount

Total Billed Amount

Parts on Order estimated time for new repair

Number of skilled labor hours

Skilled labor cost

Number of unskilled labor hours

Unskilled labor cost

Number of Labor Hours

Date Materials Ordered

Date Materials Received

SAMPLE

Hazardous Material Report

HAZARD MATERIAL REPORT
INVOICE DATE
CONTRACT #
Date	Work Order #	MFH Type	MFH FACILITY #	Address	Item Description	QUANITY	DISPOSED LOCATION

&C&"-,Bold"&14SELF-HELP ISSUE LOG

SAMPLE

Monthly Heat Service Call Repor

DETAIL HEAT CALL LOG

INVOICE DATE

CONTRACT #

Date Request Received

Time Called/Notified

Category (Emergency, Urgent, Routine)

Response Date

Response Time

Work Order #

Facility #

Address

Unit Type

Type of Service

Detail Description of Work Performed/Service

Complete Date

Complete Time

Part Number

Part Description

Quanity of Part

Each Price of Part

Extended Cost

Less Reimbursable Amount

Total Billed Amount

Parts on Order estimated time for new repair

Number of skilled labor hours

Skilled labor cost

Number of unskilled labor hours

Unskilled labor cost

Number of Labor Hours

Date Materials Ordered

Date Materials Received

SAMPLE

Canceled SC log

CANCELLED/NO SHOW APPOINTMENTS
	INVOICE DATE
	CONTRACT #
Date Request Received	Work order #	MFH Facility #	Address	Unit Type	Category	Description	Date Canceled	Date NO Show	Canceled by Contractor	Canceled by Occupant

&C&"-,Bold"&14SAMPLE CANCELED SERVICE CALL LOG

SAMPLE

Service Call Summary Log

MONTHLY SERVICE CALL SUMMARY

Month / Year

Emergencies

Urgent

Routine

Gov Owned

801 Lease

Gov Owned

801 Lease

Gov Owned

801 Lease

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

Number of Work Orders

Cost for Work Orders

&C&"-,Bold"&14SAMPLE SERVICE CALL SUMMARY LOG

SAMPLE

Heat ExchangerHydronic Heating

HEAT EXCHANGER/HYDRONIC HEATING SYSTEM
SEMI-ANNUAL	PERFORM SEM-ANNUAL ITEMS
ANNUAL	PERFORM QUARTERLY, SEMI-ANNUAL AND ANNUAL
SEMI-ANNUAL	INSPECT PIPING FOR LEAKS AND MAKE NEEDED REPAIRS
SEMI-ANNUAL	CHECK FOR PROPER TEMPERATURE
SEMI-ANNUAL	CHECK pH OF HYDRONIC HEAT SYSTEM
ANNUAL	CLEAN STRAINERS
SEMI-ANNUAL	CHECK CIRCULATING PUMPS FOR PROPER OPERATION
SEMI-ANNUAL	LUBRICATE CIRCULATING PUMPS
SEMI-ANNUAL	CHECK MECH ROOM FOR FIRE AND ELECTRICAL HAZARDS
SEMI-ANNUAL	CLEAN MECH ROOM AND AREA
	2009		2010		2011		2012
SEMI-ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS
ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS

HRV Checklist

HRV units
QUARTERLY	PERFORM QUARTERLY ITEMS							CHECK
SEMI-ANNUAL	PERFORM QUARTERLY AND SEM-ANNUAL ITEMS							WHEN
ANNUAL	PERFORM QUARTERLY, SEMI-ANNUAL AND ANNUAL							COMPLETE
QUARTERLY	CHECK UNIT FOR OPERATION PRIOR TO MAINTENANCE
SEMI-ANNUAL	INSPECT FAN FOR BENT OR BROKEN BLADES
QUARTERLY	CHECK BELTS FOR WEAR, TENSION AND ALIGNMENT
ANNUAL	REPLACE BELTS, ADJUST TENSION AND ALIGN SHEAVES
QUARTERLY	CHANGE FILTERS, INITIAL AND DATE SIDE OF FILTER
QUARTERLY	INSPECT PIPING AND VALVES FOR LEAKS, MAKE NEEDED REPAIRS
QUARTERLY	INSPECT UNIT FOR EXCESSIVE CORROSION
SEMI-ANNUAL	CHECK BLOWER MOTOR FOR PROPER OPERATION
QUARTERLY	LUBRICATE SHAFT AND MOTOR BEARINGS
QUARTERLY	CHECK COIL, CLEAN IF NEEDED
ANNUAL	CLEAN COIL, DRIP PAN, AND BLOWER
ANNUAL	CLEAN AIR PLENUM
QUARTERLY	CHECK UNIT FOR OPERATION AFTER MAINTENANCE
QUARTERLY	CLEAN UNIT AND SURROUNDING AREA AFTER MAINTENANCE
	2009		2010		2011		2012
QUARTERLY	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS
SEMI-ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS
QUARTERLY	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS
ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS

Mech Rm check list

MECH ROOM EXHAUST FANS
SEMI-ANNUAL	CHECK UNIT FOR OPERATION PRIOR TO MAINTENANCE
SEMI-ANNUAL	INSPECT FAN FOR BENT OR BROKEN BLADES
SEMI-ANNUAL	LUBRICATE SHAFT AND MOTOR BEARINGS
SEMI-ANNUAL	CHECK UNIT FOR OPERATION AFTER MAINTENANCE
SEMI-ANNUAL	CLEAN UNIT AND SURROUNDING AREA AFTER MAINTENANCE
	2009		2010		2011		2012
SEMI-ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS
SEMI-ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS

Stem condensate check list

STEAM-CONDENSATE SYSTEMS
SEMI-ANNUAL	PERFORM SEM-ANNUAL ITEMS
ANNUAL	PERFORM QUARTERLY, SEMI-ANNUAL AND ANNUAL
SEMI-ANNUAL	VISUALLY INSPECT SYSTEM FOR LEAKS, REPAIR AS NEEDED
SEMI-ANNUAL	CHECK STEAM PRESSURE GUAGES, REPLACE IF NEEDED
SEMI-ANNUAL	ADJUST PRV AS NECESSARY TO MAINTAIN CORRECT PRESSURE
SEMI-ANNUAL	OBSERVE CONDENSATE VENT LINE FOR STEAM BLOWS, REPAIR BAD TRAPS
SEMI-ANNUAL	CHECK FLOAT AND ALTERNATING SWITCH ON CONDENSATE STATION
SEMI-ANNUAL	CHECK OPERATION OF CONDENSATE PUMPS AND MOTORS
SEMI-ANNUAL	INSPECT CONDENSATE TANK FOR LEAKS
ANNUAL	CLEAN STRAINERS
ANNUAL	CLEAN DRIP LEGS
	2009		2010		2011		2012
SEMI-ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS
ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS

Stem Elect hot water check list

STEAM / ELECTRIC HOT WATER HEATERS
SEMI-ANNUAL	PERFORM SEM-ANNUAL ITEMS
SEMI-ANNUAL	CHECK FOR PROPER WATER TEMPERATURE, CORRECT AS NEEDED
SEMI-ANNUAL	VISUALLY INSPECT SYSTEM FOR LEAKS, REPAIR AS NEEDED
SEMI-ANNUAL	CHECK PUMPS FOR PROPER OPERATION, REPAIR AS NEEDED
SEMI-ANNUAL	LUBRICATE PUMP AND MOTOR
SEMI-ANNUAL	CLEAN UNIT AND SURROUNDING AREA
	2009		2010		2011		2012
SEMI-ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS
SEMI-ANNUAL	DATE	INTIALS	DATE	INITIALS	DATE	INTIALS	DATE	INITIALS

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