Atch__20_-_BLANK_SAMPLE_DD_Form_1354_Transfer_and_Acceptance_of_DoD_Real_Property.pdf
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TRANSFER AND ACCEPTANCE OF DoD REAL PROPERTY Form Approved OMB No. 0704-0188
PAGE OF PAGES
1. FROM (Organization Name) 2. DATE PREPARED
(YYYYMMDD)
3. PROJECT/JOB
NUMBER
4. SERIAL NUMBER
7. CONTRACT
NUMBER(S)
5. TO (Organization - Installation Code and Name) 6. RPSUID/SITENAME/
INSTCODE/INSTNAME
8. TRANSACTION DETAILS
a. METHOD (X all that apply)
ACQUISITION BY CONSTRUCTION
TRANSFER BETWEEN SERVICES
CAPITAL IMPROVEMENT
INVENTORY ADJUSTMENT
PARTIAL ASSET
PLACED-IN-SERVICE
TOTAL ASSET
PLACED-IN-SERVICE
9.
ITEM
NO.
11.
CATEGORY
CODE
12.
CATCODE
DESCRIPTION
14.
SUST.
CODE
20.
FUND
SOURCE
15.
PRIMARY
UM
18.
SECONDARY UM
QUANTITY
17.
SECONDARY
UM
16.
PRIMARY UM
QUANTITY
19.
COST
23.
ITEM
REMARKS
24. STATEMENT OF COMPLETION. The facilities listed hereon are in accordance with maps, drawings, and specifications and change orders approved by the authorized representative of the using agency except for the deficiencies listed on the reverse side.
25a. ACCEPTED BY (Typed Name and Signature) b. DATE SIGNED
(YYYYMMDD)
a. TRANSFERRED BY (Typed Name and Signature)
c. TITLE (Area Engr./Base Engr./DPW/Construction Agent)
b. DATE SIGNED
(YYYYMMDD)
c. TITLE (DPW/RPAO) 26. PROPERTY
VOUCHER NUMBER
PREVIOUS EDITION IS OBSOLETE.̀̀
b. WHEN/EVENT (X one)
7a. PLACED-IN-
SERVICE DATE
(YYYYMMDD)
c. TYPE (X one)
DRAFT INTERIMFINAL
10a.
FACILITY
NO.
AREA OTHER 21.
FUND
ORG
22.
INTER-
EST
CODE
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
Adobe Designer 9.0
10b.
RPUID
13.
TYPE
CODE
The public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, Alexandria,VA 22350-3100 (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if itdoes not display a currently valid OMB control number.
DD FORM 1354, APR 2013
27. CONSTRUCTION DEFICIENCIES (Attach blank sheet for continuations) 28. PROJECT REMARKS (Attach blank sheet for continuations)
INSTRUCTIONS
GENERAL. This form has been designed and issued for use in connection with the transfer of military real property between the military departments and to or from other government agencies. It supersedes ENG Forms 290 and 290B (formerly used by the Army and Air Force) and NAVDOCKS Form 2317 (formerly used by the Navy).
Existing instructions issued by the military departments relative to the preparation of DD Form 1354 are applicable to this revised form to the extent that the various items and columns on the superseded forms have been retained. The military departments may promulgate additional instructions, as appropriate.
For detailed instructions on how to fill out this form, please refer to Unified Facilities Criteria (UFC) 1-300-08, dated 16 April 2009 or later.
SPECIFIC DATA ITEMS.
1. From. Name of the transferring agency.
2. Date Prepared. Date of actual preparation. Enter all dates in YYYYMMDD format (Example: March 31, 2010 = 20100331).
3. Project/Job Number. Project number on a DD Form 1391 or Individual Job Order Number.
4. Serial Number. Sequential serial number assigned by the preparing organization (e.g., 2010-0001).
5. To. Name and address of the receiving installation, activity, and Service of the Real Property Accountable Officer (RPAO).
6. RPSUID/SITENAME/INSTCODE/INSTNAME. Site Unique Identifier and name or installation code and name where the constructed facility is located.
7. Contract Number(s). Contract number(s) for this project.
7a. Placed-In-Service Date. RPA Placed In Service Date. This is the date the asset is actually placed-in-service.
8. Transaction Details.
a. Method of Transaction. Mark (X) as many boxes as apply.
b. When/Event. When or event causing preparation of DD Form 1354. X only one box.
c. Type. Draft, interim, or final DD Form 1354. X only one box.
9. Item Number. Use a separate item number for each facility, no item number for additional usages.
10a. Facility Number. Assigned in accordance with the Installation/Base Master Numbering Plan.
10b. RPUID. Identified in Real Property Inventory.
11. Category Code. The category code describes the facility usage.
12. Catcode Description. The category code name which describes the facility usage.
13. Type. Type of construction: P for Permanent; S for Semi- permanent; T for Temporary.
14. Sustainability Code. Reports whether or not an asset meets the sustainability goals set forth in Section 2(f)(ii) of Executive Order 13423.
15. Area: UM 1. Area unit of measure; use the unit of measure associated with the category code selected in 11.
16. Total Quantity UM 1. The total area for the measure identified in Item 14. Use negative numbers for demolition.
17. Other: UM 2. Unit of Measure 2 is the capacity or other measurement unit (e.g., LF, MB, EA, etc.).
18. Total Quantity UM 2. The total capacity/other for the measure identified in Item 17.
19. Cost. Cost for each facility; for capital improvements to existing facilities, show amount of increase only. If there is no increase for the capital improvement, enter N/A.
20. Fund Source. Enter the Fund Source Code for this item.
21. Funding Organization. Enter the code for the organization responsible for acquiring this facility.
22. Interest Code. Enter the code that reflects government interest or ownership in the facility.
23. Item Remarks. Remarks pertaining only to the item number identified in Item 9; show cost sharing.
24. Statement of Completion. Typed name, signature, title, and date of signature by the responsible transferring individual or agent.
25. Accepted By. Typed name, signature, title, and date of signature by the RPAO or accepting official.
26. Property Voucher Number. Next sequential number assigned by the RPAO in voucher register.
27. Construction Deficiencies. List construction deficiencies in project during contractor turnover inspection.
28. Project Remarks. Project level remarks and continuation of blocks.
DD FORM 1354 (BACK), APR 2013
DD Form 1354, Transfer and Acceptance of DoD Real Property, April 2013
WHS/ESD/IMD
9.0.0.2.20120627.2.874785 TRANSFER AND ACCEPTANCE OF DoD REAL PROPERTY Form Approved OMB No. 0704-0188
PAGE
OF
PAGES
1. FROM (Organization Name)
2. DATE PREPARED
(YYYYMMDD)
3. PROJECT/JOB
NUMBER
4. SERIAL NUMBER
7. CONTRACT
NUMBER(S)
5. TO (Organization - Installation Code and Name)
6. RPSUID/SITENAME/
INSTCODE/INSTNAME
8. TRANSACTION DETAILS
a. METHOD (X all that apply)
ACQUISITION BY CONSTRUCTION
TRANSFER BETWEEN SERVICES
CAPITAL IMPROVEMENT
INVENTORY ADJUSTMENT
PARTIAL ASSET
PLACED-IN-SERVICE
TOTAL ASSET
PLACED-IN-SERVICE
9.
ITEM
NO.
11.
CATEGORY
CODE
12.
CATCODE
DESCRIPTION
14.
SUST.
CODE
20.
FUND
SOURCE
15.
PRIMARY
UM
18.
SECONDARY UM
QUANTITY
17.
SECONDARY
UM
16.
PRIMARY UM
QUANTITY
19.
COST
23.
ITEM
REMARKS
24. STATEMENT OF COMPLETION. The facilities listed hereon are in accordance with maps, drawings, and specifications and change orders approved by the authorized representative of the using agency except for the deficiencies listed on the reverse side.
25a. ACCEPTED BY (Typed Name and Signature)
b. DATE SIGNED
(YYYYMMDD)
a. TRANSFERRED BY (Typed Name and Signature)
c. TITLE (Area Engr./Base Engr./DPW/Construction Agent)
b. DATE SIGNED
(YYYYMMDD)
c. TITLE (DPW/RPAO)
26. PROPERTY
VOUCHER NUMBER
PREVIOUS EDITION IS OBSOLETE.̀̀
b. WHEN/EVENT (X one) 7a. PLACED-IN-
SERVICE DATE
(YYYYMMDD)
c. TYPE (X one)
DRAFT
INTERIM
FINAL
10a.
FACILITY
NO.
AREA
OTHER
21.
FUND
ORG
22.
INTER-
EST
CODE
PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.
Adobe Designer 9.0 10b.
RPUID
13.
TYPE
CODE
The public reporting burden for this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, Alexandria,VA 22350-3100 (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if itdoes not display a currently valid OMB control number.
DD FORM 1354, APR 2013
27. CONSTRUCTION DEFICIENCIES (Attach blank sheet for continuations)
28. PROJECT REMARKS (Attach blank sheet for continuations)
INSTRUCTIONS
GENERAL. This form has been designed and issued for use in connection with the transfer of military real property between the military departments and to or from other government agencies. It supersedes ENG Forms 290 and 290B (formerly used by the Army and Air Force) and NAVDOCKS Form 2317 (formerly used by the Navy).
Existing instructions issued by the military departments relative to the preparation of DD Form 1354 are applicable to this revised form to the extent that the various items and columns on the superseded forms have been retained. The military departments may promulgate additional instructions, as appropriate.
For detailed instructions on how to fill out this form, please refer to Unified Facilities Criteria (UFC) 1-300-08, dated 16 April 2009 or later.
SPECIFIC DATA ITEMS.
1. From. Name of the transferring agency.
2. Date Prepared. Date of actual preparation. Enter all dates in YYYYMMDD format (Example: March 31, 2010 = 20100331).
3. Project/Job Number. Project number on a DD Form 1391 or Individual Job Order Number.
4. Serial Number. Sequential serial number assigned by the preparing organization (e.g., 2010-0001).
5. To. Name and address of the receiving installation, activity, and Service of the Real Property Accountable Officer (RPAO).
6. RPSUID/SITENAME/INSTCODE/INSTNAME. Site Unique Identifier and name or installation code and name where the constructed facility is located.
7. Contract Number(s). Contract number(s) for this project.
7a. Placed-In-Service Date. RPA Placed In Service Date. This is the date the asset is actually placed-in-service.
8. Transaction Details.
a. Method of Transaction. Mark (X) as many boxes as apply.
b. When/Event. When or event causing preparation of DD Form 1354. X only one box.
c. Type. Draft, interim, or final DD Form 1354. X only one box.
9. Item Number. Use a separate item number for each facility, no item number for additional usages.
10a. Facility Number. Assigned in accordance with the Installation/Base Master Numbering Plan.
10b. RPUID. Identified in Real Property Inventory.
11. Category Code. The category code describes the facility usage.
12. Catcode Description. The category code name which describes the facility usage.
13. Type. Type of construction: P for Permanent; S for Semi- permanent; T for Temporary.
14. Sustainability Code. Reports whether or not an asset meets the sustainability goals set forth in Section 2(f)(ii) of Executive Order 13423.
15. Area: UM 1. Area unit of measure; use the unit of measure associated with the category code selected in 11.
16. Total Quantity UM 1. The total area for the measure identified in Item 14. Use negative numbers for demolition.
17. Other: UM 2. Unit of Measure 2 is the capacity or other measurement unit (e.g., LF, MB, EA, etc.).
18. Total Quantity UM 2. The total capacity/other for the measure identified in Item 17.
19. Cost. Cost for each facility; for capital improvements to existing facilities, show amount of increase only. If there is no increase for the capital improvement, enter N/A.
20. Fund Source. Enter the Fund Source Code for this item.
21. Funding Organization. Enter the code for the organization responsible for acquiring this facility.
22. Interest Code. Enter the code that reflects government interest or ownership in the facility.
23. Item Remarks. Remarks pertaining only to the item number identified in Item 9; show cost sharing.
24. Statement of Completion. Typed name, signature, title, and date of signature by the responsible transferring individual or agent.
25. Accepted By. Typed name, signature, title, and date of signature by the RPAO or accepting official.
26. Property Voucher Number. Next sequential number assigned by the RPAO in voucher register.
27. Construction Deficiencies. List construction deficiencies in project during contractor turnover inspection.
28. Project Remarks. Project level remarks and continuation of blocks.
DD FORM 1354 (BACK), APR 2013
| Page number of this page.: |
| Total number of pages.: |
| 1. From (Organization name).: |
| 3. Project/job number.: |
| 4. Serial number.: |
| 5. To (Organization - installation code, name, and service of Real Property Accountable Officer (RPAO)).: |
| 6. Real Property Site Unique Identifier and site name or installation code and name.: |
| 7. Contract number(s).: |
| 8. Transaction details. a. Method. Press space bar to mark X if acquisition by construction.: Off |
| X if transfer between services.: Off |
| X if capital improvement.: Off |
| X if inventory adjustment.: Off |
| c. Type. X first box if draft, second box if final, or third box if interim.: |
| 9. Item number, line 1 of 10. Use a separate item number for each facility.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 14. Sustainability code.: |
| 15. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 16. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 17. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 18. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 19. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 20. Fund source. Fund source code for this item.: |
| 21. Funding Organization. Code for organization responsible for acquiring facility.: |
| 22. Interest Code. Code that reflects government interest or ownership in facility.: |
| 23. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 2.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 3: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 4.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 5.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 6.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 7.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 8.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 9.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 14. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 15. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 16. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 17. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 18. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 19. Fund source. Fund source code for this item.: |
| 20. Funding Organization. Code for organization responsible for acquiring facility.: |
| 21. Interest Code. Code that reflects government interest or ownership in facility.: |
| 22. Item remarks. (Pertaining only to the item number in Column 9.): |
| 9. Item number, line 10.: |
| 10.a. Facility number. Unique facility number identified in Real Property Inventory.: |
| 10.b. Real property unique identifier.: |
| 11. Category code.: |
| 12. Catcode Description. Code name which describes the facility usage.: |
| 13. Type of construction. P for Permanent, S for Semipermanent, T for Temporary.: |
| 15. Area. Primary unit of measure (use the unit of measure associated with the category code selected in 11).: |
| 16. Area. Primary Unit of Measure Quantity. The total area for the measure identified in item 14. Use negative numbers for demolition.: |
| Other. 17. Secondary unit of measure. Capacity or other measurement unit (e.g., LF, MB, EA, etc.).: |
| 18. Secondary unit of measure quantity. Total capacity/other for measure identified in item 16.: |
| 19. Cost. Cost for each facility. Show amount of increase only, or N/A.: |
| 20. Fund source. Fund source code for this item.: |
| 21. Funding Organization. Code for organization responsible for acquiring facility.: |
| 22. Interest Code. Code that reflects government interest or ownership in facility.: |
| 23. Item remarks. (Pertaining only to the item number in Column 9.): |
| 23. Statement of Completion. a. Transferred by (name).: |
| Signature.: |
| c. Title (Area engineer/base engineer/DPW/Construction Agent).: |
| 24.a. Accepted by (name).: |
| Signature.: |
| c. Title (DPW/RPAO).: |
| 25. Property voucher number.: |
| 2. Date prepared (4 digit year, 2 digit month, 2 digit day).: |
| 7.a. Placed-in-Service Date (4 digit year, 2 digit month, 2 digit day).: |
| b. Date signed (4 digit year, 2 digit month, 2 digit day).: |
| b. Date signed (4 digit year, 2 digit month, 2 digit day).: |
| 26. Construction deficiencies. Attach blank sheet for continuations.: |
| 27. Project remarks. Attach blank sheet for continuations.: |
File details come from the government source that posted it. Updated .