Attachment 10 - BLANK SAMPLE AF Form 3065.xlsx

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Dismantling of Modular Facility & Storage Racks
Solicitation number
FA850124R0005
Issued by

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This document appears to be a blank template for the AF Form 3064 CONTRACT PROGRESS SCHEDULE and the AF Form 3065 CONTRACT PROGRESS REPORT. It provides sample forms and instructions for contractors to report on the progress of a federal contract.

The related federal contract opportunity is for the Dismantling of Modular Facility & Storage Racks at Robins AFB, GA. The solicitation number is FA850124R0005. The work involves developing and executing a detailed plan and schedule for dismantling the modular facility and storage racks, clean-up, and disposal of materials and waste. Site visits are offered from March 25-29 to allow offerors to inspect the site. The solicitation notes that funds are not presently available, so no award will be made until funds are secured, and the government reserves the right to cancel the solicitation. The Department of the Air Force Materiel Command Air Force Sustainment Center is the issuing agency.

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Attachment 9 - BLANK SAMPLE AF Form 3064.xlsx XLSX spreadsheet
Statement of Work .docx DOCX document
Service Contract Act WD 2015-4495.pdf PDF
Cargo Rollers and Treehouse Picture.docx DOCX document
Solicitation - FA850124R0005 Final.pdf PDF

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AF Form 3064 CONTRACT PROGRESS SCHEDULE (See Contractor's Instructions on Reverse) Form Approved OMB NO. 0704-0188

1. CONTRACT NO.8. PROJECT TITLE10. APPROVAL RECOMMENDED BY
FA8501-XX-X-XXXXProject Title, Robins AFB, GADATE SIGNEDINSTALLATION'S ENGINEER'S SIGNATURE
2. STARTING DATE/ NTPX/XX/20179. SUBMITTED BY:
3. COMPLETION DATEERROR:#VALUE!DATE SIGNEDCONTRACTOR'S NAME (LAST, FIRST, I) ADDRESS (STREET, CITY, STATE, ZIP)CONTRACTOR'S SIGNATURE11. APPROVED BY
4. PURCHASE REQUEST NO.DATE SIGNEDCONTRACTING OFFICER'S SIGNATURE
5. PROJECT NO.XXXXXX
6. ACTUAL STARTING DATEX/XX/2017
7. ACTUAL COMP DATE
LINE NO.WORK ELEMENTSXXXXXX.XX%
AXXXXX.XXAugSepOctNovDecJanFebMarX/X/2017
1CLIN 1
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Total0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%
0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%0.00%ERROR:#VALUE!
37CLIN 2
Fence202.17%ERROR:#VALUE!
ERROR:#VALUE!

&"Arial,Bold"&8AF FORM 3064, JUN 90 &"Arial,Bold Italic"&6 PREVIOUST EDITION IS OBSOLETE

AF Form 3065

CONTRACT PROGRESS REPORT OMB NO. 0704-0188

CONTRACTORADDRESS
0
0
REPORT NO.PERIOD COVEREDPROJECT NO.CONTRACT NO.COMPLETION DATE
1FROM:TO:XXXXXXFA8501-XX-X-XXXX
LINE NO.WORK ELEMENT% OF TOTAL JOB% COMPLETED THIS PERIOD% COMPLETED CUMULATIVE
10.00%0.00%0.00%
20.00%0.00%0.00%
30.00%0.00%0.00%
40.00%0.00%0.00%
50.00%0.00%0.00%
60.00%0.00%0.00%
70.00%0.00%0.00%
80.00%0.00%0.00%
90.00%0.00%0.00%
100.00%0.00%0.00%
110.00%0.00%0.00%
120.00%0.00%0.00%
130.00%0.00%0.00%
140.00%0.00%0.00%
150.00%0.00%0.00%
160.00%0.00%0.00%
170.00%0.00%0.00%
180.00%0.00%0.00%
190.00%0.00%0.00%
200.00%0.00%0.00%
210.00%0.00%0.00%
220.00%0.00%0.00%
230.00%0.00%0.00%
240.00%0.00%0.00%
250.00%0.00%0.00%
260.00%0.00%0.00%
270.00%0.00%0.00%
280.00%0.00%0.00%
290.00%0.00%0.00%
300.00%0.00%0.00%
310.00%0.00%0.00%
320.00%0.00%0.00%
330.00%0.00%0.00%
340.00%0.00%0.00%
350.00%0.00%0.00%
360.00%0.00%0.00%
370.00%0.00%0.00%
380.00%0.00%0.00%
390.00%0.00%0.00%
400.00%0.00%0.00%
410.00%0.00%0.00%
420.00%0.00%0.00%
430.00%0.00%0.00%
440.00%0.00%0.00%
TOTAL0%0%0%
REMARKS
Construction Inspector: Print Name ______________________ Signature:
Date
At the Contracting discretion and according to the payments clause of the contract, the information provided on this form may be used for computing progress payments.
PROGRESS OR COMPLETION CERTIFICATE
I hereby certify that the contractor has satisfactorily completed the indicated percentage of the contract per contract specs.
SUBMITTED BY OR FOR
TYPED NAME AND TITLESIGNATUREDATE
Project Manager
REVIEWED BY OR FOR CONTRACTING OFFICER
TYPED NAME AND TITLESIGNATUREDATE

CONTRACTOR

78th CIVIL ENGINEERS

Sheet1

% COMPLETED THIS PERIOD
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
ERROR:#REF!
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
ERROR:#REF!

Sheet2

Microsoft_Word_97_-_2003_Document.doc Public reporting burden for this collection of information is estimated to average 15 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 the collection of information including suggestions for reducing this burden in Department of Defense, Washington Headquarters Service. Directorate for information Operations and Report. 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22292-4302, and to the Office of Management and Budget, Paperwork Reduction Project 0704-0188, Washington, DC 20503. Please DON NOT RETURN your (form questionnaire) to either of these addresses. Send your completed (form questionnaire) to: SAF AQCO, Washington, DC 20330-1000.

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