Laundry_Attachment_7_Sample_Daily_Report.pdf

Attachment 7—HSFE70-15-R-0031 – SAMPLE—“Daily Reports—Contractor (sample format)”

Contract Number: ___________________________ Task Order #____________ CLIN #s________

Date: _______________ Signature: COR or Authorized FEMA Rep: _______________________

Toilet Inventory & Operational Status Report Time Total

Regular Toilet Stalls

Equipment Operational Status

(e.g. 18 of 20 Fully Mission Capable (FMC) 2 of 20 Not Mission Capable (NMC))

Total Accessible Toilet Stalls

Equipment Operational Status (e.g. 18 of 20 Fully

Mission Capable (FMC) 2 of 20 Not Mission

Capable (NMC))

Inoperable Equipment Status:

(e.g. awaiting parts, maintenance, awaiting installation or replacement)

Proposed Remedy and Estimated Timeframe to restore FMC status

Print: Name/Title/E- Mail & Phone Number-- Contractor On site representative

8:00 am (e.g. 20) (e.g. 18 of 20 FMC 2 of 20 NMC)

(e.g. 2) (e.g.2 of 2 FMC

0 NMC)

(e.g. Both toilets awaiting maintenance)

(e.g. Repair/replace seat estimated completion date 3/18/2015)

Contract Number: ___________________________ Task Order #____________ CLIN #s________

Date: _______________ Signature: COR or Authorized FEMA Rep: _______________________

Support Equipment Inventory & Operational Status Report Time Type Equipment

(e.g. generator, water bladder or water tanker)

Equipment Operational Status (e.g. 18 of 20 Fully Mission Capable

(FMC) 2 of 20 Not Mission Capable

(NMC))

Type Equipment (e.g. generator, water bladder, or water tanker)

Equipment Operational Status (e.g. 18 of 20 Fully Mission Capable

(FMC) 2 of 20 Not Mission Capable

(NMC))

Inoperable Equipment Status:

(e.g. awaiting parts, awaiting maintenance, awaiting installation, or replacement)

Proposed Remedy and Estimated Timeframe to restore FMC status

Print: Name/Title/E- Mail & Phone Number-- Contractor On site representative

8:00 am (e.g. Generators) (e.g. 3 of 4 FMC 1 of 4 NMC)

(e.g. Water Bladders)

(e.g. 2 of 2 FMC

0 NMC)

(e.g. Generator awaiting parts)

(e.g. Install new valve estimated completion date

3/18/2015)

Contract Number: ___________________________ Task Order #____________ CLIN #s________

Date: _______________ Signature: COR or Authorized FEMA Rep: _______________________

Services Status Report Type of Service

(e.g. cleaning, Supplies, potable water deliveries, waste water removal service)

Time Started

Time Completed

If Daily Service not performed why?

Proposed Remedy and Estimated Timeframe to complete service

Type & Status of affected

Equipment:

(Fully Mission

Capable (FMC) 2 of 20 Not Mission Capable (NMC)

Next Date/Time Service is to be executed

Print: Name/Title/E-Mail & Phone Number-- Contractor On site representative

(e.g. Potable Water Delivery)

8:00 am 8:30 am n/a n/a n/a 3/18/2015

(e.g. Restroom Cleaning)

8:00 am 10:00 am n/a n/a n/a 3/18/2015