Attachment_5_-_Quarterly_Report_Template.pdf

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PERSONAL RADIATION DETECTOR ( HSHQDN-17-R-0003)
Solicitation number
HSHQDN-17-R-0003
Issued by

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Attachment 5 - Quarterly Report Template

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Text version

HSHQDN-17-R-0003

Attachment 5

Reporting Period: MM/DD/YYYY - MM/DD/YYY

Component Vendor

Name

Contract

Number Order Number

Modification

Number

Order Date

(format:

mm/dd/yyyy)

Period of

Performance Start

Period of

Performance End CLIN / Item #

Item Name or

Product / Service

Description

Tag or SKU

Number

Product Line(s) /

Types (s)

Order Type (FFP, T&M, LH, etc.)

Quantity

DHS IDIQ Unit

Price

DHS Unit Price

Paid Savings Achieved

Savings

Percentage

Achieved

Total DO

Value

(including options)

Changes to Total

DO Value

Total Amount

Obligated

Current

Modification

Amount

Obligated

Aggregate

Amount

DHS Order

Contracting Officer DHS Order COR

DHS Order POC

Phone

DHS Order POC

Email Contractor POC

Contractor POC

Phone

Contractor POC

Email

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

-$ -$ -$ 0% -$ -$ -$ -$ -$

Total Discount

FLETC

ICE

TSA

USCG

USSS

CBP

DHS/HQ

FEMA

US-VISIT

Total Obligated

Summary

Total Orders

Monthly Obligation by Component

CIS

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