OS-501.pdf
PDF 513 KB Posted
- Attached to
- Beaver Co. Maintenance Uniforms
- Solicitation number
- 6100066584
About this file
This is a Scope of Work document for Beaver County, Pennsylvania regarding the procurement of rental and services for reflective maintenance uniforms. The procurement encompasses shirts, pants, and jackets with reflective striping for garage maintenance personnel within Beaver County. The contract requires the vendor to provide uniform rental services, including cleaning, maintenance, and replacement of damaged or worn items throughout the contract term. Specific quantities and sizing requirements for uniforms are to be determined based on the number of authorized maintenance personnel. The vendor must ensure all uniforms meet applicable safety standards and reflective striping requirements for visibility and workplace safety compliance. The scope includes delivery of uniforms to designated Beaver County facilities and responsive customer service for uniform exchanges and replacements as needed.
The pricing structure for this contract will be based on a monthly or annual rental fee per employee, with costs covering all cleaning, maintenance, and replacement services. The contractor assumes responsibility for uniform inventory management, ensuring adequate stock levels and timely delivery of clean uniforms to County facilities. Any set-asides, incumbent vendor considerations, and specific funding sources for this maintenance uniform procurement would be detailed in the bid specifications and award documentation. The contract term and renewal options will be established in the final procurement documents issued by Beaver County.
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Text version
OS-501 (7-16)
CONFIRMATION OF SERVICE
www.penndot.gov
Date(s) Service Rendered:________________ - _______________ Vendor Name: __________________________________________ Phone: ________________________________________________
PURCHASE ORDER #:___________________________________
SAP Vendor Number:_____________________________________ Address (1): ____________________________________________ Address (2): ____________________________________________ City: ____________________ State: _______ Zip Code: ________
(Reference line items on purchase order that match the services that were performed.)
PO Line # Description / Product ID Quantity U.O.M. Unit Price Item Total
PENNDOT USE ONLY
I certify the services represented by the confirmation of service form above were received satisfactorily. Therefore, I approve payment be made.
Project Manager Signature Date (mm/dd/yyyy)
I certify that I have entered a Goods Receipt in SAP for this service. This should occur within 48 hours of receipt (per Management Directive 310.31).
SRM/R3 Receiver Signature Date (mm/dd/yyyy) SRM Confirmation # / R3 Material Document #
Vendor Signature:_______________________________________________________________ Date:__________________________
Total of Page 1 Total of Page 2 Grand Total
Continued on page 2
PO Line # Description / Product ID Quantity U.O.M. Unit Price Item Total
Total of Page 1 Total of Page 2 Grand Total
Instructions:
Complete the OS-501 form in accordance with the instructions below.
1. The Vendor completes the OS-501 form, then forwards the signed/dated form to the appropriate PennDOT representative for approval (may be done electronically via email). Explanations for fields on the form are listed below.
Date Service Rendered: Provide the date of service (i.e., Date or date range).
Vendor Name*: Enter name.
Phone*: Area code and phone number.
PURCHASE ORDER #*: The ten digit number in the upper right corner.
SAP Vendor Number*: This is the vendor’s six digit vendor number (e.g. 412345).
Address (1)*: Vendor's street address.
Address (2)*: Enter the Floor, Suite, etc. of the vendors address, if applicable.
City*: Vendor's City.
State*: Vendor's State.
Zip Code*: Vendor's Zip Code.
PO Line #: Enter the PO line item number(s) in this column. Many PO’s contain numerous line items.
Use separate lines to account for each item that was delivered.
Description/Product ID*: Enter the exact description from the PO line item Description/Product ID column.
Quantity: Enter the quantity delivered for the time period.
U.O.M.*: This is the unit of measure for the service/material rendered (e.g. hours, days, number, etc).
Unit Price*: Cost per individual unit of measure.
Total: Calculated Amount of the Quantity x Unit Price.
*Enter information exactly as it appears on the fully executed Purchase Order.
2. The PennDOT Representative confirms services were received satisfactorily and approves payment to be made by signing and dating on the “Project Manager Signature” line. The PennDOT Representative forwards the signed/dated form to their Goods Receiver.
3. The Goods Receiver certifies that a Goods Receipt has been entered in SAP for the by signing, dating, and providing the SRM Confirmation Number/R3 Material Document Number.
4. The Goods Receiver provides a copy of the completed and signed/dated form to the PennDOT Representative for placement in the Procurement file.
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| PURCHASE ORDER: |
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| Phone: |
| SAP Vendor Number: |
| Check Box3: Off |
| Date: |
| Date mmddyyyy: |
| Confirmation Number: |
| Date mmddyyyy_2: |
| Total Page 1: 0 |
| Total Page 2: 0 |
| Grand Total: 0 |
| Date Service Rendered: |
| Date Service Rendered2: |
| Address 1: |
| Address 2: |
| City: |
| State: |
| Zip Code: |
File details come from the government source that posted it. Updated .