S02 - 02c2_537-19-125 - SOW Att - Contractor Production Report.pdf

PDF 87 KB Posted

Attached to
Z1DA--537-19-125 Renovate Electronic Security System (VA-22-00034826)
Solicitation number
36C25222B0016
Issued by

About this file

This document contains a Contractor Production Report template and information about the related federal contract opportunity Z1DA--537-19-125 to renovate the electronic security system at a Department of Veterans Affairs facility.

The Contractor Production Report is a form used by construction contractors to record daily work details like weather, work performed, safety inspections, equipment used, and labor hours. Contractors must submit the report regularly to ensure sufficient progress toward completing the contract on schedule. The federal contract opportunity is posted by the Veterans Health Administration Veterans Integrated Service Network 12 to renovate the electronic security system. Offerors should respond by the specified date to be considered for award of the contract to provide the required security system renovation services.

View the file

Other files

Show all 21

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

OMB No.: 2900-0208 Exp. Date: Mar 31. 2022 Respondent Burden: 24 Minutes

CONTRACTOR PRODUCTION REPORT

(Attach additional sheets if necessary)

DATE

CONTRACT NUMBER TITLE AND LOCATION (Title and Location of Construction Contract) REPORT NUMBER

CONTRACTOR SUPERINTENDENT

AM WEATHER (Weather data, include precipitation & winds) PM WEATHER (Weather data, include precipitation & winds) MAX TEMP (F) MIN TEMP (F)

WORK PERFORMED TODAY

SCHEDULE ACTIVITY NO. WORK LOCATION AND DESCRIPTION EMPLOYER NUMBER TRADE HOURS

JOB SAFETY

WAS A JOB SAFETY MEETING HELD THIS DATE?

(If YES, attach copy of the meeting minutes) YES NO

WERE THERE ANY LOST TIME ACCIDENTS THIS DATE?

(If YES, attach copy of completed OSHA report) YES NO

WAS CRANE/MANLIFT/TRENCHING/SCAFFOLD/HV ELEC/HIGH WORK/HAZMAT

WORK DONE? (If YES, attach statement or checklist showing inspection performed)

YES NO

TOTAL WORK HOURS ON JOB SITE, THIS

DATE, INCL CON'T SHEETS

CUMULATIVE TOTAL OF WORK HOURS

FROM PREVIOUS REPORT

TOTAL WORK HOURS FROM START OF

CONSTRUCTION

SCHEDULE

ACTIVITY NO.

LIST ANY SAFETY ACTION TAKEN TODAY/SAFETY

INSPECTION CONDUCTED

(Include any safety topic covered during the safety meeting)

SAFETY REQUIREMENTS

HAVE BEEN MET

EQUIPMENT/MATERIAL RECEIVED TODAY TO BE INCORPORATED IN JOB (Indicate a schedule activity number) SCHEDULE ACTIVITY NO. SUBMITTAL NUMBER DESCRIPTION OF EQUIPMENT/MATERIAL RECEIVED

CONSTRUCTION AND PLANT EQUIPMENT ON JOB SITE TODAY, INDICATE

HOURS USED AND SCHEDULE ACTIVITY NUMBER

SCHEDULE ACTIVITY NO. OWNER DESCRIPTION OF CONSTRUCTION EQUIPMENT USED TODAY (Include Make and Model)

SCHEDULE ACTIVITY NO. REMARKS

CONTRACTOR/SUPERINTENDENT DATE REPORT PREPARED

The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to respond to , a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who must complete this form will be average 24 minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. If your firm does not already have a similar form, this is used to record the data necessary to assure the contractor provides sufficient labor and materials to accomplish the contract work. This form or a similar document is required to guarantee the performance of the work necessary to complete the project.

VA FORM

JUL 2018 10101

OMB No.: 2900-0208 Exp. Date: Mar 31. 2022 Respondent Burden: 24 Minutes O M B No.: 2900-0208 Exp. Date: Mar 31. 2022 Respondent Burden: 24 Minutes Department of Veterans Affairs LOGO

CONTRACTOR PRODUCTION REPORT

(Attach additional sheets if necessary)

CONTRACTOR PRODUCTION REPORT

(Attach additional sheets if necessary)

DATE

CONTRACT NUMBER

TITLE AND LOCATION (Title and Location of Construction Contract)

REPORT NUMBER

CONTRACTOR

SUPERINTENDENT

AM WEATHER (Weather data, include precipitation & winds) PM WEATHER (Weather data, include precipitation & winds)

MAX TEMP (F)

MIN TEMP (F)

WORK PERFORMED TODAY

SCHEDULE ACTIVITY NO.

WORK LOCATION AND DESCRIPTION

EMPLOYER

NUMBER

TRADE

HOURS

JOB SAFETY

WAS A JOB SAFETY MEETING HELD THIS DATE?

(If YES, attach copy of the meeting minutes)

WERE THERE ANY LOST TIME ACCIDENTS THIS DATE?

(If YES, attach copy of completed OSHA report)

WAS CRANE/MANLIFT/TRENCHING/SCAFFOLD/HV ELEC/HIGH WORK/HAZMAT

WORK DONE? (If YES, attach statement or checklist showing inspection performed)

TOTAL WORK HOURS ON JOB SITE, THIS

DATE, INCL CON'T SHEETS

CUMULATIVE TOTAL OF WORK HOURS

FROM PREVIOUS REPORT

TOTAL WORK HOURS FROM START OF

CONSTRUCTION

SCHEDULE

ACTIVITY NO.

LIST ANY SAFETY ACTION TAKEN TODAY/SAFETY

INSPECTION CONDUCTED

(Include any safety topic covered during the safety meeting) EQUIPMENT/MATERIAL RECEIVED TODAY TO BE INCORPORATED IN JOB (Indicate a schedule activity number)

SCHEDULE ACTIVITY NO.

SUBMITTAL NUMBER

DESCRIPTION OF EQUIPMENT/MATERIAL RECEIVED

CONSTRUCTION AND PLANT EQUIPMENT ON JOB SITE TODAY, INDICATE

HOURS USED AND SCHEDULE ACTIVITY NUMBER

SCHEDULE ACTIVITY NO.

OWNER

DESCRIPTION OF CONSTRUCTION EQUIPMENT USED TODAY (Include Make and Model)

SCHEDULE ACTIVITY NO.

REMARKS

CONTRACTOR/SUPERINTENDENT

DATE REPORT PREPARED

The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to respond to , a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who must complete this form will be average 24 minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. If your firm does not already have a similar form, this is used to record the data necessary to assure the contractor provides sufficient labor and materials to accomplish the contract work. This form or a similar document is required to guarantee the performance of the work necessary to complete the project.

VA FORMJUL 2018

V A Form 1 0 1 0 1, JULY 2018 10101 C:\Program Files\Adobe\Form Designer\Forms\Adobe.xft\VA3918.xft David Wachter April 2015 5.0

OA&MM

VA3918

{CF3222A7-20FA-11D4-ABC1-00D0B71D6ABB}

PDFForms.xml Spelling Checker;{224F7DEA-B7C1-11D3-AB40-00902712A5C9};PLSSpeller.cab Intra-Agency Transfer Request David Wachter VA Form 3918

JULY 2018

10101, CONTRACTOR, PRODUCTION, CONSTRUCTION

Missie Vaccaro-Palomaki VA Form 10101, CONTRACTOR PRODUCTION REPORT Rafael Taylor/Sterai Payne/Karen Bruce (003A2A)

DATE REPORT PREPARED

The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to respond to , a collection of information unless it displays a valid O M B number. We anticipate that the time expended by all individuals who must complete this form will be average 24 minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. If your firm does not already have a similar form, this is used to record the data necessary to assure the contractor provides sufficient labor and materials to accomplish the contract work. This form or a similar document is required to guarantee the performance of the work necessary to complete the project.:

CONTRACTOR/SUPERINTENDENT:
SCHEDULE ACTIVITY NUMBER, line 4 of 4:
OWNER, line 4 of 4:
REMARKS, line 4 of 4:
SCHEDULE ACTIVITY NUMBER, LINE 4 OF 5:
WORK LOCATION AND DESCRIPTION, LINE 4 OF 5:
HOURS, LINE 4 OF 5:
SCHEDULE ACTIVITY NUMBER, LINE 5 OF 5:
WORK LOCATION AND DESCRIPTION, LINE 5 OF 5:
HOURS, LINE 5 OF 5:
SAFETY REQUIREMENTS

HAVE BEEN MET "YES" CHECK BOX.: 0

SAFETY REQUIREMENTS

HAVE BEEN MET "YES" CHECK BOX.: 0

SAFETY REQUIREMENTS

HAVE BEEN MET "YES" CHECK BOX.: 0

SAFETY REQUIREMENTS

HAVE BEEN MET "YES" CHECK BOX.: 0

"NO" CHECK BOX.: 0
"NO" CHECK BOX.: 0
"NO" CHECK BOX.: 0
TOTAL WORK HOURS ON JOB SITE, THIS

DATE, INCL CON'T SHEETS:

CUMULATIVE TOTAL OF WORK HOURS

FROM PREVIOUS REPORT:

TOTAL WORK HOURS FROM START OF

CONSTRUCTION (Auto calculated field):

File details come from the government source that posted it. Updated .