SOW Attachment (7) Contractor Production Report Form.doc

61 KB Posted

Attached to
NSWCPD BLDG 4 AHU 3 Repairs (21-N E-084)
Solicitation number
N6449821Q0257
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CONTRACTOR PRODUCTION REPORT

(ATTACH ADDITIONAL SHEETS IF NECESSARY)

DATE

CONTRACT NO
TITLE AND LOCATION

REPORT NO

Building 1000 – Air Handlers AS-5 and 6 Repairs

CONTRACTOR

SUPERINTENDENT

AM WEATHER

PM WEATHER

MAX TEMP (F)
MIN TEMP (F)

WORK PERFORMED TODAY

Schedule

Activity No.

WORK LOCATION AND DESCRIPTION
EMPLOYER
NUMBER
TRADE
HRS

JOB

SAFETY

WAS A JOB SAFETY MEETING HELD THIS DATE?

FORMCHECKBOX

YES

FORMCHECKBOX

NO

TOTAL WORK HOURS ON JOB SITE,

THIS DATE, INCL CON'T SHEETS

WERE THERE ANY LOST TIME ACCIDENTS THIS DATE?

(If YES attach copy of completed OSHA report)

FORMCHECKBOX

YES

FORMCHECKBOX

NO

CUMULATIVE TOTAL OF WORK

HOURS FROM PREVIOUS REPORT

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

(If YES attach statement or checklist showing inspection performed.)

FORMCHECKBOX

YES

FORMCHECKBOX

NO

TOTAL WORK HOURS FROM

START OF CONSTRUCTION

WAS HAZARDOUS MATERIAL/WASTE RELEASED INTO THE ENVIRONMENT?

(If YES attach description of incident and proposed action.)

FORMCHECKBOX

YES

FORMCHECKBOX

NO

Schedule

Activity No.

LIST SAFETY ACTIONS TAKEN TODAY/SAFETY INSPECTIONS CONDUCTED
FORMCHECKBOX

SAFETY REQUIREMENTS HAVE BEEN MET.

EQUIPMENT/MATERIAL RECEIVED TODAY TO BE INCORPORATED IN JOB (INDICATE SCHEDULE ACTIVITY NUMBER)

Schedule

Activity No.

Submittal #
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 (incl Make and Model)
Hours Used

Schedule

Activity No.

REMARKS

CONTRACTOR/SUPERINTENDENT
DATE

SOW Attachment (7) Contractor Production Report Form

Sheet 1 of 1

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