Technical Exhibit 7 - Delivery Order.pdf

29 KB Posted

Attached to
Latrines Follow-On
Solicitation number
W9124R20Q0024
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7.7 Delivery Order

CHEMICAL TOILETS CONTRACT NUMBER:

CONTRACTOR: PUBLIC WORKS DELIVERY ORDER NUMBER: 000

Job Description: (check appropriate CLIN) Quantity Length

Daily (1-2 days) $0.00

Weekly (3-7 days) $0.00

Monthly (30 days) $0.00

Handicap Weekly $0.00

Handicap Monthly $0.00

Extra cleaning toilet $0.00

Hand Washing Stations (Daily) $0.00

Hand Washing Stations (Weekly) $0.00

Hand Washing Stations (Monthly) $0.00

Extra clean Hand Washing Stations $0.00

Relocation of units $0.00

Repair/Replace Toilet $0.00

Repair /Replace Hand wash $0.00

Repair/Replace Handicap $0.00

LOCATION: TOTAL $0.00

Regular Toilets

Handicap Toilet

FROM: TO: Hand Wash Stations

Point of Contact Office Phone

Cell

Phone WBS# Verified By

Date

DATE ISSUED BY DPW

FOLLOWING SECTION IS TO BE COMPLETED BY THE COR @ DPW

WORK MEET CONTRACT REQUIREMENTS (CIRCLE YES/NO)

YES NO

DATE

REVISED COR COMMENTS/INSTRUCTIONS:

COR SIGNATURE:

THIS SECTION TO BE COMPLETED BY THE CONTRACTOR

DATE TOILET

PLACED DATE TOILET PICKED UP CONTRACTOR SIGNATURE

WORK PERFORMED:

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