Technical Exhibit K - Moving Request Service Form.pdf
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- Solicitation number
- W91ZLK-25-R-0002
About this file
This is a Moving Service Request Form (Form G4R#) used by the US Army Combat Capabilities Development Command Chemical Biological Center (DEVCOM-CBC) for requesting moving services and cubicle reconfigurations. The two-page form is dated March 7, 2023 and requires information from both the proponent (page 1) and G4 lead (page 2).
The form requires basic requestor information including submission date, requested service date, proponent name, organization (CBC-ENG, CBC-R&O, or CBC-OOD), contact number, division, email, building number, and room number. Users must specify whether they need a move request or cubicle reconfiguration. For move requests, the form includes a statement of work section where requestors must detail what needs to be moved and the destination location. Page 2 contains sections for G4 lead comments, final inspection notes, completion date, inspector identification, and completion signature. Requests are to be submitted via email to usarmy.apg.devcom-cbc.mbx.g4@army.mil.
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Text version
G4R#
MOVING SERVICE REQUEST FORM
Revised 3/7/23 Page 1 of 2
INSTRUCTIONS: PROPONENT, PLEASE FILL OUT INFORMATION ON PAGE 1.
TO SUBMIT PLEASE EMAIL TO: usarmy.apg.devcom-cbc.mbx.g4@army.mil
SUBMISSION DATE REQUESTED SERVICE DATE
PROPONENT NAME ORG ☐ CBC-ENG ☐ CBC-R&O ☐ CBC-OOD
CONTACT# DIVISION
BUILDING# ROOM#
CHOOSE FROM OPTIONS LISTED
☐ MOVE REQUEST ☐ CUBICLE RECONFIGURATION
ADDITIONAL COMMENTS:
PROPONENT SIGNATURE:
X
STATEMENT OF WORK: (If Move Request, please list what you need moved and the location you need it moved to) mailto:usarmy.apg.devcom-cbc.mbx.g4@army.mil
G4R#
MOVING SERVICE REQUEST FORM
Revised 3/7/23 Page 2 of 2
INSTRUCTIONS: G4 LEAD, FILL OUT INFORMATION ON PAGE 2
ADDITIONAL COMMENTS:
FINAL INSPECTION NOTES:
COMPLETION DATE:
INSPECTED BY:
SIGNATURE OF COMPLETION:
X
| PROPONENT NAME: |
| CBCENG: Off |
| CBCRO: Off |
| CBCOOD: Off |
| CONTACT: |
| CBCENG CBCRO CBCOODDIVISION: |
| EMAIL: |
| BUILDING: |
| ROOM: |
| MOVE REQUEST: Off |
| CUBICLE RECONFIGURATION: Off |
| STATEMENT OF WORK If Move Request please list what you need moved and the location you need it moved toRow1: |
| STATEMENT OF WORK If Move Request please list what you need moved and the location you need it moved toRow2: |
| STATEMENT OF WORK If Move Request please list what you need moved and the location you need it moved toRow3: |
| STATEMENT OF WORK If Move Request please list what you need moved and the location you need it moved toRow4: |
| STATEMENT OF WORK If Move Request please list what you need moved and the location you need it moved toRow5: |
| STATEMENT OF WORK If Move Request please list what you need moved and the location you need it moved toRow6: |
| ADDITIONAL COMMENTSRow1: |
| ADDITIONAL COMMENTSRow2: |
| ADDITIONAL COMMENTSRow3: |
| ADDITIONAL COMMENTSRow4: |
| ADDITIONAL COMMENTSRow5: |
| ADDITIONAL COMMENTSRow1_2: |
| ADDITIONAL COMMENTSRow2_2: |
| ADDITIONAL COMMENTSRow3_2: |
| ADDITIONAL COMMENTSRow4_2: |
| ADDITIONAL COMMENTSRow5_2: |
| ADDITIONAL COMMENTSRow6: |
| ADDITIONAL COMMENTSRow7: |
| FINAL INSPECTION NOTESRow1: |
| FINAL INSPECTION NOTESRow2: |
| FINAL INSPECTION NOTESRow3: |
| FINAL INSPECTION NOTESRow4: |
| FINAL INSPECTION NOTESRow5: |
| FINAL INSPECTION NOTESRow6: |
| FINAL INSPECTION NOTESRow7: |
| INSPECTED BY: |
| Date1_af_date: |
| Date2_af_date: |
| Text3: |
| G4R#: |
| Text5: |
| Text6: |
| Date7_af_date: |
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