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Sheet1 (2)
| Electronic Security Systems Service Order Form | |
| PART I - SERVICE ORDER INFORMATION | |
| CONTRACTOR: | Contract Number: |
| FACILITY NAME : | CLIN Number |
| FACILITY LOCATION: | Service Call Date: |
| SO REQUEST NO: | Service Ticket Number: |
| SERVICE ORDER DATE: | Type (Routing, Emergency, PMI): |
| SOW (include LOCATION attach additional sheets as required): | |
Schedule of Completion (DDMMYY):
| PART II - COST SUMMARY | | | | | | |
| LABOR UTILIZED | | | | | | |
| Labor Classification | Reg Labor Hours | Reg Labor Rate | Reg Labor Amount | OT Hours | Contr O/T Rate | OT Amount |
| | | $0.00 | | | $0.00 |
| | | $0.00 | | | $0.00 |
| | | $0.00 | | | $0.00 |
| | | $0.00 | | | $0.00 |
| | | | TOTAL OT LABOR | | $0.00 |
| NOTE: Labor costs included under the FFP will not be billed. | | | | TOTAL REGULAR LABOR | | $0.00 |
| PARTS/MATERIALS/SUPPLIES | | | | |
| Description | Qty | Unit | Unit Price | Amount |
| NOTE: Equipment costs provided under the FFP will not be billed | | | | |
| | | | $0.00 |
| | | | $0.00 |
| | | | $0.00 |
| | | | $0.00 |
| | | | $0.00 |
| | | | $0.00 |
| | | | $0.00 |
| SUBCONTRACTS | | | Sub Total Parts/Materials/Supplies | $0.00 |
| | $0.00 | Material Shipping Cost | $0.00 |
| | $0.00 | Tax (Enter Rate: _______%) | $0.00 |
| | $0.00 | Material Handling ( _______%) | $0.00 |
| | $0.00 | Total Mat/Sup Cost | $0.00 |
| | $0.00 | Total Subcontractor Cost | $0.00 |
| Subtotal Subcontracts | | $0.00 | Total Overtime Labor | $0.00 |
| Subcontractor Handling Charge (Enter Rate) | 0.00% | $0.00 | Total Regular Labor | $0.00 |
| | | Bond (DBA only) | $0.00 |
| Total Subcontractor Price | | $0.00 | Total Service Order Cost | $0.00 |
| TOTAL TO BE INVOICED |
| PART III - AUTHORIZATION | |
| Firm-Fixed Price (FFP) | FFP/NON LABOR | TIME & MATERIALS PRICE |
| (This Service Order) | (This Service Order) | |
| $___________________ | $___________________ | NTE $___________________ |
SIGNED:
| *CONTRACTING OFFICER | DATE |
| *Required if Service Order Cost is over $2,500 | |
| RECEIPT AND ACCEPTANCE IS HEREBY ACKNOWLEDGED | |
| SIGNED: | |
| CONTRACTOR | DATE |
| PART IV - CERTIFICATION OF SERVICES | |
| I certify that the services under the above Service Order have been satisfactorily completed. | |
| SIGNED: | |
| Contracting Office Representative | DATE |
| DATE/TIME WORK COMPLETED | FOR FINAL BILLING OVERTIME LABOR TO BE CHARGED ( ) Yes ( ) No |
| Distribution: | |
| NOTE: SOs up to $2,500 to be approved by COR. Orders above $2,500 must be approved by the Contracting Officer. | RIA Form ESS-1 |
