Attachment 04 - Samples of Records-Reports and Forms.pdf
PDF 688 KB Posted
- Solicitation number
- W911RX-22-Q-0041
View the file
Other files
Show all 24
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
Attachment 4
Samples of Records, Reports, and Forms
The Contractor may utilize the samples of contract reports below when developing, preparing, maintaining records, reports, and forms required to be submitted in this contract.
Daily Quality Control Report
Service Order Procedure Sheet
Washer and Dryer Maintenance and Repair Service Order Log
Monthly Report
DAILY QUALITY CONTROL REPORT
(Contractor’s Name and Address)
Contract No: W911RX- Date: Report No:
Description and Location of Work:
Weather: ; Temperature: Min Max ; Precip: Inches Type
Contractor/Subcontractors: (Areas of responsibility and labor count for each.)
a.
b.
c.
d.
e.
f.
Equipment Data: (Indicate Items of construction equipment, other than hand tools, at the job site, and whether or not used.)
Work Performed Today: Estimated % Complete
Results of Surveillance: (Include satisfactory work inspected, deficiencies found, corrective actions taken, and when corrective actions are completed and reinspected.)
Material Inspected: (Include any material arrived on site, also material incorporated in the construction.)
DAILY QUALITY CONTROL REPORT - Page 2 (Contractor’s Name and Address)
Tests Required, Performed and Results:
Instructions Received or Given: (Include any instructions received from, or given to, Government representatives or other
Government contractors.)
Remarks: (Include any item not addressed in other sections, problems with plans or specifications, any disputes.)
Safety: (Note all unsafe conditions, equipment, personnel, surroundings and corrective actions, also safety meetings.)
Correspondence:
Documents on Work Site yes no Submittal Date Date Approved
Plans Number Sent Received yes no
Specifications
Manufacturer’s Installation Instructions
Shop Drawings
Permits
Other:
Signature of Quality Control Inspector _____________________________________________________
Signature of Quality Control Manager _____________________________________________________
NOTICE
Service Order Procedure Sheet
CUSTOMERS,
THIS NOTICE IS TO INFORM YOU THAT IF A WASHER OR DRYER NEEDS REPAIRED, PLEASE CALL
DPW HOUSING BRANCH AT 239-2727, 24 HOURS A DAY. IF THERE IS NO ANSWER PLEASE LEAVE A
MESSAGE. PLEASE PROVIDE THE LOCATION OF MACHINE REQUIRING REPAIR, THE MACHINE
NUMBER (EXAMPLE: WASHER W100 OR DRYER D120), AND DESCRIPTION OF THE ISSUE WITH THE
MACHINE. THE CONTRACTOR HAS A LIMITED TIME TO FIX THE MACHINES. IF THE MACHINE IS NOT
FIXED WITHIN TWO WORKING DAYS, PLEASE CALL AGAIN SO APPROPRIATE ACTION CAN BE
TAKEN.
DPW HOUSING BRANCH 785-239-2727
Washer and Dryer Maintenance and Repair Service Order Log Contract Number:
Contractor:
Service Order Number
Date Reported
Building Number
Floor
Machine Number
Caller Name/Unit
Caller Number
Reported Malfunction Nature of Repairs
Date Repair
Completed Technician
Initials
Monthly Report Contract Number:
Contractor:
Month:
Building Number
Floor
Machine Number
Date Maintenance
Performed Task Completed Repairs Made Technician
Initials
File details come from the government source that posted it. Updated .