Exhibit_1_Daily_Inspection_Report.docx

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Fire Suppression, Fire Alarm, Fire Sprinkler Systems Inspection, Testing & Maintenance, JBLM, WA
Solicitation number
W911S8-16-R-0006
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Exhibit 1 Daily Inspection Report

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EXHIBIT 1

DAILY CONTRACT QUALITY CONTROL REPORT

For use of this form, see instructions on reverse

1. CONTRACT NUMBER
3. ABBREVIATED CONTRACT NAME
4. NAME OF CONTRACTOR (COMPANY NAME)

2. TASK ORDER NUMBER

5. NOTICE TO PROCEED
7. WEATHER AND TEMPERATURE
0800 HOURS
1200 HOURS
1500 HOURS

6. ACTUAL DATE STARTED

8a. CONTRACTOR DESCRIBE WORK BEING PERFORMED (INCLUDE LOCATION OF WORK)

8b. NUMBER OF WORKERS ON JOB
Be. NAME OF CONTRACTOR'S REPRESENTATIVE

9. CONTRACTOR RECORD GOVERNMENT REPRESENTATIVE'S INSTRUCTIONS (IF ANY)

10. CONTRACTOR DESCRIBE DIFFICULTIES ENCOUNTERED (INCLUDE DELAYS, DESCRIBE WORK NOT PERFORMED IN ACCORDANCE WITH THE CONTRACT, CORRECTIVE ACTIONS, ETC.)

11. GOVERNMENT REPRESENTATIVE COMMENTS TO ITEMS 8, 9, AND 10; WAS A SITE INSPECTION PERFORMED OF ANY WORK?
YESDATE OF INSPECTIONNOD N/AD

12. PROJECT MANAGER REVIEW/COMMENTS

13. CONTRACT LEGAL COMPLETION DATE
14. PERCENT COMPLETE
15. CONTRACTOR'S QUALITY CONTROL SIGNATURE
DATE SIGNED
16. QUALITY ASSURANCE SIGNATURE
DATE SIGNED
17. PROJECT MANAGER REVIEW SIGNATURE
DATE SIGNED
18. COR OR CO SIGNATURE
DATE SIGNED
19. REPORT IS FOR DATE(S)
20. REPORT SERIAL NUMBER

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EXHIBIT I

INSTRUCTIONS FOR FILLING OUT DAILY CONTRACT QUALITY CONTROL REPORTS

A. CONTRACTOR'S INSTRUCTIONS -GENERAL:

1. Fill out a report each day when work is in progress, and not less than one each week when no work is proceeding.

2. The Government encourages electronic delivery of these reports via E-MAIL attachments; however, if you have to hand-deliver the reports. give them directly to the Quality Assurance Evaluator (QAE). or deliver them to ESD in Building 2012. Delivery of the report may also be by FAX. The E-MAIL addresses of the assigned Government QAE, Project Manager, and Project Team Members will be provided by the Government. FAX number will also be provided. If you have to mail the Quality Control Reports for a period when no work is being accomplished. mail them to: Public Works (PW), ATTN: IMWE-LEW-PWF, MS 17, Box 339500, Fort Lewis, WA 9S433-9500.

3. If you have any questions about the Daily Contract Quality Control Report, contact your assigned Government QAE or assigned Project

B. CONTRACTOR'S INSTRUCTIONS -SPECIFIC: (Information for filling in the report).

BLOCKS 1-6 Fill in the Contract Number, Task Order Number (if applicable), Abbreviated Contract Name; your company's name, the date you were given the Notice to Proceed (NTP) by the Contracting Officer, and the date you started work on the contract.

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BLOCK 7

BLOCK Sa

BLOCK Sb BLOCK Be BLOCK 9

BLOCK10

BLOCK13

BLOCK14

BLOCK 15

BLOCK19

BLOCK 20

If the weather affects your contract, record it here; if you are working indoors, leave it blank.

Write in what you've been doing and what you've been working on in detail in this block. Include the location of the work, facility/ building number, and names of subcontractors working. Identify the delivery dates and quantities of any major equipment scheduled for installation when it arrives. Identify commencement and completion of construction phases when they occur (Examples: "started demo work on Bldgs XXX, YYY", "finished demo work on Bldgs XXX, YYY"; "started boiler installation in Bldgs XXX. YYY"; "finished boiler work in Bldgs XXX. YYY"). In addition to the above, identify any other activities you consider pertinent to the project. Use additional pages if necessary.

Write in the number of workers on the job consistent with the work described in Block Sa.

Write in the name of the contractor's representative on the job at the time the work described in Block Sa was being performed. Write in any instructions given to you by the Government QAE, Contracting Officer's Representative (COR), or Project Manager. Write in any problems you may have encountered.

Write in the legal completion date (LCD) of contract. Write in estimated percent of work completed.

The Contractor Quality Control Representative signs and dates here. This date must be consistent with the date of your signature;

do not backdate.

Write in the date(s) or period(s) covered by the report. This is NOT the day you turn it in.

This is a sequential report number (Example: If it's the eleventh report you are turning in, write in "11").

C. QUALITY ASSURANCE EVALUATOR'S INSTRUCTIONS:

BLOCK 11

BLOCK16

QAE evaluate the input given by the contractor. If you have performed an inspection of the work identified by the contractor in BlockS, indicate this by checking "YES"; record the date of inspection. If no, check "NO". If the work involved does not require inspection, check "N/A". Provide any input, comments, etc., which are or may be relevant to the evaluation of the contractor's work. Coordinate input requiring any further action with Engineering (Project Manager, COR, Assigned Lead, etc.) and/or Contractor, if required. Identify these actions on the report.

Sign and date the report. Forward the report to the Project Manager or COR if further action is required; if no further action is required file the report in the electronic files designated for the project. If the report was not submitted in electronic format, scan the hard copy for the electronic file.

D. ENGINEERING INSTRUCTIONS: (Project Manager or COR review report; add comments, if any, and /or attach comments; initiate any action required based on your review).

BLOCK 12

BLOCK 17

Write in the results of any reviews, and/or include any related pertinent comments; cross reference any related reports or provide attachments if required.

Sign and date report.

E. COR/CO INSTRUCTIONS: BLOCK18 Sign and date report.

F. COPY DISTRIBUTION: QAE, COR, or Project Manager provides the contractor a copy of all reports that have Government comments added.

File details come from the government source that posted it. Updated .