Free VA Form 10-6001a - Contract Progress Report - Federal



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OMB Approval No. 2900-0208 Estimated burden 12 minutes CONTRACT PROGRESS REPORT TO REPORT FOR PERIOD ENDING Project Manager (087 ) Office of Facilities Department of Veterans Affairs Washington, DC 20420 2. CONTRACT NO. 3. DATE CONTRACT AWARD LOCATION OF PROJECT 1. PROJECT NO. 4. DATE NOTICE TO PROCEED RECEIVED 5. DATE CONSTRUCTION STARTED 6. NAME AND ADDRESS OF CONTRACTOR 7. DESCRIPTION OF CONTRACT 8. ORIGINAL CONTRACT AMOUNT 9. SCHEDULED PERCENT COMPLETION 10. ACTUAL PERCENT COMPLETION 11. ORIGINAL CONTRACT COMPLETION DATE ITEM NO. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53. VA FORM DEC 2005 12. EXTENDED CONTRACT COMPLETION DATE 13. ESTIMATED COMPLETION DATE 14. DATE COMPLETED BRANCH OF WORK (A) TOTAL VALUE (B) VALUE

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OMB Approval No. 2900-0208 Estimated burden 12 minutes

CONTRACT PROGRESS REPORT
TO

REPORT FOR PERIOD ENDING

Project Manager (087 ) Office of Facilities Department of Veterans Affairs Washington, DC 20420
2. CONTRACT NO. 3. DATE CONTRACT AWARD

LOCATION OF PROJECT

1. PROJECT NO.

4. DATE NOTICE TO PROCEED RECEIVED

5. DATE CONSTRUCTION STARTED

6. NAME AND ADDRESS OF CONTRACTOR

7. DESCRIPTION OF CONTRACT

8. ORIGINAL CONTRACT AMOUNT 9. SCHEDULED PERCENT COMPLETION 10. ACTUAL PERCENT COMPLETION 11. ORIGINAL CONTRACT COMPLETION DATE ITEM NO. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. 53.
VA FORM DEC 2005

12. EXTENDED CONTRACT COMPLETION DATE 13. ESTIMATED COMPLETION DATE 14. DATE COMPLETED

BRANCH OF WORK (A)

TOTAL VALUE (B)

VALUE OF WORK IN PLACE-END LAST PERIOD (C)

VALUE OF WORK INSTALLED IN CURRENT PERIOD (D)

SUPPLEMENTAL AGREEMENT - ADD SUPPLEMENTAL AGREEMENT - DEDUCT TOTAL $$$

10-6001a

CONTRACT FISCAL DATA 54. 55. 56. 57. 58. 59. 60. 61. 62. 63. CURRENT CONTRACT AMOUNT (From Item 53, Col. B) VALUE - WORK IN PLACE TO DATE (Item 53, Cols. C plus D) VALUE - UNUSED MATERIALS PREVIOUSLY PAID FOR VALUE - UNUSED MATERIALS PAID FOR THIS PERIOD EARNED TO DATE (Items 55 plus 56 plus 57) RETAINAGE (Based on Item 58 less cost of bond premiums) TOTAL PREVIOUS PAYMENTS PAYMENT THIS PERIOD TOTAL PAYMENT TO DATE (Item 60 plus 61) VALUE - CONTRACT NOT EARNED (Item 54 minus 58)
65. MATERIALS STATUS 66A. WORK PROGRESS 66B. PROGRESS FACTOR

$ $ $ $ $ $ $ $ $ $
67. SUBMISSIONS OVERDUE

64. EQUIPMENT STATUS

CHANGE ORDERS, SUPPLEMENTAL AGREEMENTS, AND TIME EXTENSIONS ITEM NO. SYMBOLS (A) 68A. CO SUPPL. AGREE. PREV. REPORTED, SYM 68B. CO CHANGE ORD., PREV. REPORTED, NO. 68C. FIELD SUPPL. AGREE. PREV. REPORTED, NO. 68D. FIELD CHANGE ORD. PREV. REPORTED, SYM. 69. 70. 71. 72. 73. TIME EXTENS. PREV. REPORTED, NO. ISSUED THIS PERIOD ISSUED THIS PERIOD ISSUED THIS PERIOD ISSUED THIS PERIOD TO TO TO TO TO INCL. INCL. INCL. INCL. INCL. DATE APPROVED (B) DAYS EXTENSION (C) ADDITIONS (D) DEDUCTIONS (E)

74. REMARKS

75. SIGNATURE OF RESIDENT ENGINEER

76. DATE

The Paperwork Reduction Act of 1995 requires us to notify you that this information collection is in accordance with the clearance requirements of section 3507 of the Paperwork Reduction Act of 1995. We may not conduct or sponsor, and you are not required to respond to, a collection of information unless it displays a valid OMB number. We anticipate that the time expended by all individuals who must complete this form will average 12 minutes. This includes the time it will take to read instructions, gather the necessary facts and fill out the form. If your firm does not already have a similar form, this is used to record the data necessary to assure the contractor provides sufficient labor and materials to accomplish the contract work. This form or a similar document is required to guarantee the performance of the work necessary to complete the project.

REVERSE OF 10-6001a, DEC 2005

File Size: 275.0 kB
Pages: 2
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State: Federal
Category: Veterans Forms
Word Count: 477 Words, 3,086 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.va.gov/vaforms/medical/pdf/vha-10-6001a%20.pdf