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DHS Material Inspection Report

This material inspection acceptance and receiving report documents the inspection of materials and services received by the Department of Homeland Security. It includes details such as contract and order numbers, descriptions of materials inspected, quantities received and accepted or rejected, and signatures of the inspector and approver.

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Haseeb Rehman
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268 views2 pages

DHS Material Inspection Report

This material inspection acceptance and receiving report documents the inspection of materials and services received by the Department of Homeland Security. It includes details such as contract and order numbers, descriptions of materials inspected, quantities received and accepted or rejected, and signatures of the inspector and approver.

Uploaded by

Haseeb Rehman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DATE

DEPARTMENT OF HOMELAND SECURITY

MATERIAL INSPECTION ACCEPTANCE AND RECEIVING REPORT


1. CONTRACT NO. AND LATEST
MODIFICATION NO.

2. ORDER NO.

3. REPORT NO.

4. MATERIAL AND/OR SERVICES INSPECTED

5. CONTRACTOR

6. LOCATION WHERE ITEMS WERE DELIVERED OR


CONTRACTOR PERFORMED

7. MANUFACTURER

8. PLACE OF INSPECTION

9.

CONTRACT LINE
ITEM NO(S)
(If applicable)

INSPECTION DATES
10. RECEIVED

11. READY

12. STARTED

PREVIOUS
REPORTS

THIS
REPORT

TOTAL TO
DATE

16. SUBMITTED
17. REJECTED
18. ACCEPTED

QUANTITY
13. COMPLETED

14. REJECTED

15. ACCEPTED

19. QUANTITY ON
ORDER
20. ACCEPTED TO
DATE
21. BALANCE
REMAINING

22. REMARKS (Use Continuation Sheet for Additional Entries)

23. INSPECTED BY

24. TITLE AND TELEPHONE NUMBER

The materials and/or services listed herein have been inspected or certified test data has been examined, by me or under my
supervision. The materials and/or services listed above as accepted conform to contract requirements. Those listed as rejected do not
conform and may not be delivered, except as authorized under "Remarks."
25. SIGNATURE AND PRINTED NAME

DHS Form 700-21 (12/03)

26. TITLE AND TELEPHONE NUMBER

27. DATE

DEPARTMENT OF HOMELAND SECURITY

MATERIAL INSPECTION ACCEPTANCE AND RECEIVING REPORT (Continued)


3. REPORT NO.

8.

CONTRACT LINE
ITEM NO(S)
(If applicable)

DHS Form 700-21 (12/03)

INSPECTION DATES
9. RECEIVED

10. READY

11. STARTED 12. COMPLETED

QUANTITY
13. REJECTED

14. ACCEPTED

Page 2

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