10-6001A VA Form 10-6001a Contract Progress Report

OMB Approval No. 2900-0208
Estimated burden 12 minutes

REPORT FOR PERIOD ENDING

CONTRACT PROGRESS REPORT
TO

Project Manager (087 )
Office of Facilities
Department of Veterans Affairs
Washington, DC 20420

1. PROJECT NO.

2. CONTRACT NO.

LOCATION OF PROJECT

3. DATE CONTRACT AWARD

6. NAME AND ADDRESS OF CONTRACTOR

4. DATE NOTICE TO PROCEED RECEIVED

5. DATE CONSTRUCTION STARTED

7. DESCRIPTION OF CONTRACT

8. ORIGINAL CONTRACT AMOUNT

12. EXTENDED CONTRACT COMPLETION DATE

9. SCHEDULED PERCENT COMPLETION
10. ACTUAL PERCENT COMPLETION

13. ESTIMATED COMPLETION DATE
14. DATE COMPLETED

11. ORIGINAL CONTRACT COMPLETION DATE
ITEM
NO.

BRANCH OF WORK

TOTAL VALUE

(A)

(B)

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.

SUPPLEMENTAL AGREEMENT - ADD

52.

SUPPLEMENTAL AGREEMENT - DEDUCT
TOTAL

53.
VA FORM
DEC 2005

10-6001a

$$$

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

VALUE OF WORK INSTALLED
IN CURRENT PERIOD
(D)

CONTRACT FISCAL DATA
54.

CURRENT CONTRACT AMOUNT (From Item 53, Col. B)

55.

VALUE - WORK IN PLACE TO DATE (Item 53, Cols. C plus D)

56.

VALUE - UNUSED MATERIALS PREVIOUSLY PAID FOR

57.

VALUE - UNUSED MATERIALS PAID FOR THIS PERIOD

58.

EARNED TO DATE (Items 55 plus 56 plus 57)

59.

RETAINAGE (Based on Item 58 less cost of bond premiums)

60.

TOTAL PREVIOUS PAYMENTS

61.

PAYMENT THIS PERIOD

62.

TOTAL PAYMENT TO DATE (Item 60 plus 61)

63.

VALUE - CONTRACT NOT EARNED (Item 54 minus 58)

64. EQUIPMENT STATUS

$
$
$
$
$
$
$
$
$
$

65. MATERIALS STATUS

66A. WORK PROGRESS

66B. PROGRESS FACTOR

67. SUBMISSIONS OVERDUE

CHANGE ORDERS, SUPPLEMENTAL AGREEMENTS, AND TIME EXTENSIONS
ITEM
NO.

DATE
APPROVED
(B)

SYMBOLS
(A)

68A. CO SUPPL. AGREE. PREV. REPORTED, SYM

TO

INCL.

68B. CO CHANGE ORD., PREV. REPORTED, NO.

TO

INCL.

68C. FIELD SUPPL. AGREE. PREV. REPORTED, NO.

TO

INCL.

68D. FIELD CHANGE ORD. PREV. REPORTED, SYM.

TO

INCL.

69.

TIME EXTENS. PREV. REPORTED, NO.

TO

INCL.

70.

ISSUED THIS PERIOD

71.

ISSUED THIS PERIOD

72.

ISSUED THIS PERIOD

73.

ISSUED THIS PERIOD

DAYS
EXTENSION
(C)

ADDITIONS

DEDUCTIONS

(D)

(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