VA 10101 Contractor Production Report

CONTRACTOR PRODUCTION REPORT

OMB No.: 2900-0208
Exp. Date: Mar 31. 2022
Respondent Burden: 24 Minutes
DATE

(Attach additional sheets if necessary)

CONTRACT NUMBER

REPORT NUMBER

TITLE AND LOCATION (Title and Location of Construction Contract)

CONTRACTOR

SUPERINTENDENT

AM WEATHER (Weather data, include precipitation & winds)

PM WEATHER (Weather data, include precipitation & winds)

MAX TEMP (F)

MIN TEMP (F)

WORK PERFORMED TODAY
SCHEDULE ACTIVITY NO.

WORK LOCATION AND DESCRIPTION

EMPLOYER

NUMBER

TRADE

HOURS

JOB SAFETY
WAS A JOB SAFETY MEETING HELD THIS DATE?
(If YES, attach copy of the meeting minutes)

YES

NO

TOTAL WORK HOURS ON JOB SITE, THIS
DATE, INCL CON'T SHEETS

WERE THERE ANY LOST TIME ACCIDENTS THIS DATE?
(If YES, attach copy of completed OSHA report)

YES

NO

CUMULATIVE TOTAL OF WORK HOURS
FROM PREVIOUS REPORT

WAS CRANE/MANLIFT/TRENCHING/SCAFFOLD/HV ELEC/HIGH WORK/HAZMAT
WORK DONE? (If YES, attach statement or checklist showing inspection performed)

YES

NO

TOTAL WORK HOURS FROM START OF
CONSTRUCTION

LIST ANY SAFETY ACTION TAKEN TODAY/SAFETY
INSPECTION CONDUCTED
(Include any safety topic covered during the safety meeting)

SCHEDULE
ACTIVITY NO.

SAFETY REQUIREMENTS
HAVE BEEN MET

EQUIPMENT/MATERIAL RECEIVED TODAY TO BE INCORPORATED IN JOB (Indicate a schedule activity number)
SCHEDULE ACTIVITY NO.

SUBMITTAL NUMBER

DESCRIPTION OF EQUIPMENT/MATERIAL RECEIVED

CONSTRUCTION AND PLANT EQUIPMENT ON JOB SITE TODAY, INDICATE
HOURS USED AND SCHEDULE ACTIVITY NUMBER
SCHEDULE ACTIVITY NO.

SCHEDULE ACTIVITY NO.

CONTRACTOR/SUPERINTENDENT

OWNER

DESCRIPTION OF CONSTRUCTION EQUIPMENT USED TODAY (Include Make and Model)

REMARKS

DATE REPORT PREPARED

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 be average 24 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.
VA FORM
JUL 2018

10101