Form GSA 1678 GSA 1678 Status Report of Orders and Shipments

STATUS REPORT OF
ORDERS AND SHIPMENTS

NOTE: This report is required in accordance
with the terms of the contract and the
instructions on the reverse of this form.

OMB Control Number: 3090-0027
Expiration Date: 11/30/2024

PAGE

OF
PAGES

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a
valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3090-0027. We estimate that it will take 5 minutes to read the instructions, gather the facts, and answer the questions. Send only
comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street,
NW, Washington, DC 20405.
1. TO:

2. NAME OF CONTRACTOR

4. CONTRACT NUMBER

5. REPORT PERIOD COVERED

3. LOCATION OF PLANT
FROM:

6. PURCHASE ORDER DATA
ORDER NUMBER
(a)

NATIONAL STOCK
NUMBER
(b)

7. INSPECTION AND TESTING
QUANTITY
AND UNIT
(c)

DATE
RECEIVED
(d)

DATE DUE
FOR
INSPECTION
(a)

DATE
DATE
OFFERED FOR RELEASED FOR
INSPECTION
SHIPMENT
(b)
(c)

8. DATE DUE FOR
SHIPMENT
DELIVERY AT
DESTINATION

TO:

9. SHIPMENT
DATE
SHIPPED
(a)

QUANTITY
SHIPPED
(b)

10. BALANCE
DUE
QUANTITY

CERTIFICATION - The information reported above and on the attached sheets (if any) has been verified by the undersigned as accurate and complete for the period indicated in block 5.
SIGNATURE OF AUTHORIZED OFFICIAL

GENERAL SERVICES ADMINISTRATION

TITLE

DATE

GSA 1678 (REV. 6/2015)

INSTRUCTIONS
I. GENERAL
A. A report period is from the first through the last day of a calendar month,
notwithstanding that the ordering period applicable to a requirements contract
may not coincide with these dates.
B. Contractors shall report on each new order received during the report period,
and each order shown in a preceding report as not completely shipped. If no
orders are on hand during a report period, a negative report shall be submitted.
C. A separate report shall be submitted for each plant location.
D. Contractors shall continue to furnish reports after the expiration of the contract
period until all shipments required under the contract have been made.
II. SPECIFIC ENTRIES
A. Block 1, Insert mailing address of the office assigned responsibility for the
administration of the contract (unless preprinted).
B. Blocks 2, 4, and 5 are self-explanatory.
C. Block 3, insert city and State. If the contractor has more than one plant in the
same city, insert complete address.
D. Insert page numbers in the spaces provided.

F. Columns 7(a) through 7(c). These columns apply only to contracts which
include an "Availability for Inspection and Testing, and Shipment" (or Delivery)
clause. Entries are not required in these columns if the contractor is authorized
to ship the supplies under a Quality Approved Manufacturer Agreement.
G. Column 8. Insert date based on the time for shipment/delivery provisions of the
contract, or in accordance with any authorized extensions of time for shipment
or delivery.
(NOTE: If the contract includes a "Monthly Supply Potential" (MSP) clause
and the contractor has exercised his option thereunder to extend the
shipping/delivery time with respect to the acceptance of orders for quantities
exceeding his MSP, entries in this column showing extended due dates shall
be asterisked and briefly explained below in the space provided for remarks.)
H. Column 10. If a partial shipment is made, but the unshipped quantity is within
the limitation of the "Variation in Quantity" clause of the contract, and if the
contractor does not intend to include the unshipped quantity with a future
shipment, insert a zero or "none".
I. Certification. The certification is required only on the first page of each monthly
report.

E. Columns 6(a) through 6(d) are self-explanatory.

REMARKS

GSA 1678 (REV. 6/2015) BACK