DEP Memorandum on Federal Reimbursement Documentation, September 18, 2001

NYC 9/11 Public Portal Document

MATERIALS RECORD FORM INSTRUCTIONS (materials from inventory or purchased)

Fill in the entire heading. Ensure name, DSR number, time period and category is accurately completed. Please note: use a separate form for each category of work at each worksite.

COLUMN

a Enter vendor's name where materials were purchased (even if taken from stock). b Enter brief description of item. c Enter quantity or amount used for work. d Enter the price of each item (i.e. 1,000 flares @ $2.00 each. $2.00 is the unit price). e Multiply quantity (column c) by unit price (column d) and enter total cost of item. f Enter date materials were purchased (even if taken from stock).

g Enter the number from the check or purchase order/ invoice when material was purchased. h Enter the date/s the material was used. 1 Check either box: If materials were purchased, mark the invoice box. If materials were taken from inventory, mark the stock box.

—Sign-the Materials Record form. Use additiona-i sheets when necessary. Each record needs to be certified. The information to complete this form is available from the purchasing unit and other documents.

Refer to the Applicant's Handbook for materials eligibility.

NYC-WTC_000152518