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The documents on this page are PDF files identified by the symbol Adobe pdf symbol and require the free Adobe Acrobat Reader Software.

Bureau Forms

 

Other DEP Forms
File
Size		 Effective
Date		 Form
Number		  Form Name
26KB 07/2011 Microsoft Word symbol 55-001 General Release
85KB 02/2012 Microsoft Word symbol 55-002 Monthly Vehicle / Equipment Usage Log
29KB 02/2012 Microsoft Word symbol 55-003 State Fuel Card PIN Assignment Request
77KB 06/2012 Microsoft Word symbol 55-004 Florida Fuel and Maintenance Card Program Card User Agreement
40KB 07/2008 Microsoft Word symbol 55-005 Monthly Log Receipt Submittal Form
43KB 03/2012 Microsoft Word symbol 55-006 Monthly Miscellaneous State Fuel Card Usage Log
33KB 11/2011 Microsoft Word symbol 55-007 State Fuel Card Replacement Receipt Form
36KB 08/2010 Microsoft Word symbol 55-008 DEP New / Replacement State Fuel Card Acceptance Form
37KB 07/2012 Microsoft Word symbol 55-009 State Fuel Card Request Form
n/a 08/2007 Microsoft Internet Explorer 7 symbol 55-109 Copy Center Duplicating Request Form (only available with access to DEP Intranet)
38KB 08/2012 Microsoft Word symbol 55-200 Contract Reprocurement Summary Form
48KB 03/2002 Microsoft Word symbol 55-201 Emergency/Single Source/Contract Exception Procurement
118KB 08/2010 Microsoft Word symbol 55-202 Contract Initiation Form
564KB 10/2008 Microsoft Excel symbol 55-203 Contract/Grant Review Form [guide]
44KB 03/2002 Microsoft Word symbol 55-204 Telephone or Verbal Quotation Form
123KB 08/2010 Microsoft Word symbol 55-205 Standard Form Contract
26KB 03/2002 Microsoft Word symbol 55-206 Standard Form Amendment
28KB 06/2006 Microsoft Excel Symbol 55-207 Contract Budget Form
30KB 08/2010 Microsoft Word symbol 55-208 Separation of Duties Notice
72KB 06/2005 Microsoft Word symbol 55-209 Federal Sub-recipient and Vendor Determination Checklist
32KB 12/2010 Microsoft Word symbol 55-210 Certification of Applicability to Single Audit Act Reporting
38KB 08/2010 Microsoft Word symbol 55-211 Property Reporting Form
36KB 08/2010 Microsoft Word symbol 55-212 Property Reporting Form
36KB 07/2008 Microsoft Word symbol 55-214 Grant Agreement Information Sheet
66KB 03/2009 Microsoft Word symbol 55-215 Single Audit Act (Special Audit Requirements)
66KB 12/2012 Microsoft Word symbol 55-217 Subcontractor Utilization Report Form
45KB 03/2002 Microsoft Word symbol 55-218 Liquidated Damages Assessment
38KB 05/2008 Microsoft Word symbol 55-219 Contract Payment Requirements (Cost Reimbursement Contracts)
33KB 03/2002 Microsoft Word symbol 55-220 General Provisions (Debarment/Suspension/Ineligibility)
57KB 03/2002 Microsoft Word symbol 55-221 General Provisions (Disclosure of Lobbying Activities)
59KB 08/2010 Microsoft Word symbol 55-222 Advance Payment Justification Form
50KB 07/2010 Microsoft Word symbol 55-223 Payment Request Summary Form
39KB 08/2010 Microsoft Word symbol 55-224 Memo for Closure of Grant Agreement
47KB 08/2002 Microsoft Word symbol 55-225 Grant Managers Evaluation of Grantee Performance
91KB 08/2009 Microsoft Word symbol 55-226 Sample - State of Florida Grant Assistance
119KB 08/2009 Microsoft Word symbol 55-227 Sample - State of Florida Grant Agreement
57KB 08/2002 Microsoft Word symbol 55-228 Progress Report Form
44KB 07/2010 Microsoft Excel symbol 55-229 DEP Budget-Cost Analysis Form
70KB 08/2011 Microsoft Word symbol 55-230 Federal Funding Accountability and Transparency Act Form Information for a Subaward to a Recipient
38KB 12/2012 Microsoft Word symbol 55-231 Bureau of Finance & Accounting Review Form for DEP 55-230
29KB 09/2011 Microsoft Word symbol 55-232 Certification Regarding Scrutinized Companies Lists
63KB 09/2006 Microsoft Word symbol 55-241 Exemption from Workers Compensation Insurance Requirements for Non-Construction Organizations ONLY
93KB 12/2010 Microsoft Word symbol 55-244 MyFloridaMarketPlace   Add/Change/Delete Request Form
117KB 08/2010 Microsoft Word symbol 55-253 Guide for Completing the Florida Single Audit Act Checklist for Non-State Organizations - Recipient/Sub-recipient vs. Vendor Determination
(Checklist Form Appearance - Instruction by Number Version)
79KB 12/2005 Microsoft Word symbol 55-254 Guide for Completing the Florida Single Audit Act Checklist for Non-State Organizations - Recipient/Sub-recipient vs. Vendor Determination
(DEP Reformat of Original Checklist with Instructions)
81KB 12/2005 Microsoft Word symbol 55-255 Guide for Completing the Federal Sub-recipient and Vendor Determination Checklist
(Checklist Form Appearance - Instruction by Number Version)
71KB 12/2005 Microsoft Word symbol 55-256 Guide for Completing the Federal Sub-recipient and Vendor Determination Checklist
(DEP Reformat of Original Checklist with Instructions)
188KB 07/2012 Microsoft Excel symbol 55-263 Invoice Approval Form for Contracts/Grants/MFMP Service Direct Orders
155KB 08/2011 Microsoft Excel symbol 55-264 Invoice Approval Form for Recurring Charges
76KB 12/2012 Microsoft Word symbol 55-301 Purchasing Card - Cardholder Profile Information
312KB 12/2012 Microsoft Word symbol 55-302 Purchasing Card - Within Division Transfer Form
48KB 10/2009 Microsoft Word symbol 55-303 Purchasing Card - Emergency Card Profile Information
46KB 05/2010 Microsoft Word symbol 55-304 Purchasing Card Reviewer Information
26KB 04/2004 Microsoft Word symbol 55-305 Purchasing Card Exam
26KB 10/2009 Microsoft Word symbol 55-306 State Purchasing Card Cardholder Agreement
34KB 07/2012 Microsoft Word symbol 55-307 Purchasing Card Replacement Receipt Form
32KB 03/2012 Microsoft Word symbol 55-308 Purchasing Card Property Number Request
95KB 06/2011 Microsoft Word symbol 55-310 Purchasing Card Receipt Submittal
99KB 12/2012 Microsoft Word symbol 55-311 Purchasing Card Transaction Reconciliation
111KB 08/2000 Microsoft Word symbol 55-313 Purchase Order Requisition
11KB 08/2000 Microsoft Word symbol 55-314 Tallahassee Purchase Orders
41KB 08/2000 Microsoft Word symbol 55-315 Telephone Or Verbal Quotation Form
34KB 08/2010 Microsoft Word symbol 55-316 Emergency/Single Source/Contract Exception Procurement
33KB 02/2011 Microsoft Excel Symbol 55-317

Partial Payment Tracking for MFMP Direct Orders
28KB 08/2010 Microsoft Word symbol 55-318 Purchase Order Change Request
29KB 05/2011 Microsoft Word symbol 55-319 Criteria For Evaluating Copying Requirements And Cost
23KB 08/2010 Microsoft Word symbol 55-320 Field Purchase Orders
27KB 08/2010 Microsoft Word symbol 55-321 FPO Book Issuance Request
84KB 04/2004 Microsoft Word symbol 55-322 FPO Authorization Log
37KB 04/2004 Microsoft Word symbol 55-323 Report Of Unissued Field Purchase Orders
40KB 04/2004 Microsoft Word symbol 55-324 Field Purchase Order Delegation Of Authority
26KB 08/2010 Microsoft Word symbol 55-325 American Express Charge Card Request
39KB 08/2011 Microsoft Word symbol 55-326 Sprint Nextel Consolidation Account User Add/Change/Delete Request Form
40KB 01/2010 Microsoft Word symbol 55-327 Verizon Consolidation Account User Add/Change/Delete Request Form
23KB 08/2010 Microsoft Word symbol 55-401 Permanent Property Transfer
53KB 02/2013 Microsoft Word symbol 55-402 Property Loan Agreement
44KB 06/2004 Microsoft Word symbol 55-403 Property Custodian Delegation
36KB 02/2012 Microsoft Word symbol 55-404 Report of Missing Inventory Items
37KB 12/2011 Microsoft Word symbol 55-405 Donated Property Report
97KB 07/2012 Microsoft Word symbol 55-406 Certification of Surplus Property
22KB 03/2009 Microsoft Word symbol 55-407 Surplus Property Disposal Certification/Receipt
34KB 12/2011 Microsoft Word symbol 55-408 Request for Vehicle/Trailer Tag Replacement
26KB 08/2004 Microsoft Word symbol 55-409 Request for Trade of Equipment
39KB 08/2010 Microsoft Word symbol 55-412 Records Transfer Form
41KB 08/2010 Microsoft Word symbol 55-413 Records Disposition Document
23KB 08/2010 Microsoft Word symbol 55-414 Florida Property Insurance Trust Fund - Property Schedule
27KB 08/2010 Microsoft Word symbol 55-415 Request for Builders Risk Insurance Coverage
33KB 08/2010 Microsoft Word symbol 55-416 Records Retrieval Request

 

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Related Department of Management Services Forms

File
Size		 Effective
Date		 Form
Number		 Form Name
130KB 06/2005 Microsoft Word symbol  MP6301 Request for Purchase of Mobile Equipment
22KB 09/2000 Microsoft Word symbol  FORM Sub-Compact Exemption
57KB 06/2002 Microsoft Word symbol  FORM Performance Bond Waiver
780KB 05/2005 Adobe pdf symbol  MP6401

Request for Disposal of Mobile Equipment
33KB 06/1988 Microsoft Word symbol  6401B Equipment Without Commercial Value

 

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Procedures and Other Forms

File
Size		 Effective
Date		 Form
Number		 Form Name
27KB 01/2001 Microsoft Word symbol Document AMERICAN EXPRESS Corporate Card Application
34KB 01/2003 Microsoft Excel Symbol DFS DI4-261 Auto Accident Report
69KB 07/2005 Microsoft Word symbol FSAA-CSFA Agency Request Form for New CSFA Project Number
31KB 06/2002 Microsoft Word symbol Document Contract Provisions
93KB 08/2010 Microsoft Word symbol Document Division/District Location Codes
n/a 11/2005 DFS DO-850 Coverage Request Form - Notice: DO NOT submit form electronically.  Print and email (Sean.Webster@dep.state.fl.us or Leon.Scott@dep.state.fl.us), fax (850-412-0765)
or mail (MS95)
89KB 07/2005 Microsoft Word symbol DFS-A2-PD Florida Single Audit Act State Project Determination Checklist
85KB 07/2005 Microsoft Word symbol DFS-A2-NS Florida Single Audit Act Checklist for Non-State Organizations
Recipient/Sub-recipient VS. Vendor Determination
1,842KB 07/2008 Microsoft Word symbol Document DEP State Fuel Card Reporting Instructions
96KB 01/2003 Microsoft Word symbol DFS DI4-1403 General Liability Loss Report
46KB 06/2000 Microsoft Word symbol DFS DI4-854 Notice of Property Loss
27KB 11/2003 Microsoft Word symbol Document Purchasing Card Commodities Exam
25KB 03/2004 Microsoft Word symbol Document Regulations
23KB 03/2004 Microsoft Word symbol Sample Memo to Division/District Safety Program Coordinators
23KB 03/2004 Microsoft Word symbol Sample Accident Reimbursement Memo to Revenue Section
51KB 04/2002 Microsoft Word symbol Document Single Audit Report Review Checklist
26KB 03/2004 Microsoft Word symbol Document Commercial Card Claims - Statement of Disputed Items
32KB 06/2000 Microsoft Word symbol DFS DI4-855 Statement - Lightning Loss
235KB 03/2004 Microsoft Word symbol Sample Transmittal Letter to Department of Financial Services
14KB 03/2004

Adobe pdf symbol Document

 Voyager Petroleum Fleet Card Usage Procedures 
97KB 03/2004 Microsoft Word symbol Document Quality Assurance Contract Language
24KB 03/2004 Adobe pdf symbol Document Disposal of Surplus Tangible Personal Property

 

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Last updated: May 22, 2013

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