Schedule 5-6 Duplicating Facility Report

Duplicating Facility Report

REPORT PERIOD ENDING

Region :

03

Schedule 5-6

9/30/2007

Schedule

5-6

NAME OF DEPARTMENT OR AGENCY

Name and address of activity

0

Department of Energy

0

0

0

0

Part I - COST INFORMATION FOR FISCAL YEAR

ITEM

STAFFING

OPERATIONS OTHER THAN

DUPLICATING /1

DUPLICATING /2

ADMIN

PRODUCTION

(COLUMN A)

(COLUMN B)

Staff personnel and salaries

Cost of paper, ink, etc.. (Cost per 1000 units=$11.49)

Depreciation of equipment

Amount spent for repairs

Allowance for space used Sq. Footage:

Amount spent for rentals

TOTAL COST

$-

$-

1 / Include in column A cost of all duplicating, including

2/ Include in column B cost of all operations not

but not limited to, platemaking, duplicating, scoring

involving duplicating (column A). Cost to be

numbering, folding, collating, drilling, stitching, tying

included in column B will include, but not be

padding, trimming, wrapping, and all other operations

restricted to, addressing, distribution, camera

necessary to complete the duplicating or binding

work (other than lithographic), photostating, etc.

PART II - PRODUCTION INFORMATION FOR FISCAL YEAR

EQUIPMENT

#Machine in each

Number of Originals

Total Produced

UNITS PER IMPRESSION

Category Reported

or Plates

Exchanging Overruns

(Column C)

(Column D)

(Column E)

(Column F)

11" X 17" or less

1

(Maximum image 10 3/4" X 14")

11" X 17" or less, tandem

2

(Maximum image 10 3/4" X 14")

Electrostatic Duplicators *

(Staffed):

Rated speed 70-89 cpm

1

Rated speed over 89 cpm

1

Other (Specify)

TOTAL PRODUCED IN FACILITY FOR FISCAL YEAR

0

Cost per 1000 Units (Total cost of duplicating)

Err:502

FORMULA: Part I , Col A / Part II, Col F. (Drop last 3 digits of Col F when computing cost / 1000)

NAME / TITLE OF PERSON IN CHARGE

SIGNATURE

DATE SIGNED

* Electrostatic duplicators include, but are not limited to, Xerox 8000 and 9000 series; Kodak 100 AF's, 150 AF's, and 250 AF's and IBM Copier III's when

used in a duplicating facility.

Duplicating Facility Report

Region :

03

PART III - EQUIPMENT INVENTORY

Schedule

5-6

NAME OF DEPARTMENT OR AGENCY

NAME AND LOCATION OF PLANT

FOR PERIOD

Department of Energy

0

ENDING

0

0

9/30/2007

DESCRIPTION

Age

Condition

INSTALL

Status

Years

See *

Serial Number

MODEL

DATE

See **

Duplication:

Binding:

* CONDITION : N=NEW, E=EXCELLENT, G=GOOD, F=FAIR, P=POOR, U=UNSERVICABLE

** STATUS: "ADDED" OR "DELETED" when applicable

Duplicating Facility Report

Region :

03

PART III - EQUIPMENT INVENTORY

Schedule

5-6

NAME OF DEPARTMENT OR AGENCY

NAME AND LOCATION OF PLANT

FOR PERIOD

Department of Energy

0

ENDING

0

0

9/30/2007

DESCRIPTION

Age

Condition

INSTALL

Status

Years

See *

Serial Number

MODEL

DATE

See **

Binding Continues:

* CONDITION : N=NEW, E=EXCELLENT, G=GOOD, F=FAIR, P=POOR, U=UNSERVICABLE

** STATUS: "ADDED" OR "DELETED" when applicable