TRANSFER RECEIPT
DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER
[
City, State
]
[Outpatient Clinic Name]
Lease No. ___________________
[Date]
Acceptance is hereby made by the Department of Veterans Affairs Veterans Health Service and
Research Administration this date, from the Department of Veterans Affairs Office of Facilities, of
[Outpatient Clinic Name], constructed by ________________ under Lease No. ______________.
Such acceptance is made with the recognition that the contractor will complete items of correction
listed on the ____Partial-Final or ____Final Inspection Report and other deficiencies which may
appear prior to the final settlement of the Lease.
It is further understood that this acceptance does not relieve the Developer of any contractual
obligations, including guarantee requirements.
FOR THE DEPARTMENT OF VETERANS AFFAIRS
Veterans Health Service and Research Administration
------------------------------------------
[Signature of Facility Director]
------------------------------------------
Date
FOR THE OFFICE OF FACILITIES
_______________________________
For the Contracting Officer
_______________
[Date]
TRANSFER RECEIPT -- 1 of 1
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