Blocks 1 to 7: contract, location and contractor
Contract or task order number, location (street, city and state), program office, contractor's name and address, type of work, whether the contract is for supplies or services, and project number.
GSA219
Contract Deliverable Inspection Report (Internal Acquisitions)
- Agency
- GSA
- Revision
- Rev. 9/2021
- Fillable fields
- 33
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 219: Contract Deliverable Inspection Report (Internal Acquisitions)
GSA Form 219, Contract Deliverable Inspection Report (Internal Acquisitions), is a General Services Administration form dated 9/2021 in its footer. GSA hosts it in its forms library, and GSA's page lists no authority or regulation for it.
The instructions on the back say GSA 219 is used for documenting contract compliance by the Contracting Officer's Representative (COR) prior to initiation of payment for products or services received, on all contracts and task orders awarded by GSA for internal supplies and services. The form says it documents the required separation of duties between the ordering and inspecting functions, and that the COR is the GSA responsible party for accepting the work for payment purposes.
The front has 23 numbered blocks covering the contract and contractor, dollar amounts, the period of performance, the officials involved, the inspection and the COR's approval. The back holds the instructions, two definitions, the final inspection procedure and reinspection costs. You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 219
Blocks 8 to 11: amounts and period of performance
Total obligated amount, total current outstanding amount and total awarded amount in dollars, then the award start date, current period of performance end date and estimated ultimate completion date.
Blocks 12 to 15: the officials
Designated receiving official, Contracting Officer's Representative (COR), contract specialist and contracting officer.
Blocks 16 to 21: the inspection
Type of inspection (initial, interim or final), the dates of the last inspection and this inspection, and yes or no boxes for additional inspections, payment and retainage recommended.
Block 22: condition and recommendations
The general condition of the products supplied or, for service awards, the deliverables submitted, sufficiency of the labor force, delays or corrective actions, recommendations, significant change orders or modifications since the last inspection and the percentage of completion to date.
Block 23: COR approval
The name of the COR, a signature and a date.
How to complete GSA Form 219
- 1
Fill in the contract details
Complete blocks 1 to 15 with the contract or task order, the contractor, the dollar amounts, the period of performance and the officials involved.
- 2
Mark the type of inspection
Check INITIAL, INTERIM or FINAL in block 16, then enter the date of the last inspection and the date of this inspection in blocks 17 and 18.
- 3
Record the recommendations
Answer yes or no in blocks 19 to 21 for additional inspections, payment and retainage recommended.
- 4
Describe the work in block 22
State the condition of the products or deliverables, the labor force, delays or corrective actions, change orders or modifications since the last inspection and the percentage of completion.
- 5
Follow the final inspection procedure
For a final inspection, the instructions say to give the contractor a list of items to correct, furnish the Contracting Officer a copy of the letter, note impracticable items in a supplementary statement and indicate the date the work was completed.
- 6
COR signs block 23
The COR enters a name, signs and dates the COR APPROVAL block.
Why fill Form GSA219 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes and what the form says
Where it goes
The form prints no address. The instructions say the COR is the GSA responsible party for accepting the work for payment purposes, and that the Contracting Officer receives a copy of the letter to the contractor after a final inspection.
Supplementary statement
Items whose completion is not practicable go in a supplementary statement, with a recommendation on the amount, if any, to be deducted from the contract price. The form says a copy should NOT be given to the contractor.
Reinspection costs
The form says costs of extra final inspections are forwarded in separate statement form, including salary, subsistence, transportation and miscellaneous expenses, based on inspection and travel time.
Not a public filing
The form covers contracts and task orders GSA awards for internal supplies and services. The PDF prints no OMB number, burden statement or privacy notice.
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Who uses GSA Form 219?
The form is used by GSA staff on GSA's own internal acquisitions. The instructions and blocks name these people.
Official sources and the blank
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Questions about Form GSA219
Who fills out GSA Form 219?
The instructions say the Contracting Officer's Representative (COR) uses it to document contract compliance before payment is initiated. The COR may inspect the work or oversee the inspection by another GSA employee, and signs block 23.
What contracts does GSA Form 219 cover?
The instructions say it is used on all contracts and task orders awarded by GSA for internal supplies and services.
What is the difference between a COR and a Designated Receiving Official?
The form defines a COR as an individual authorized in writing by the Contracting Officer to perform specific technical or administrative contract functions. A Designated Receiving Official receives and inspects goods or services but has NOT received that authorization.
What does the form say happens after a final inspection?
The contractor gets a list of all items needed to complete the contract, the Contracting Officer gets a copy of that letter, impracticable items go in a supplementary statement, and the Inspector indicates the date the work was completed.
How are extra final inspections recorded?
The form says their costs are forwarded in separate statement form, covering salary, subsistence, transportation and miscellaneous expenses, based on the time for the inspection and for travel.
How is GSA Form 219 different from GSA Form 220?
GSA Form 219 covers GSA contracts and task orders for internal supplies and services. GSA Form 220 says it is used on construction contracts awarded under new construction and repair and alteration programs.