GSA3423

Mechanical Contract Inspection Report

Agency
GSA
Revision
Rev. 5/2010
Fillable fields
301
Pages
2
Official source
GSA form page
Checked
October 20, 2026
Fill GSA3423 online
Page 1 of form GSA3423

GSA Form 3423: Mechanical Contract Inspection Report

GSA Form 3423, Mechanical Contract Inspection Report, is a General Services Administration form, GSA 3423 (REV. 5/2010), hosted in GSA's forms library. The form says it will be used for the Inspection of areas and equipment under mechanical contracts by inspectors to record results.

The header names the building, report number, contract number and inspection, the inspector, the start and completion times, the reviewer and the contractor's receipt. The form says the condition of the area(s) and equipment will be rated SATISFACTORY, UNSATISFACTORY, or OUT OF SERVICE, and to explain unsatisfactory or out of service rating in remarks. A table on the front and a continuation table on the back hold one row per location and piece of equipment.

The form prints no OMB number or privacy statement. You can fill it out free in your browser on this page and download the result without an account.

Top of page 1 of GSA Form 3423: Mechanical Contract Inspection Report, as printed by GSA

What's on GSA Form 3423

Building and contract

Building, report number, contract number and a block labeled Inspection.

Inspector and time

Inspector's name (print), inspector's signature, and the time the inspection started and was completed.

Review and contractor's receipt

Reviewed by with a date, and the contractor's receipt with the contractor's signature, time and date.

Inspection table

Location (mechanical area), equipment number, type of equipment, condition checked as satisfactory, unsatisfactory or out of service, remarks, and initial and date.

Back: continuation table

The back, marked GSA 3423 (REV. 5/2010) BACK, repeats the same table columns for more rows.

How to complete GSA Form 3423

  1. 1

    Fill in the header

    Enter the building, report number, contract number and inspection, then the inspector's printed name.

  2. 2

    Record the time

    Enter the time the inspection started and the time it was completed.

  3. 3

    Rate each area and piece of equipment

    For each row, enter the location, equipment number and type, and check one condition: satisfactory, unsatisfactory or out of service.

  4. 4

    Explain unsatisfactory ratings

    The form says to explain unsatisfactory or out of service rating in remarks, then initial and date the row.

  5. 5

    Sign, review and record receipt

    The inspector signs, the reviewer adds a name and date, and the contractor signs the receipt with the time and date.

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Where it goes and what the form says

Purpose stated on the form

The form says it will be used for the Inspection of areas and equipment under mechanical contracts by inspectors to record results.

Ratings stated on the form

The condition of the area(s) and equipment will be rated SATISFACTORY, UNSATISFACTORY, or OUT OF SERVICE, with unsatisfactory or out of service ratings explained in remarks.

No routing printed

The form prints no mailing address or submission instructions. The contractor's receipt block records when the contractor received it.

What the form does not print

No OMB number, privacy statement, authority or deadline appears on the form, and GSA's page lists no authority or regulation.

Related forms

Who fills out GSA Form 3423?

  • The inspector

    The form says inspectors use it to record results. The inspector prints a name and signs in the header.

  • Row initials and date

    Each row of the table ends with an INITIAL AND DATE column, so every entry carries initials and a date.

  • The reviewer

    A REVIEWED BY block with a date sits below the time started and completed.

  • The contractor, on receipt

    The CONTRACTOR'S RECEIPT block takes the contractor's signature, the time and the date.

The instructions and signature blocks on the front show these roles.

Official sources and the blank

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Questions about Form GSA3423

Who issues GSA Form 3423?

The footer reads GENERAL SERVICES ADMINISTRATION and GSA 3423 (REV. 5/2010). GSA hosts it in its forms library.

What is GSA Form 3423 used for?

The form says it will be used for the Inspection of areas and equipment under mechanical contracts by inspectors to record results.

What ratings does the form use?

The form says the condition of the area(s) and equipment will be rated SATISFACTORY, UNSATISFACTORY, or OUT OF SERVICE. Each row has a check column for each rating.

What goes in the Remarks column?

The form says to explain unsatisfactory or out of service rating in remarks.

Does the contractor sign GSA Form 3423?

The header has a CONTRACTOR'S RECEIPT block with the contractor's signature, the time and the date.

Is there more room for equipment rows?

Yes. The back page, marked GSA 3423 (REV. 5/2010) BACK, continues the same table with location, equipment, condition, remarks and initial and date columns.