Photo of two staff members talking

Office of Logistics Management

 




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OLM Forms & Catalogs

  • By Department:

  • Logistics Management
  • Property Administration  
  • Records Retention
  • Warehouse Catalogs

  • By Materials Form Number:
  • LM-1   -   Move Request (instructions)
  • LM-2   -   Removal Request (instructions)
                  
    Movable Assets, Computer Software,
                 
    Fixed/Building Service Systems Assets
     
  • LM-3    -  e-Portal Authorization - UCH
    LM-3B  -  Logistics Management Report Request
    LM-3C  - e-Portal Authorization - CMHC

    LM-3P  - e-Portal Authorization - Pharmacy
    LM-3Q  - Q-Sight Authorization
    LM-3S  -  Surplus Property Authorization
     
  • LM-4   -   Materials Return Form (To Logistics Management)
  • LM-5   -   Inventory Certificate
  • LM-6   -   Inventory Count
     
  • LM-7   -  Water Cooler Request Form
     
  • LM-8   -   PAR Request  -  (Excel Format: LM-8)
                  See "Attachments"
    LM-8A -  PAR: Getting Started & LM-8B -  PAR:  Project Check List
     
  • LM-9   -   Supply Alert
  • LM-10 -   Bill Only
     
  • LM-11 -   UCH Fleet & Vehicle Requests
    LM-11A - Request Permission for Home Garaging On a Continuous Basis
    LM-11B - Motor Vehicle Monthly Usage Report
     
  • Implantable Device(s) Instruments or Supplies for Procedures. 
    See Purchasing Web Page for process Information.               
  • LM-14 -   New Supply Transfer Voucher
    (When transferring/borrowing supplies from other departments)
  • LM-15 -   LM Action Request Form
  • LM-16 -   Materials Logistics Distribution Form (Sample)
  • LM-17 -   Shipping & Return Materials Authorization Form  (HCA-614)
  • LM-18 -   Mail Service Request Form
  • All Property IC Forms
  • By Property Administration Form Number:

  • Record of Property Gifts and Donations
    IC-1     - Equipment IC-1
    IC-1A   - Art IC-1A  

  • Record of Constructed Equipment
    IC-2

  • Record of Property:  Loaned, Demonstration or Evaluation to UCH
    IC-3 (instructions)

  • Record of Transfers From: Other Agencies (State or Federal), Institutions, Organizations
    IC-4 (instructions)

  • Record of Property Loaned: Between Departments, Loaned to Another Institution, Loaned to an Individual  
    IC-5    Property Loan Form (instructions)
    IC-5A  Record of Loaned Art

  • Record of Property Disposition: Transfers Within Departments, Between Departments, Between Buildings, Off-Site Health Center Locations or Approved Storage Facilities, Transfer to Another Institution, Trade-In, Sell, Declare Surplus (Property Use Only), Cannibalize, Other Approved Disposition
    IC-6 (instructions)

  • Maintenance of Equipment Notice
    IC-9

  • Inventory Certificates:
    IC-10  -  Disposition
    IC-11  -  Inventory

  • Report of Loss or Damages to Real and Personal Property:
    To be submitted by Inventory Control.  Please complete the IC-12 signature routing form and attach to the CO-853.  Signatures must be in order listed.
    CO-853  including
    IC-12

  • Compliance and Risk Assessment Monitoring: (Internal Form Only)
    IC-15

  • SURPLUS PROPERTY:
    LM-2 (instructions)
    Declaration of Excess Property - Removal Request:

    Removal Request
    Movable Assets, Computer Software,
    Fixed/Building Service Systems Assets

  • MOVE REQUESTS:
    LM-1
    Please complete the
    LM-1 form (instructions) in full for all Move Requests.

  1. Insurance is available for all moves, but must be requested prior to move date. 

  2. Please help keep our asset inventory current, by supplying HC numbers on all forms, or by requesting a full inventory of your department after move is completed.

  3. Boxes, labels and other packing supplies can be ordered through the Central Warehouse.

  4. Always inform Telecommunications, Public Safety, Mail Room and Distributions Services ten (10) working days prior to your move.

  • Records Retention Form:

  • UCH Records Storage Request Form: 
    UCH Records Transmittal Form Sample  
    (Sample)
    Iron Mountain Records Transmittal Forms & Sheets
  • General
     
    • Data Processing Certificate of Compliance   (WORD) (PDF)

    • Digital Imaging Certificate of Compliance     (WORD) (PDF)

    • Microfilm Certificate of Compliance             (WORD) (PDF)

    • Certification Target for Microfilmed Public Records   (WORD) (PDF)

  • State Agencies
     
    • Records Disposition Authorization (Form RC-108)   RC-108
                                                                                   (Please use this form version and not the one on State Web Site)

    • Records Inventory Worksheet (Form RC-104)   (WORD) (PDF)

    • Records Management Liaison Officer Designation (Form RC-078)   (WORD) (PDF)

    • Records Retention Schedule Worksheet (Form RC-050W)   (WORD)

    • Request for Removal of Personal Data Files from Agency Records
      (Form RC-077)  
      (WORD) (PDF)

    • State Archives Memorandum of Transfer   (PDF)

    • State Records Center Records Storage List  (Form RC-100)   (WORD)

    • State Records Center Reference Request  (Form RC-200)   (WORD)

  • Municipal Government
     

 

  • Central Warehouse Catalogs:  (Please use the ePortal Navigator System for these forms)

  1. Chemical Supply Catalog

  2. Dental Supply Catalog

  3. Lab Supply Catalog

  4. Medical Warehouse Catalog
     

  5. Medical Suture Catalog

  6. Office & Housekeeping Supply Catalog

 

 

Your Logistics & Operations Team

Jeff Boyko, University Director for Office of Logistics Management 

Jack Ferraro, Logistics & Records Specialist

Alex Schwarz, Central Distribution & Clinical Transportation & Operations Manager

Adam Mike, UCH Materials Central Warehouse & Logistics Supervisor 

Don Carr, Warehouse Materials Supervisor

Thimmayya Billava, Records/Logistics Management Officer & Finance Supervisor

Lisa Nuzenski, Surplus & Moving Supervisor