12024B18R9006_Attachment_4_12-18-2017.pdf

Solicitation No. 12024B18R9006 US Forest Service National Long Term Fire Retardant National Office

Attachment 4 – Exhibit J-2 Retardant Inventory/Use Worksheet

J2 - 1

Retardant Base ____ Contractor ____ Gallons/Ton Gallons/Pounds_________________

Retardant Type Contract No. Inclusive Dates This period______________________

RETARDANT

DELIVERY

OTHER SERVICES MISC DEBITS/ CREDITS

DATE

*TONS

DELIVERED

RE-

LOAD

OFF-

LOAD

WATER

LOAD

AMOUNT

REMARKS

TOTA

L

TOTAL $ $ $ $ $

*Truck Weight Invoices must accompany this worksheet

REMARKS:

INVENTORY SUMMARY

Tons Gal/Ton Gallons Gallons Gallons Gallons (Sub-total) (Total) (Grand Total) plus less

GRAND TOTAL OF GALLONS FOR PAYMENT PURPOSES $_________________

A Bulk Retardant on Hand beginning of this period

B Mixed Retardant on Hand beginning of this period

_______ X ______ = ___________

C Total retardant delivered this period

______ X _____ = ___________

D Bulk Retardant on Hand end of this period

E Mixed Retardant on Hand end of this period

______ X _____ = ___________