Appendix C - Receipt of Service.docx
DOCX document 26 KB Posted
- Attached to
- Region 3 HAZMAT Removal and Disposal Services
- Solicitation number
- 15DDHQ20R00000014
About this file
This document contains a receipt template for hazardous waste removal services and a related solicitation for hazardous materials collection, transportation, disposal and destruction services. The receipt template requires contractors to document site information, arrival and departure times, employee names, container quantities verified by a DEA or FBI representative, and adulteration of controlled substances prior to removal. The solicitation seeks proposals for indefinite delivery/indefinite quantity multiple award contracts covering four regions, with one region set aside for small businesses. Services include authorized central storage pickup for the Department of Justice Drug Enforcement Administration across 12 states. Proposals are due under Solicitation 15DDHQ20R00000014 for Region 3 hazardous materials response and disposal.
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Other files
| File | Type | Posted |
|---|---|---|
| Amendment 0002 signed.pdf | ||
| 15DDHQ20R00000014 HAZMAT SVC conformed to amendment 0002.pdf | ||
| Amendment 0001.pdf | ||
| 15DDHQ20R00000014 HAZMAT SVC conformed to amendment 0001.pdf | ||
| Appendix B - Containers and Materials.docx | DOCX document | |
| Appendix D - Response Facility Information.docx | DOCX document | |
| 15DDHQ20R00000014 HAZMAT SVC.pdf | ||
| Appendix E - Generating Facilities revised.docx | DOCX document | |
| Appendix A3 - Mid Continental Region SB Set Aside.docx | DOCX document |
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Text version
Appendix C
RECEIPT FOR SERVICES
The following information must be completed for each Generating Facility and verified by the on-site representative at the site prior to the Contractor’s departure.
Task Order number:___________________ DEA Control/Call number:_________________ Case “S” Number: ____________________
Date/Time of Initial Call: / / ________ AM/PM Site ____ of _____ Agreed Upon Date/Time of Arrival:_____/____/____ ________ AM/PM (if multiple Locations)
Site Address:
Latitude (y): ________________________ Longitude (x):____________________________ Delays, if any, were caused by: ________________________________________________________________________
Name of each contract employee responding to the Generating Facility:
Time Crew Arrived on Site: _______________ AM/PM Time Crew Departed Site:____________AM/PM
Manifest / Shipping Document Control Number(s): ____________________________________
Total number of containers removed from the Generating Facility: ________________________ [This MUST agree with the quantity of containers identified on the manifest(s) and/or DOT Shipping Document(s).]
DEA/FBI REPRESENTATIVE VERIFICATION
On behalf of (Agency Name) _________________________________________________, I have verified the following:
Identification:
All contractors presented valid photo identification upon arrival at the generating facility. All drivers hauling hazardous waste must have a valid CDL with HazMat endorsement.
Containers:
Verified the total number of containers removed from the generating facility.
Adulteration:
All mixtures and/or waste suspected of containing listed or controlled substances were adulterated prior to removal from the generating facility.
I have reviewed and confirmed all information contained on this form and acknowledge receipt of the services provided by the contractor. I rate the contractor’s performance as ___outstanding ___acceptable __unacceptable.
Printed Name of DEA/FBI Representative Signature Date
Form DEA-602 Receipt for Service (2019)
File details come from the government source that posted it. Updated .