2.04.15 Attachment (14) - Set-Off Action Form.xlsx

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Bridge DPM Contract Schedule I & II
Solicitation number
N0060426Q4024
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This is a Set-Off Action Form template used by Fleet Logistics Center Pearl Harbor to document and authorize deductions from contractor invoices across multiple federal agencies and payment offices. The form is designed to communicate authorized contract deductions that were not applied to an initial invoice, allowing the deduction to be applied to a subsequent invoice instead.

The template contains six versions routing to different federal payment and accounting offices: Navy Aloha Center (M/L), DFAS Rome/AP/DCC (A), U.S. Coast Guard Finance Center (CG), DFAS Limestone BVF/LI (F), Army Comptroller Transaction Voucher Certification Branch (MA), and Marine Corps Base Finance (ML), and DFAS Cleveland Pacific Accounts Payable (N). Each version follows the same structure: documenting the original invoice number and authorized deduction amount with percentage, noting that the invoice was processed without the deduction, and specifying which subsequent invoice the deduction will be applied to. The form requires enclosure of DD Form 2772 (Contracting Report) and a copy of the original invoice. The point of contact is listed as a Transportation Assistant at Fleet Logistics Center Pearl Harbor with phone number 808-473-7700. This template serves as a standardized mechanism for managing invoice adjustments and deductions across the Navy and other federal military services' financial systems.

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2.04.5 Attachment (4) - DTR Appx A-G, Att A-G2 - Publications.pdf PDF
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2.04.7 Attachment (6) - DTR Appx A-G, Att A-G5 - Acronyms.pdf PDF
2.04.16 Attachment (15) - Invoice Submission Form (SAMPLE).xlsx XLSX spreadsheet
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MASTER

DATE:
FROM:FLEET LOGISTICS CENTER PEARL HARBOR
JPPSO-HAWAII (CODE 448)
4825 BOUGAINVILLE DRIVE
HONOLULU, HI 96818
TO:NAVY ALOHA CENTER(M/L)
988 SPENCE STREET, BLDG 2652
CODE: NHB
HONOLULU, HI 96818
SUBJ:Set-Off Action for:
(Contractor)(Contract No)
ENCL.:( 1 )DD FORM 2772, Contracting Report No:
(Service Order No.)
( 2 )Copy of Invoice number:
Members name:
1.In reference to subject contract, the following set-off action is authorized per enclosure (1)
Invoice No. :
Member's Name:0
Total Invoice Amount:
Authorized Contract Deduction:(%)
Adjusted Deduction Total:$ - 0
2.The above invoice was processed and Forwarded to your office on
without applying the authorized deduction. A copy of the invoice is provied as enclosure (2).
3.In accordance with subject contract, the above deduction is applied to the following invoice:
Invoice Number:
Service Order Number:
Member's Name:
Total invoice amount:
Authorized contract deduction:
Adjusted Invoice Total:$ - 0
4.Point of Contact: [Name], Transportation Assistant, ph: 808-473-7700

A

DATE:
FROM:FLEET LOGISTICS CENTER PEARL HARBOR
JPPSO-HAWAII (CODE 448)
4825 BOUGAINVILLE DRIVE
HONOLULU, HI 96818
TO:DFAS ROME/AP/DCC( A )
325 BROOKS ROAD
ROMEO, NY 13441-4527
SUBJ:Set-Off Action for:
(Contractor)(Contract No)
ENCL.:( 1 )DD FORM 2772, Contracting Report No:
(Service Order No.)
( 2 )Copy of Invoice number:
Members name:
1.In reference to suject contract, the following set-off action is authorized per enclosure (1)
Invoice No. :0
Member's Name:0
Total Invoice Amount:
Authorized Contract Deduction:(%)
Adjustment Voucher Total:$ - 0
2.The above invoice was processed and Forwarded to your office on
without applying the authorized deduction. A copy of the invoice is provied as enclosure (2).
3.In accordance with suject contract, the above deduction is applied to the following invoice:
Invoice Number:
Service Order Number:
Member's Name:
Total invoice amount:
Authorized contract deduction:
Adjust voucher total:$ - 0
4.Point of Contact: [Name], Transportation Assistant, ph: 808-473-7700

CG

DATE:
FROM:FLEET LOGISTICS CENTER PEARL HARBOR
JPPSO-HAWAII (CODE 448)
4825 BOUGAINVILLE DRIVE
HONOLULU, HI 96818
TO:COMMANDING OFFICER( CG )
U. S. COAST GUARD FINANCE CENTER
1430A KRISTINA WAY
CHESAPEAKE, VA 23326
SUBJ:Set-Off Action for:
(Contractor)(Contract No)
ENCL.:( 1 )DD FORM 2772, Contracting Report No:
(Service Order No.)
( 2 )Copy of Invoice number:
Members name:
1.In reference to suject contract, the following set-off action is authorized per enclosure (1)
Invoice No. :0
Member's Name:0
Total Invoice Amount:
Authorized Contract Deduction:(%)
Adjustment Voucher Total:$ - 0
2.The above invoice was processed and Forwarded to your office on
without applying the authorized deduction. A copy of the invoice is provied as enclosure (2).
3.In accordance with suject contract, the above deduction is applied to the following invoice:
Invoice Number:
Service Order Number:
Member's Name:
Total invoice amount:
Authorized contract deduction:
Adjust voucher total:$ - 0

4. Point of Contact: [Name], Transportation Assistant, ph: 808-473-7700

F

DATE:
FROM:FLEET LOGISTICS CENTER PEARL HARBOR
JPPSO-HAWAII (CODE 448)
4825 BOUGAINVILLE DRIVE
HONOLULU, HI 96818
TO:DFAS BVF/LI(N/H)
27 ARKANSAS RD., STE 300
LIMESTONE, ME 04751-6216
SUBJ:Set-Off Action for:
(Contractor)(Contract No)
ENCL.:( 1 )DD FORM 2018, Contracting Report No:
DD FORM 2772, Contracting Report No:(Service Order No.)
( 2 )Copy of Invoice number:
Members name:
1.In reference to subject contract, the following set-off action is authorized per enclosure (1)
Invoice No. :0
Member's Name:0
Total Invoice Amount:
Authorized Contract Deduction:(%)
Adjustment Voucher Total:$ - 0
2.The above invoice was processed and Forwarded to your office on
without applying the authorized deduction. A copy of the invoice is provied as enclosure (2).
3.In accordance with subject contract, the above deduction is applied to the following invoice:
Invoice Number:
Service Order Number:
Member's Name:
Total invoice amount:
Authorized contract deduction:
Adjust voucher total:$ - 0
4.Point of Contact: [Name], Transportation Assistant, ph: 808-473-7700

MA

DATE:
FROM:FLEET LOGISTICS CENTER PEARL HARBOR
JPPSO-HAWAII (CODE 448)
4825 BOUGAINVILLE DRIVE
HONOLULU, HI 96818
TO:COMPT TRAN VOUCH CERT BRANCH (TVCB)( M/A )
ATTN CODE 470
814 RADFORD BLVD. SUITE 20318
ALBANY, GA 31704-0318
SUBJ:Set-Off Action for:
(Contractor)(Contract No)
ENCL.:( 1 )DD FORM 2772, Contracting Report No:
(Service Order No.)
( 2 )Copy of Invoice number:
Members name:
1.In reference to suject contract, the following set-off action is authorized per enclosure (1)
Invoice No. :0
Member's Name:0
Total Invoice Amount:
Authorized Contract Deduction:(%)
Adjustment Voucher Total:$ - 0
2.The above invoice was processed and Forwarded to your office on
without applying the authorized deduction. A copy of the invoice is provied as enclosure (2).
3.In accordance with suject contract, the above deduction is applied to the following invoice:
Invoice Number:
Service Order Number:
Member's Name:
Total invoice amount:
Authorized contract deduction:
Adjust voucher total:$ - 0

4. Point of Contact: [Name], Transportation Assistant, ph: 808-473-7700

ML

DATE:
FROM:FLEET LOGISTICS CENTER PEARL HARBOR
JPPSO-HAWAII (CODE 448)
4825 BOUGAINVILLE DRIVE
HONOLULU, HI 96818
TO:COMMANDING GENERAL( M/L )
ATTN: LSAP
BOX 63063 MCBH
KANEOHE BAY, HI 96863-3063
SUBJ:Set-Off Action for:
(Contractor)(Contract No)
ENCL.:( 1 )DD FORM 2772, Contracting Report No:
(Service Order No.)
( 2 )Copy of Invoice number:
Members name:
1.In reference to suject contract, the following set-off action is authorized per enclosure (1)
Invoice No. :0
Member's Name:0
Total Invoice Amount:
Authorized Contract Deduction:(%)
Adjustment Voucher Total:$ - 0
2.The above invoice was processed and Forwarded to your office on
without applying the authorized deduction. A copy of the invoice is provied as enclosure (2).
3.In accordance with suject contract, the above deduction is applied to the following invoice:
Invoice Number:
Service Order Number:
Member's Name:
Total invoice amount:
Authorized contract deduction:
Adjust voucher total:$ - 0

4. Point of Contact: [Name], Transportation Assistant, ph: 808-473-7700

N

DATE:
FROM:FLEET LOGISTICS CENTER PEARL HARBOR
JPPSO-HAWAII (CODE 448)
4825 BOUGAINVILLE DRIVE
HONOLULU, HI 96818
TO:DFAS CLEVELAND( N )
PACIFIC ACCOUNTS PAYABLE
P.O . BOX 998023
CLEVELAND, OH 44199
SUBJ:Set-Off Action for:
(Contractor)(Contract No)
ENCL.:( 1 )DD FORM 2772, Contracting Report No:
(Service Order No.)
( 2 )Copy of Invoice number:
Members name:
1.In reference to suject contract, the following set-off action is authorized per enclosure (1)
Invoice No. :0
Member's Name:0
Total Invoice Amount:
Authorized Contract Deduction:(%)
Adjustment Voucher Total:$ - 0
2.The above invoice was processed and Forwarded to your office on
without applying the authorized deduction. A copy of the invoice is provied as enclosure (2).
3.In accordance with suject contract, the above deduction is applied to the following invoice:
Invoice Number:
Service Order Number:
Member's Name:
Total invoice amount:
Authorized contract deduction:
Adjust voucher total:$ - 0
4.Point of Contact: [Name], Transportation Assistant, ph: 808-473-7700

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