2.04.16 Attachment (15) - Invoice Submission Form (SAMPLE).xlsx
XLSX spreadsheet 29 KB Posted
- Attached to
- DPM Household Goods Packing, Moving, and Storage
- Solicitation number
- N0060426R0003
About this file
This is a sample invoice submission form template in Excel format for use by contractors responding to NAVSUP Fleet Logistics Center Pearl Harbor Solicitation N0060426R0003. The template does not contain specific product or service requirements, pricing structures, or substantive contract terms. It serves as an appendix to guide contractors on the required format and data elements for submitting invoices under the commercial packing, containerization, and local drayage services contract. Contractors responding to this Indefinite-Delivery Requirements contract—which is structured as a Firm-Fixed-Price agreement with an estimated maximum value of $45.3M over five years—would use this form to document billable services under the three schedules (Outbound, Inbound, and Intracity). The template is intended to standardize invoice documentation and facilitate administrative processing for services supporting Department of Defense personnel relocations.
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Text version
SI CONTRACTOR FORM
SCHEDULE I (BASE YEAR)
Date of Order: Contract Number: Order Number:
Member's Name: Consignee:
Estimated Weight: Actual Weight: Date Services Provided:
P/U Address: Delivery Address:
Services Provided:
Additional Services:
| INVOICE INFORMATION | |||||||||
| ITEM | QUANTITY | UNIT | UNIT PRICE | TOTAL | Additional ITEM | QUANTITY | UNIT | UNIT PRICE | TOTAL |
| 0001AA | NCWT | ||||||||
| 0001AB | NCWT | ||||||||
| 0001AC | NCWT | ||||||||
| 0001AD | NCWT | ||||||||
| 0002AA | NCWT | ||||||||
| 0002AB | NCWT | ||||||||
| 0003AA | NCWT | ||||||||
| 0003AB | NCWT | ||||||||
| 0003AC | NCWT | ||||||||
| 0003AD | NCWT | ||||||||
| 0003AE | NCWT | ||||||||
| 0003AF | NCWT | ||||||||
| 0004AA | NCWT | ||||||||
| 0004AB | NCWT | ||||||||
| 0004AC | NCWT | ||||||||
| 0004AD | NCWT | ||||||||
| 0005AA | NCWT | ||||||||
| 0005AB | NCWT | ||||||||
| 0005AC | NCWT | ||||||||
| 0005AD | NCWT | ||||||||
| 0006AA | NCWT | ||||||||
| 0006AB | NCWT | ||||||||
| 0006AC | NCWT | ||||||||
| 0006AD | NCWT | ||||||||
| 0007AA | NCWT | ||||||||
| 0007AB | NCWT | ||||||||
| 0008AA | NCWT | ||||||||
| 0008AB | NCWT | ||||||||
| 0009AA | NCWT | ||||||||
| 0010AA | EA | ||||||||
| 0010AB | EA | ||||||||
| 0010AC | Cu ft or fraction thereof | ||||||||
| 0011AA | EA | ||||||||
| 0011AB | EA | ||||||||
| 0011AC | EA | ||||||||
| 0012AA | EA | ||||||||
| 0012AB | EA |
If excess cost is involved provide details regarding additional payments (members cost):
TOTAL INVOICE AMOUNT: TOTAL WEIGHT:
SAMPLE
N00604-15-R-3017 Attachment (15) – Invoice Submission Form
SAMPLE
File details come from the government source that posted it. Updated .