Attachment B - SF1449.pdf

PDF 1 MB Posted Sep 13, 2022

Attached to: 2023 Light Duty Vocational Trucks
Solicitation number: 47QMCA22R0014
Issued by: GSA Federal Acquisition Service

About this file

Written by GovTribe AI · Dec 30, 2023

This document is a draft solicitation for light duty vocational trucks. The solicitation number is 47QMCA22R0014 and is being issued by the GSA Federal Acquisition Service to procure 2023 light duty vocational trucks. The anticipated due date for proposals is September 12, 2022, though AutoBid will remain open until then. The solicitation is set aside for small businesses and will result in an indefinite delivery, indefinite quantity contract to be awarded on an unrestricted basis. Pricing will be firm fixed price and the period of performance is one base year with four one-year options. Delivery locations and payment terms are included.

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47QMCA22R0014 Amendment 0004 SF30 09_30_2022.pdf	PDF	Sep 30, 2022
47QMCA22R0014 Amendment 003 SF30 09_21_2022.pdf	PDF	Sep 21, 2022
47QMCA22R0014 Pre-Proposal Conference slides 09_20_2022.pptx	PPTX presentation	Sep 21, 2022
47QMCA22R0014 Solicitation Document 09_13_2022.pdf	PDF	Sep 13, 2022
Attachment A - Proposal Checklist.docx	DOCX document	Sep 13, 2022
47QMCA22R0014 Amendment 002 SF30 09_13_2022.pdf	PDF	Sep 13, 2022
47QMCA22R0014 Amendment 001 SF30 08_16_2022.pdf	PDF	Aug 16, 2022
Attachment G - 2023 Model Year Estimated Quantities.xlsx	XLSX spreadsheet	Jul 19, 2022
Attachment Q - AutoChoice Online Ordering Instructions.pdf	PDF	Jul 19, 2022
Attachment M2 - Supplemental Weekly Vendor Status Reports Template.xlsx	XLSX spreadsheet	Jul 19, 2022
Attachment P - AutoBid Vendor Instructions.pdf	PDF	Jul 19, 2022
Attachment R1 - UltraMod Instructions.pdf	PDF	Jul 19, 2022
Attachment D1 - Technical Proposal Template.docx	DOCX document	Jul 19, 2022
Attachment H1 - Optional Equipment Analysis.pdf	PDF	Jul 19, 2022
Attachment E3 - Option MBC Description.pdf	PDF	Jul 19, 2022
Attachment I - 888E Proposal Template.xlsx	XLSX spreadsheet	Jul 19, 2022
Attachment B - SF1449.pdf	PDF	Jul 19, 2022
Attachment E1 - Federal Vehicle Standard 307BB.pdf	PDF	Jul 19, 2022
Attachment J - NMY Cut-off Date Pricing Template.xlsx	XLSX spreadsheet	Jul 19, 2022
Attachment F2 - Schedule of Items - FCA US LLC.pdf	PDF	Jul 19, 2022
Attachment L - Weekly Contractor Status Reports Submission Requirements.docx	DOCX document	Jul 19, 2022
Attachment K3 - DIT Process for 2023 Light Duty Trucks Solicitation (Leasing).docx	DOCX document	Jul 19, 2022
Attachment R2 - UltraMod Worksheet.pdf	PDF	Jul 19, 2022
Attachment D2 - Technical Exceptions Worksheet.xlsx	XLSX spreadsheet	Jul 19, 2022
Attachment F4 - Schedule of Items - General Motors.pdf	PDF	Jul 19, 2022
Attachment K2 - DIT Claim Form Template (Purchasing).pdf	PDF	Jul 19, 2022
Attachment E2 - Option CF52 Description.pdf	PDF	Jul 19, 2022
Attachment F1 - Schedule of Items - Daimler Trucks North America.pdf	PDF	Jul 19, 2022
Attachment N1 - Introduction to FedConnect.pdf	PDF	Jul 19, 2022
Attachment E5 - Option MSTL Description.pdf	PDF	Jul 19, 2022
Attachment F3 - Schedule of Items - Ford.pdf	PDF	Jul 19, 2022
Attachment F5 - Schedule of Items - 888E.pdf	PDF	Jul 19, 2022
Attachment A - Proposal Checklist.docx	DOCX document	Jul 19, 2022
Attachment N2 - FedConnect Ready Set Go Guide.pdf	PDF	Jul 19, 2022
Attachment S - Full Text of Clauses Incorporated by Reference (IBR).pdf	PDF	Jul 19, 2022
Attachment K4 - DIT Process for 2023 Light Duty Vocational Solicitation (Purchasing).docx	DOCX document	Jul 19, 2022
Attachment N3 - FedConnect Vendor Reference Guide.pdf	PDF	Jul 19, 2022
Attachment O - Inspection Points Template.xlsx	XLSX spreadsheet	Jul 19, 2022
Attachment E4 - Option MCTL Description.pdf	PDF	Jul 19, 2022
Attachment H2 - Optional Equipment Combination Analysis.pdf	PDF	Jul 19, 2022
Attachment M1 - Weekly Contractor Status Reports EXAMPLE.xlsx	XLSX spreadsheet	Jul 19, 2022
Attachment E6 - Option MTTP Description.pdf	PDF	Jul 19, 2022
47QMCA22R0014 Solicitation Document 07_15_2022.pdf	PDF	Jul 19, 2022
Attachment C - Offeror Response Document.docx	DOCX document	Jul 19, 2022
Attachment K1 - DIT Claim Form Template (Leasing).pdf	PDF	Jul 19, 2022

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SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER PAGE 1 OF

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME b. TELEPHONE NUMBER (No collect calls)

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO 16. ADMINISTERED BY CODE

18a. PAYMENT WILL BE MADE BY CODE17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

BELOW IS CHECKED

RFQ IFB RFP

SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR

30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS UNRESTRICTED OR

NAICS:

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

SET ASIDE: % FOR:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE ARE NOT ATTACHED

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

8 (A)

EDWOSB

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

STANDARD FORM 1449 (REV. 2/2012) BACK

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

40. PAID BY

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

PARTIAL FINAL

37. CHECK NUMBER

38. S/R ACCOUNT NO. 39. S/R VOUCHER NUMBER

36. PAYMENT

COMPLETE PARTIAL FINAL

Printing C:\FORMFLOW\FORMS\SF\S1449_3.FRP BarbMWilliams SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1. REQUISITION NUMBER

PAGE 1 OF

2. CONTRACT NO.

3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE

DATE

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

b. TELEPHONE NUMBER (No collect calls)

8. OFFER DUE DATE/

LOCAL TIME

9. ISSUED BY

13b. RATING

14. METHOD OF SOLICITATION

CODE

15. DELIVER TO

16. ADMINISTERED BY

CODE

18a. PAYMENT WILL BE MADE BY

CODE

17a. CONTRACTOR/

OFFEROR

CODE

FACILITY

CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

BELOW IS CHECKED

RFQ

IFB

RFP

SEE ADDENDUM

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only)

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . . YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 30b. NAME AND TITLE OF SIGNER (Type or print) 30c. DATE SIGNED 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 31b. NAME OF CONTRACTING OFFICER (Type or print) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

10. THIS ACQUISITION IS

UNRESTRICTED OR

NAICS:

SIZE STANDARD:

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

SET ASIDE:

% FOR:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

ARE

ARE NOT ATTACHED

ARE

ARE NOT ATTACHED

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA 27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA \\iaimain\apps1\Pam_Ward\Logos\Pointer.jpg Right Arrow Pointing to Call the Contact Point for this Solicitation/Contract/Order 8 (A)

EDWOSB

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

SMALL BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SMALL BUSINESS

STANDARD FORM 1449 (REV. 2/2012)

BACK

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED

INSPECTED

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE 42a. RECEIVED BY (Print) 42b. RECEIVED AT (Location) 42c. DATE REC'D (YY/MM/DD) 42d. TOTAL CONTAINERS

40. PAID BY

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELPHONE NUMBER OF AUTHORZED GOVERNMENT REPRESENTATIVE 32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

33. SHIP NUMBER

34. VOUCHER NUMBER

35. AMOUNT VERIFIED

CORRECT FOR

PARTIAL

FINAL

37. CHECK NUMBER

38. S/R ACCOUNT NO.

39. S/R VOUCHER NUMBER

36. PAYMENT

COMPLETE

PARTIAL

FINAL

1. REQUISITION NUMBER:

PAGE 1 OF:

2. CONTRACT NUMBER:

4. ORDER NUMBER:

5. SOLICITATION NUMBER: 47QMCA22R0014

7. FOR SOLICITATION INFORMATION CALL: a. NAME: ARIELLE ALMAN

7. FOR SOLICITATION INFORMATION CALL: b. TELEPHONE NUMBER (No collect calls): 202-208-3422

9. ISSUED BY CODE:

% For : 100

12. DISCOUNT TERMS: NET 30 DAYS

13b. RATING:

15. DELIVER TO: AS SPECIFIED ON EACH MOTOR VEHICLE DELIVERY ORDER PLACED AGAINST THE CONTRACT

16. ADMINISTERED BY CODE:

16. ADMINISTERED BY: SAME AS BLOCK 9

17a. CONTRACTOR/ OFFEROR CODE:

17a. CONTRACTOR/ OFFEROR:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER:

18a. PAYMENT WILL BE MADE BY: U.S. GENERAL SERVICES ADMINISTRATION

ACCOUNTS PAYABLE BRANCH (BCEB)

PO BOX 419018

KANSAS CITY, MO 64141

19. ITEM NUMBER. Line 1 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES: 2023 LIGHT DUTY VOCATIONAL TRUCKS

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 2 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 3 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 4 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 5 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 6 of 8.:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 7 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 8 of 8.:

20. SCHEDULE OF SUPPLIES/ SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

25. ACCOUNTING AND APPROPRIATION DATA:

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED. INITIALS : ONE

29. AWARD OF CONTRACT: REFERENCE OFFER:

DATE. YOUR OFFER ON SOLICITATION

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS.:

30b. NAME OF SIGNER (Type or print):

30b. TITLE OF SIGNER (Type or print):

31b. NAME OF CONTRACTING OFFICER (Type or print):

10. THIS ACQUISITION IS UNRESTRICTED: 0

10. THIS ACQUISITION IS SET ASIDE:: 1

11. DELIVERY FOR FOB DESTINATION UNLESS BLOCK IS MARKED SEE SCHEDULE: 0

13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700): 0

14. METHOD OF SOLICITATION RFQ: 0

10. THIS ACQUISITION IS NAICS:: 336112

10. THIS ACQUISITION IS SIZE STANDARD:: 1,500 employees

14. METHOD OF SOLICITATION IFB: 0

14. METHOD OF SOLICITATION RFP: 1

18a. PAYMENT WILL BE MADE BY CODE: 12:00PM EST

18a. PAYMENT WILL BE MADE BY CODE: U.S. GENERAL SERVICES ADMINISTRATION

LIGHT VEHICLES BRANCH (QMAAA)

1800 F STREET NW

WASHINGTON, DC 20405

29. AWARD OF CONTRACT : 1

29. AWARD OF CONTRACT : 0

29. AWARD OF CONTRACT : 1

29. AWARD OF CONTRACT : 0

27a. ARE ATTACHED: 1

27a. ARE NOT ATTACHED: 0

27b. ARE ATTACHED: 0

27b. ARE NOT ATTACHED: 0

42c. DATE RECEIVED. Enter 2 digit month, 2 digit day and 4 digit year.: 2022-09-13

42c. DATE RECEIVED. Enter 2 digit month, 2 digit day and 4 digit year.: 2022-10-14

3. AWARD/ EFFECTIVE DATE. Enter 2 digit month, 2 digit day and 4 digit year.:

32B SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE. THIS IS A PRTECTED FIELD.:

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK IS CHECKED SEE ADDENDUM: 1

26. TOTAL AWARD AMOUNT (FOR GOVT. USE ONLY):

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN

OFFER : 0

41b. SIGNATURE OF CERTIFYING OFFICER. :

10. THIS ACQUISITION IS 8 (A): 0

10. THIS ACQUISITION IS SMALL BUSINESS: 0

10. THIS ACQUISITION IS SMALL BUSINESS: 1

10. THIS ACQUISITION IS SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS: 0

10. THIS ACQUISITION IS HUBZONE SMALL BUSINESS: 0

19. ITEM NUMBER. Line 1 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

19. ITEM NUMBER. Line 2 of 28.:

20. SCHEDULE OF SUPPLIES/SERVICES:

21. QUANTITY:

22. UNIT:

23. UNIT PRICE:

24. AMOUNT:

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21. QUANTITY:

22. UNIT:

24. AMOUNT:

19. ITEM NUMBER. Line 8 of 28.:

19. ITEM NUMBER. Line 9 of 28.:

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20. SCHEDULE OF SUPPLIES/SERVICES:

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23. UNIT PRICE:

24. AMOUNT:

32a. QUANTITY IN COLUMN 21 HAS BEEN ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32d. PRINTED NAME OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

32d. PRINTED TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE.:

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

32F. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

32G. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE:

33. SHIP NUMBER:

34. VOUCHER NUMBER:

35. AMOUNT VERIFIED CORRECT FOR:

37. CHECK NUMBER:

38. S/R ACCOUNT NUMBER:

39. S/R VOUCHER NUMBER:

40. PAID BY:

41b. TITLE OF CERTIFYING OFFICER:

42a. RECEIVED BY (Print):

42b. RECEIVED AT (Location):

42d. TOTAL CONTAINERS:

32a. QUANTITY IN COLUMN 21 HAS BEEN RECEIVED: 0

32a. QUANTITY IN COLUMN 21 HAS BEEN INSPECTED : 0

32a. QUANTITY IN COLUMN 21 HAS BEEN ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: 0

41c. DATE. Enter 2 digit month, 2 digit day and 4 digit year.:

33. SHIP NUMBER PARTIAL: 0

33. SHIP NUMBER FINAL: 0

32c. DATE. Enter 2 digit month, 2 digit day and 4 digit year.:

36. PAYMENT COMPLETE: 0

36. PAYMENT PARTIAL: 0

36. PAYMENT FINAL: 0

41b. SIGNATURE OF CERTIFYING OFFICER. THIS IS A PROTECTED FIELD.:

File details come from the government source that posted it. Updated Sep 21, 2022.