5 _ 2023.05.15_CM_104 D Co.pdf

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DECEMBER 28, 2022

NEBRASKA NATIONAL GUARD

of

BPA ORDER REQUEST

NEBRASKA NATIONAL GUARD

Contracting Office Joint Forces Headquarters Suite 2200 .\`NENG_Full Qualityv6.jpg Failure to follow any of the instructions, be it the file naming convention or leaving a field blank, will result in rejection of order.

Field Colors:

1. Blue - User fills in.

2. Green - Prepopulated or form calculation fields. User cannot edit.

3. Grey - Buttons to open fields.

File Naming Convention:

1. Requester, "Save As" file name as Requisition Number. Example: "2021.07.04.W91243.CATMLS.00001"

2. Approver, after approval, "Save" and then add '.app' at end. Example: "2021.07.04.W91243.CATMLS.00001.app"

3. Certifier, after certification, "Save" and then add '.cert' at end. Example: "2021.07.04.W91243.CATMLS.00001.app.cert" Requisition Number:

A. If requesting AFMIS Catered Meals or Raw Subsistence, Requisition Number is generated by AFMIS.

B. If requesting RRB Catered Meals or Edibles, you will create the Requisition Number using the below:

1. First field - Calendar year of delivery date. (YYYY)

2. Second field - Calendar month of delivery date. (MM)

3. Third field - Calendar day of delivery date. (DD)

4. Fourth field - Your UIC. (W91243)

5. Fifth field - Type of food. (XXXXXX)

6. Sixth field - Next sequential number. (00001) Must be five (5) digits.

"TAX-EXEMPT for NATIONAL GUARD SOLDIER CONSUMPTION" I. Determine the cycle your meals fall in.

a. If your meals are the 31st and 1st of consecutive months, then you will submit a BOR for each day as they cross cycles.

b. If there is a break in your days, for example, May 14th and then May 16th but the location is the same. You will submit one (1) BOR.

c. If there is a change in location for consecutive meals, for example, April 12th at GTS and April 13th at RTI. You will submit two (2) BORs.

II. Timeline

a. Two cycles out from delivery cycle.

i. Requester will provide Confirmed BOR to G8_Food share drive.

b. One and a half cycles out from delivery cycle.

i. Customer will approve BOR in G8_Food share drive, adding `.app' to name.

ii. Customer will complete BOR Control Log.

iii. Customer can modify initial request. Changes allowed are meal types, quantities and delivery location.

c. One cycle out from delivery cycle.

i. Customer provides L4 certified GFEBS PR.

ii. Contracting makes BPA Call to vendor.

iii. Contractor confirms receipt of BORs.

d. 14 days out from RDD.

i. Customer can adjust numbers. The only change allowed is Quantity. The change can be +/- 25% of the request.

e. 14 days out from RDD.

i. Entire BOR can be canceled.

f. 10 days out from RDD.

i. Vendor provides name of the delivery company and any details to POCs on BOR.

g. Delivery.

i. Meals are delivered according to the BOR.

ii. Vendor completes Delivery Ticket on BOR and returns to contracting.

iii. Unit certifies receipt of BOR requested meals/subsistence to the Customer. Certification will be made with the BOR and completed within three (3) business days of final delivery.

h. Reconciliation.

i. Customer submits reconciled BORs to Contracting within five (5) days of cycle closing.

i. Invoice.

i. Vendor invoices after cycle closes.

ii. Customer accepts invoice within five (5) days of invoicing.

j. Payment.

i. Vendor Pay will monitor and pay vendor after invoice acceptance.

I. Timeline

a. Contracting receives BOR minimum 14 days from RDD.

i. Customer provides L4 certified GFEBS PR.

ii. Contracting makes BPA Call to vendor.

iii. Contractor confirms receipt of BORs.

b. 7 days out from RDD.

i. Customer can adjust numbers. The only change allowed is Quantity. The change can be +/- 10% of the request.

c. Delivery.

i. Meals are delivered according to the BOR.

ii. Vendor completes Delivery Ticket on BOR and returns to contracting.

iii. Unit certifies receipt of BOR requested meals/subsistence to the Customer. Certification will be made with the BOR and completed within three (3) business days of final delivery.

d. Reconciliation.

i. Customer submits reconciled BORs to Contracting within five (5) days of cycle closing.

e. Invoice.

i. Vendor invoices after cycle closes.

ii. Customer accepts invoice within five (5) days of invoicing.

f. Payment.

i. Vendor Pay will monitor and pay vendor after invoice acceptance.

III. Definitions BPA -Blanket Purchase Agreement BPA Call -Process, from Contracting to the Vendor, to place an order BOR -BPA Order Request, used by Customer to provide information to Contracting for BPA Call. Contains all information needed for vendor to deliver the requested subsistence.

Customer -G4 Food Service Cycle -Each month will be a cycle.

Days Out -Days before delivery date.

Unit -A specific Army Unit of soldiers. 126th, 1969th, etc.

Group -A body of soldiers not tied to Army Units. Requests do not have to be made per Army Unit. One (1) BOR can be submitted for multiple Army Units drilling at the same time and feeding at the same location.

POC -Point of Contact RDD -Requested Delivery Date Request -Usually per Cycle. However, a unit could submit multiple Requests if needed. For instance, unit is drilling twice in the same Cycle. Customer would need to submit two BORs.

Requester -Army Unit POC.

BOR Naming Convention: YYYY.MM.DD_XX_XXXXXXX

1. First field - Calendar year of delivery date. (YYYY)

2. Second field - Calendar month of delivery date. (MM)

3. Third field - Calendar day of delivery date. (DD)

· If you have multiple delivery dates, then use the first date.

4. Fourth field - Type of food. (XX) Choose appropriate abbreviation.

· CM - Catered Meals (Meals submitted through AFMIS)

· GR - Groceries/Raw Subsistence

· ED - Edibles and Event Meals

· SN - Short Notice (A justification is required for all Short Notice meals.)

5. Fifth field - Your Unit Abbreviation. Type exactly how it appears on the form. (XXXXXXX) Your BOR name should look like: 2021.07.04_CM_1969 CCT

1.1. Hot - Breakfast (BK)

1.1.1. Receive meal on a plate and immediately consume at serving location.

1.1.2. Provide each of the following items per person, quantities listed are the minimum to be served:

1.1.2.1. 4 ounces of breakfast meat (bacon, Canadian bacon, turkey bacon, sausage patties or links, turkey sausage, ham, steak) - If serving bacon minimum of 3 pieces.

1.1.2.2. 6 ounces of scrambled eggs or 2 eggs (fried or peeled hard boiled)

1.1.2.3. 2 slices French toast, waffle, pancake or a starch - Starches are limited to a minimum: 1oz dry Oatmeal, 1oz dry Grits or 3oz Potatoes. Potatoes must be shredded, diced or quartered.

1.1.2.4. 2 assorted slices of bread to include at least 1 option of 100% whole grain - Note: If French toast, pancakes, or waffles are served, assorted breads may be reduced by ½ the quantity.

1.1.2.5. 1 piece of fresh fruit (apples, bananas, or oranges)

1.1.3. Provide each of the following items for 50% of the headcount, quantities listed are the minimum to be served:

1.1.3.1. 8 ounces of individual yogurt

1.1.3.2. 1 ounce of single serving cereal (assorted variety)

1.1.3.3. 8 ounces 1% low fat milk for each serving of cereal

1.1.4. Provide the following mandatory drinks per person, quantities listed are the minimum to be served:

1.1.4.1. 8 ounces of 100% fruit juice, no concentrate (orange, apple, or grape juice)

1.2. Hot - Lunch/Dinner (LN/DN)

1.2.1. Receive meal on a plate and immediately consume at serving location.

1.2.2. Provide each of the following items per person, quantities listed are the minimum to be served:

1.2.2.1. 6 ounces deboned of protein (chicken, beef, pork, turkey, or fish)- 1 cup if serving ground meat in a sauce such as spaghetti or beef stroganoff.

1.2.2.2. 1/2 cup of starch as main entrée (to include but not limited to rice, potatoes, noodles, etc.)

1.2.2.3. 1½ cups of lettuce salad and/or ½ cup of prepared salad (coleslaw, potato, pasta bean)

- Lettuce salad must contain vitamin rich leafy greens such as romaine, butter head, spinach, kale, arugula, etc. Iceberg lettuce is not to be used. (see salad defined below)

- Pasta salad will not be served if the main entrée contains pasta.

1.2.2.4. 8 oz. vegetable, hot (such as carrots, corn, green beans, mixed vegetables, etc.)

- 2 assorted slices of bread to include at least 1 option of 100% whole grain or 1 dinner roll, or similar products

1.2.2.5. 1 type of dessert per person of assorted variety Parfait 10 oz., Fruit Salad 9 oz., Cookie 1 (average weight ½ oz.), Brownie 2” square (3 oz.), Pie 3” wedge, Fruit crisp 1oz, Cake

1.2.3. Provide (one) of the following items for 50% of the headcount, quantities listed are the minimum to be served:

1.2.3.1. One piece of fresh fruit (apples, bananas, oranges)

1.2.3.2. 6 ounces of canned fruit

1.2.4. Provide the following mandatory drinks per person, quantities listed are the minimum to be served:

1.2.4.1. 8 ounces of beverage - Provide a variety of Electrolyte beverage, Kool-Aid, tea, 100% fruit juice and/or lemonade.

1.2.4.2. If serving consecutive meals, drinks should be different.

1.3. Box, Later - LN/DN

1.3.1. Provide individually boxed meal that soldier can consume up to 4 hours later at a different location.

1.3.2. Provide each of the following items per person, quantities listed are the minimum to be served:

1.3.2.1. Sandwich or wrap consisting of: 3 ounces of deli meat (ham, turkey, chicken or roast beef), 1.5 ounces of cheese (American, cheddar, provolone, or Swiss), Sandwich bread is a hoagie bun (white, wheat, or sourdough), Wrap (whole wheat or white)

1.3.2.2. 1 piece of fresh fruit apple, orange, or banana

1.3.2.3. 1 individual bag of chips (assorted variety) portion size 1 oz.

1.3.2.4. 1.4 oz. granola bar with a minimum of 28 grams carbohydrates and 8-9 grams of protein

1.3.2.5. 1.7 oz. individually packaged trail mix (legumes and dried fruit, cereal is not acceptable)

1.3.2.6. Desert: Cookie 1 (average weight ½ oz.), Brownie 2” square (3 oz.)

1.3.2.7. 12 fl. oz. Portable Drink (Electrolyte beverage, or 100% fruit juice - no concentrate)

1.4. Box, Now - BK

1.4.1. Provide individually boxed 1.1 meal that is immediately consumed but at another location.

1.5. Box, Now - LN/DN

1.5.1. Provide individually boxed 1.2 meal that is immediately consumed but at another location.

1.6. Short Notice Meals

1.6.1. Short notice, fast delivery times.

1.6.1.1. Minimum 48 hours' notice.

1.6.1.2. Meals will be 1.1, 1.2, 1.3, 1.4, and 1.5.

1.7. Holiday Meal

1.7.1. Provide each of the following items per person, quantities listed are the minimum to be served:

1.7.1.1. Roast Turkey (Boneless Turkey) – 6oz

1.7.1.2. Southwestern calico corn - 4 oz.

1.7.1.3. Mashed Potatoes - 4 oz.

1.7.1.4. Candied Sweet Potatoes - 4 oz.

1.7.1.5. Spring Salad - 3/4 cup

1.7.1.6. Chicken Gravy - 1/4 cup

1.7.1.7. Bread Dressing - 3 oz.

1.7.1.8. Assorted Fresh Pies - 1/8 PIE 10” – 1oz whip cream

1.7.1.9. Cranberry Sauce - 2 oz.

1.7.1.10. Fresh Fruit (Apple/Orange/Banana) - 1 Piece

1.7.1.11. Dinner Rolls Assorted - 1 Roll

1.7.1.12. Margarine Patties - 2 PC

1.7.1.13. Provide two (2) 8 ounce beverages per person - Provide a variety of Electrolyte beverage, Kool-Aid, iced tea, 100% fruit juice (no concentrate) and/or lemonade.

1.8. MWR Meal

1.8.1. Provide each of the following items per person, quantities listed are the minimum to be served:

1.8.1.1. Hamburger w/bun – 1 burger and bun; 3 oz. burger, 11oz bun

1.8.1.2. Hotdog w/bun – 1 hotdog and bun; 12 oz Hotdog, 11 oz bun

1.8.1.3. Baked Beans – 4 oz.

1.8.1.4. Watermelon wedge – 1 wedge, 1” wide cut in fourths.

1.8.1.5. Pasta Salad – ½ Cup

1.8.1.6. Assorted Bakery Cookies – 2 cookies, 2.25 oz each

1.8.1.7. Assorted Individual Potato Chips – 1 each, 1 oz bag

1.8.1.8. Onion, Lettuce, Tomato - 1 piece each

1.8.1.9. Pickles, slices or spears

1.8.1.10. Lemonade - 8 oz.

1.8.1.11. Assorted Carbonated Beverage – 1, 12 oz. Can

1.8.1.12. Iced tea - 8 oz.

4.5. Condiments: All meals will have required condiments that complement the specific meal. Single service items include salt, pepper, salt substitute, individual butter, syrup, sugar free syrup, sugar, sugar substitute, assorted flavored creamers, jam, jelly, honey, hot sauce, BBQ sauce, ketchup, mustard, and mayonnaise.

CANCELLATION NOTICE

I. BOR NAME

Name your BOR exactly as listed below:

a. AFMIS REQUISITION NUMBER

CATMLS

GROCER

II. REQUESTER

a. NAME

b. UNIT

c. PHONE

d. REQUEST DATE

e. EVENT DETAILS (if needed, usually RRB)

III. DELIVERY/PICKUP POC

POC

CELLPHONE

EMAIL

IV. DETAILS

a. FOOD TYPE Catered Meals

b. DELIVERY TYPE Delivery Meal Type Definitions: 1. Hot - Sit down, hot meal with plates and immediately consumed at serving location. 2. Box, Later - Cold meal, individually packaged, stored by the soldier and to be consumed within 4 hours. 3. Box, Now - Hot meal, individually packaged, immediately consumed but at another location.

c. LOCATION

ADDRESS

CITY

STATE

BUILDING NAME / NUMBER

1400 W Scott Road, Beatrice, NE 68310 160 S 1st Ave, Broken Bow, NE 68822 220 County Road A, Ashland, NE 68003 485 E 12th St, Chadron, NE 69337 2018 Armory Drive, Columbus, NE 68601 3090 East Airport Road, Grand Island, NE 68801 6700 E J St, Hastings, NE 68901 5710 Airport Road, Kearney, NE 68847 1776 N 10th St, Lincoln, NE 68508 2601 NW 25th St, Lincoln, NE 68524 2433 NW 24th St, Lincoln, NE 68524 2411 W Butler Ave, Lincoln, NE 68524 2400 NW 24th St, Lincoln, NE 68524 2000 N 33rd St, Lincoln, NE 688524 38709 E Hwy 6 & 34, McCook, NE 69001 1707 N Airport Road, Norfolk, NE 68701 817 S 1st St, Norfolk, NE 68701 1700 N Jeffers St, North Platte, NE 69101 11650 Rainwood Road, Omaha, NE 68142 6929 Mercy Rd, Omaha, NE 68106 2810 1st Ave, Scottsbluff, NE 69361 201 N 8th St, Seward, NE 69434 2225 Legion Park Road, Sidney, NE 69162 338 W 15th St, Wahoo, NE 68066 800 E 7th St, Wayne, NE 68787 1129 E 6th Street, York, NE 68467 789 County Road J, Yutan, NE 68467 789 County Road J, Yutan, NE 68467

d. CLIN

e. DATE

f. DELIVERY TIME

g. TYPE

h. QTY

TOTAL

i. OTHER INFORMATION (if needed)

i. The above Quantity should include soldiers and family members, provide a breakout below.

1. SIK Soldiers

2. Non-SIK Soldiers

3. Family

3. Other Information (if needed)

i. BATTALION CONFIRMATION Signee is confirming the above has been reviewed; and approves entitlement and meal authorization.

j. MSC CONFIRMATION Signee is confirming the above is a NENG Bona-Fide Need.

k. G4 APPROVAL BPA Order Request is Approved.

PR Number

IV. DETAILS

a. FOOD TYPE Raw Subsistence

b. DELIVERY TYPE Pickup

c. DATE

d. TIME

e. ESTIMATE

e. CITY

IF POSSIBLE, PICK UP LOCATION SHOULD BE CLOSE TO:

f. LOCATION

ADDRESS

CITY

STATE

BUILDING NAME / NUMBER

220 County Road A, Ashland NE 68003 6700 E J St, Hastings NE 68901 2411 W Butler Ave, Bldg 652, Lincoln NE 68524 220 County Road A, Bldg 31, Ashland NE 68003 210 S Reed St, Beatrice NE 68310 3807 Twin Creek Drive, Suite 104, Bellevue NE 68117 160 S 1st Ave, Broken Bow NE 68822 485 E 12th St, Chadron NE 69337 472 26th Ave, Columbus NE 68601 515 E 1st St, Crete NE 68333 1010 K St, Fairbury NE 68352 W 21st, Falls City NE 68355 910 N Lincoln St, Fremont NE 68025 1250 D St, Gering NE 69341 3010 E Airport Road, Grand Island NE 68801 2900 W Lincoln Highway, Grand Island NE 68803 2015 W 3rd St, Hastings NE 68901 5710 Airport Road, Kearney NE 68847 2507 9th Ave, Kearney NE 68847 302 S Washington St, Lexington NE 68850 1776 N 10th St, Lincoln NE 68508 2400 NW 24th St, Lincoln NE 688524 1234 Military Road, Lincoln NE 68508 2950 N Park Road, Lincoln NE 68524 505 N 27th St, Suite 9, Lincoln NE 68503 2433 NW 24th St, Lincoln NE 688524 404 W 7th St, McCook NE 69001 1249 County Road 10, Mead NE 68041 2020 4th Corso, Nebraska City NE 68410 1707 N Airport Road, Norfolk NE 68701 817 S 1st St, Norfolk NE 68701 11650 Rainwood Road, Omaha NE 68142 1700 Jeffers St, North Platte NE 69101 601 W 9th St, Ogallala NE 69153 6929 Mercy Road, Omaha NE 68106 635 N 4th St, O'Neill NE 68763 2810 1st Ave, Scottsbluff NE 69361 201 N 8th St, Seward NE 69434 2225 Legion Park Road, Sidney NE 69162 2003 4th St N, Wahoo NE 68066 ????

106 Industrial Dr, Wayne NE 68787 1129 E 6th St, York NE 68467

g. GROCERY LIST IS ATTACHED.

h. OTHER INFORMATION (if needed)

i. ARMY USE ONLY (if needed)

i. BATTALION CONFIRMATION Signee is confirming the above has been reviewed; and approves entitlement and meal authorization.

j. MSC CONFIRMATION Signee is confirming the above is a NENG Bona-Fide Need.

l. G4 APPROVAL BPA Order Request is Approved.

PR Number

IV. DETAILS

a. FOOD TYPE

b. DELIVERY TYPE

IF POSSIBLE, PICKUP LOCATION SHOULD BE CLOSE TO:

c. LOCATION

ADDRESS

CITY

STATE

BUILDING NAME / NUMBER

1400 W Scott Road, Beatrice, NE 68310 160 S 1st Ave, Broken Bow, NE 68822 220 County Road A, Ashland, NE 68003 485 E 12th St, Chadron, NE 69337 2018 Armory Drive, Columbus, NE 68601 3090 East Airport Road, Grand Island, NE 68801 6700 E J St, Hastings, NE 68901 5710 Airport Road, Kearney, NE 68847 1776 N 10th St, Lincoln, NE 68508 2601 NW 25th St, Lincoln, NE 68524 2433 NW 24th St, Lincoln, NE 68524 2411 W Butler Ave, Lincoln, NE 68524 2400 NW 24th St, Lincoln, NE 68524 2000 N 33rd St, Lincoln, NE 688524 38709 E Hwy 6 & 34, McCook, NE 69001 1707 N Airport Road, Norfolk, NE 68701 817 S 1st St, Norfolk, NE 68701 1700 N Jeffers St, North Platte, NE 69101 11650 Rainwood Road, Omaha, NE 68142 6929 Mercy Rd, Omaha, NE 68106 2810 1st Ave, Scottsbluff, NE 69361 201 N 8th St, Seward, NE 69434 2225 Legion Park Road, Sidney, NE 69162 338 W 15th St, Wahoo, NE 68066 800 E 7th St, Wayne, NE 68787 1129 E 6th Street, York, NE 68467 789 County Road J, Yutan, NE 68467 789 County Road J, Yutan, NE 68467

d. CLIN

e. DATE

f. TIME

h. QTY

i. EST. COST

j. PRICE EST.

TOTAL

k. VENDOR DETAILS (if a specific vendor is required, provide details)

l. PROVIDE DETAILS OF FOOD REQUEST

m. CONFIRMATION

V. APPROVAL

By signing, the signee is confirming the above is a NENG Bona-Fide Need.

i. BATTALION CONFIRMATION Signee is confirming the above has been reviewed; and approves entitlement and meal authorization.

j. MSC CONFIRMATION Signee is confirming the above is a NENG Bona-Fide Need.

k. G4 APPROVAL BPA Order Request is Approved.

PR Number

ADJUSTMENT

1. Add as many rows as necessary.

2. Change the CLIN # to match the CLIN from Section III that needs to be changed.

3. Only change the needed fields. Do NOT copy all details from section IV.

a. CLIN

b. QTY

TOTAL

c. OTHER INFORMATION (if needed)

d. MODIFICATION APPROVAL Modification request is Approved.

ADJUSTMENT

1. Add as many rows as necessary. 2. Change the CLIN # to match the CLIN from Section III that needs to be changed. 3. Only change the needed fields. Do NOT copy all details from section IV.

a. FOOD TYPE Raw Subsistence

b. DELIVERY TYPE Pickup

c. DATE

d. TIME

a. UPDATED GROCERY LIST IS ATTACHED. DESCRIPTION OF CHANGES IS BELOW. (if needed)

f. OTHER INFORMATION (if needed)

d. MODIFICATION APPROVAL Modification request is Approved.

7 DAY ADJUSTMENT

1. Add as many rows as necessary. 2. Change the CLIN # to match the CLIN from Section III that needs to be changed. 3. Only change the needed fields. Do NOT copy all details from section IV.

a. CLIN

b. QTY

c. EST. COST

d. PRICE EST.

TOTAL

e. PROVIDE DETAILS OF FOOD REQUEST (if needed)

f. CONFIRMATION

V. APPROVAL

BPA Order Request is Approved.

V. RECEIPT OF DELIVERY

a. Were all items received?

b. List one issue per CLIN.

CLIN

ISSUE

NAME

DATE

V. RECEIPT OF DELIVERY

a. Were all items and meals received? Were they at the proper temperature?

b. Complete an inspection on one meal.

b. Complete an inspection on each meal that had an issue. Provide to your BN/MSC for submission.

1. All items received will be identified under each meal.

2. All items will be temped upon receipt in accordance with the attached instructions.

3. Each item will be temped twice. Temps will be taken in separate pans unless only one pan is received.

4. Inspection items: protein, starch, hot/cold vegetable, and prepared salad (fruit, egg, macaroni, potato, etc; but not lettuce)

5. If a hot or cold item is held for more than one (1) hour during a meal period, another temp check is required prior to serving.

(Add another Item Line to capture it.)

a. LOCATION

ADDRESS

CITY

STATE

BUILDING NAME / NUMBER

1400 W Scott Road, Beatrice, NE 68310 160 S 1st Ave, Broken Bow, NE 68822 220 County Road A, Ashland, NE 68003 485 E 12th St, Chadron, NE 69337 2018 Armory Drive, Columbus, NE 68601 3090 East Airport Road, Grand Island, NE 68801 6700 E J St, Hastings, NE 68901 5710 Airport Road, Kearney, NE 68847 1776 N 10th St, Lincoln, NE 68508 2601 NW 25th St, Lincoln, NE 68524 2433 NW 24th St, Lincoln, NE 68524 2411 W Butler Ave, Lincoln, NE 68524 2400 NW 24th St, Lincoln, NE 68524 2000 N 33rd St, Lincoln, NE 688524 38709 E Hwy 6 & 34, McCook, NE 69001 1707 N Airport Road, Norfolk, NE 68701 817 S 1st St, Norfolk, NE 68701 1700 N Jeffers St, North Platte, NE 69101 11650 Rainwood Road, Omaha, NE 68142 6929 Mercy Rd, Omaha, NE 68106 2810 1st Ave, Scottsbluff, NE 69361 201 N 8th St, Seward, NE 69434 2225 Legion Park Road, Sidney, NE 69162 338 W 15th St, Wahoo, NE 68066 800 E 7th St, Wayne, NE 68787 789 County Road J, Yutan, NE 68467 789 County Road J, Yutan, NE 68467

c. MEAL #

d. DATE

e. DELIVERY TIME

f. INSPECTION TIME

g. MEAL TYPE Item # Item Name Item Type # of Pans Temp. Taken Per Pan (°F) DETAIL ISSUES (one issue per line)

h. NOTE ANY OTHER DISCREPANCIES/ISSUES

i. REQUESTER/UNIT REP NAME

j. DATE

k. BN/MSC NAME

l. DATE

V. CERTIFICATION

a. The government has received all items requested in Section IV and the attached list. b. Any discrepancies need to be listed individually in the Discrepancy Summary.

DISCREPANCY SUMMARY

1. Add as many rows as necessary. 2. Change the CLIN # to match the CLIN from Section IV. 3. Provide the What and the Why for each discrepancy.

Requested Qty Consumed Qty

CLIN

SIK

Non-SIK

SIK

Non-SIK Why did it change?

TOTAL

OTHER NOTES (missing items, complaints, positive comments, ideas, etc.)

NAME

DATE

V. CERTIFICATION

a. The government has received all meals requested in section IV (if applicable). Only SIK soldiers received meals. b. Any discrepancies are listed by CLIN in the Discrepancy Summary.

DISCREPANCY SUMMARY

1. Add as many rows as necessary. 2. Change the CLIN # to match the CLIN from Section IV. 3. Provide the What and the Why for each discrepancy.

Requested Qty Consumed Qty

CLIN

SIK

Non-SIK

SIK

Non-SIK Why did it change?

TOTAL

OTHER NOTES (missing items, complaints, positive comments, ideas, etc.)

NAME

DATE

CANCELLATION NOTICE

BOR

has been cancelled. Meals or Subsistence are no longer required.

DISCREPANCY SUMMARY

1. Add as many rows as necessary. 2. Change the CLIN # to match the CLIN from Section III. 3. Provide the What and the Why for each discrepancy.

CLIN

WHAT CHANGED?

WHY DID IT CHANGE?

NAME

DATE

NEARNG BOR MASTER COPY

Type Price Hot - BK Box, Later - BK Box, Now - BK Hot - LN/DN Box, Later - LN/DN Hot - DN Box, Later - DN WFS Edibles RRB Meals RRB Edibles Emergency Squirrel

VI. DELIVERY TICKET

Vendor will provide the below information.

a. VENDOR NAME

b. BPA NUMBER

c. THIRD PARTY VENDOR (if applicable)

d. WAS THE ABOVE PROVIDED AS REQUESTED?

W91243-21-A-0002 W91243-21-A-0003

DISCREPANCY SUMMARY

1. Add as many rows as necessary. 2. Change the CLIN # to match the CLIN from Section IV. 3. Provide the What and the Why for each discrepancy.

Item # What changed? Detail discrepancy.

Why did it change?

e. NAME

f. DATE 11.0.0.20130303.1.892433.887364 John Smith 104 D Co 1234567890 Army Guard training John Smith 1234567980 john.smith@army.mil John Doe 1234567890 john.dow@amry.mil