A3_Sample_Testing_Call_Order_Form.docx
DOCX document 30 KB Posted
- Attached to
- Blanket Purchase Agreement - Sample Testing
- Solicitation number
- W9127N26QA092
About this file
This is a Sample Testing Call Order Form template used to request metal coupon testing services under a Blanket Purchase Agreement (BPA) with the Department of the Army Corps of Engineers, Portland District (USACE). The form provides a standardized format for contractors to receive and execute individual testing call orders for metal coupons that support quality assurance processes for Government-procured components.
The form captures essential project information including the BPA number, contract details, and project location, along with a table identifying specific samples by ID number, material type, and required testing description. The Statement of Work section outlines labor, equipment, and materials needed to perform testing, with optional line items for small specimen machining surcharges (CLIN 0011) and extra storage (CLIN 0012). Coordination is managed through identified Government points of contact, including Sarah Knowles (Primary POC, 360-535-9321) and Brittany Heffernan (Secondary POC, 503-983-3143). Test results must be submitted via email within 24 hours of completion to the Government and the Contracting Officer's Representative. The delivery window and administration period are to be specified, with an additional 60-90 day buffer recommended for delayed deliveries or retests. Invoices are directed to Sarah Knowles and the CENWP-HDC-Invoices mailbox. Contractors must reference the associated Blanket Purchase Agreement and Performance Work Statement for specific testing requirements and performance standards, and maintain USACE Materials Testing Center validation along with ISO/IEC 17025 certification throughout the agreement period.
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Other files
| File | Type | Posted |
|---|---|---|
| A5_Sample_Test_TermsConditions_BPA.docx | DOCX document | |
| A6_QASP Sample Testing.docx | DOCX document | |
| A4_Sample_Testing_PWS.pdf | ||
| A2_Sample_Testing_Call_Order_Tracking_Sheet.xlsx | XLSX spreadsheet | |
| A1_Bid Schedule.xlsx | XLSX spreadsheet | |
| Combined Synopsis Solicitation - Sample Testing BPA - Signed.pdf | ||
| A7_ACWS Clauses and Provisions.pdf |
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Text version
Attachment 3 – Sample Testing Call Order Form
Firm Name Firm Address Blanket Purchase Agreement No. XX
For CENWP-HDC Office
1. PROJECT/CONTRACT INFORMATION.
| Contract No.: | ________________ | ||
| Contract Name (or Design Title): | ________________ | ||
| Location: | ________________ |
2. PROJECT BACKGROUND. Details for the samples included within this Call are provided within the table below including ID Number, Material Type, and Testing Description. Coupons requiring small specimen machining surcharges [are / are not] expected within this Call.
| ID Number: |
| Material Type: |
| Testing Description: |
| Example: Heat #1111, Serial #2222 |
| Example: A743 CA6NM |
| Example: Blade Coupons – CLIN 0003 Tests |
3. STATEMENT OF WORK/OBJECTIVES. Government Estimate below is based upon the Blanket Purchase Agreement No. W9127NXXA00XX Price Schedule, Option Year 1. Provide all labor, equipment, and materials to perform the work within the table below. If a coupon arrives at a Contractor facility that requires CLIN 011 in order to fabricate sub-standard specimen sizes to complete required tests, inform the Government Points of Contact identified in Section 4. The Government will inform the Contractor within 30 days of receiving test results whether CLIN 0012 will be exercised.
| ITEM NO. |
| DESCRIPTION (Title/description of tests as stated in Price Schedule) |
| Qty |
| Unit |
| Est Unit total $ |
| Est Total $ |
| 1 |
| Example: CLIN 0003 – Sample without Charpy, low carbon limit |
| 1 |
| 1 |
| $ |
| $ |
| 2 |
| (OPTIONAL) CLIN 0011 Small Specimen Machining Surcharge |
| 1 |
| Per |
| $ |
| $ |
| 3 |
| (OPTIONAL) CLIN 0012 Extra Storage |
| 1 |
| Per |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
Total
4. COORDINATION WITH GOVERNMENT.
Primary Point of Contact is Sarah Knowles, whose phone number is 360-535-9321.
Secondary Point of Contact is Brittany Heffernan, whose phone number is 503-983-3143.
Alternate POC is _______ (DL), whose phone number is _________.
5. FORMAL REPORTS AND DOCUMENTATION. Email official reports/results to the Government, ATTN: __________ (DL) and Sarah Knowles (COR), within 24 hours after completion of the tests.
Email official reports/results to the following addresses:
DL Email Any alternate POC emails brittany.m.heffernan@usace.army.mil sarah.l.knowles@usace.army.mil
6. SPECIAL CONSIDERATIONS. Reference Blanket Purchase Agreement No. W9127NXXA00XX and associated Performance Work Statement for specific testing requirements and performance standards. Test results will be used to assure the accuracy of component quality control within other USACE contracts.
7. DELIVERY REQUIREMENTS.
Estimated delivery window: _____________.
Administration period of Performance: _____________. (Add 60-90 days after estimated delivery window to account for delayed deliveries or necessary retests.)
8. BILLING REQUIREMENTS. Invoices shall be emailed to the Government, ATTN Sarah Knowles at Sarah.L.Knowles@usace.army.mil and to Outlook Mailbox: CENWP-HDC-Invoices@usace.army.mil.
File details come from the government source that posted it. Updated .