Att 4 F76 Traceability Sheet.pdf
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- Solicitation number
- SPE602-25-R-0707
- Issued by
-
Defense Logistics Agency Energy
About this file
These are two F-76 certification forms from the Defense Logistics Agency Energy for a bulk petroleum products contract. The F-76 Traceability Signature Page requires vendors to certify the composition and traceability of F-76 fuel, including materials percentages, additives, and concentration levels. Vendors must select one of three traceability options and attest that no unauthorized materials or unapproved additives have been blended into the final product.
The F-76 Synthetic Component Certification form requires vendors to confirm that synthetic paraffinic materials are derived from Fischer-Tropsch (FT) or Hydroprocessed Renewable Diesel (HRD) methods. Vendors must certify that since the last certificate of analysis, no changes have occurred in feedstock material, production location, production processes, or production units. The form requires vendors to provide the date of the most recent certificate of analysis and its identifying report number.
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DEFENSE LOGISTICS AGENCY ENERGY
8725 JOHN J. KINGMAN ROAD
FORT BELVOIR, VIRGINIA 22060-6222
DISTRIBUTION STATEMENT – A: APPROVED FOR PUBLIC RELEASE. DISTRIBUTION IS UNLIMITED
F-76 Traceability Signature Page
Contract or Solicitation Number:
CLIN:
Order Number:
Shipment Number:
Traceability OPTION selected per paragraph e.5 (circle or otherwise indicate which one of the three options is chosen):
OPTION 1 OPTION 2 OPTION 3
F-76 fuel supplied under the above contract, CLIN, order number and shipment number maintains traceability with respect the materials composition, additives and their concentration levels. This signed statement certifies that at no point have any unauthorized un- hydrotreated light cycle oils, other unauthorized materials, or additives been blended into the final product or any of its associated blend components per the most recent revision of MIL-DTL-16884 at date of contract award. All materials and additives are listed below. The percentage of each material as defined in sections 3.2, 3.2.2, and 3.2.3 (i.e. refined hydrocarbon distillate fuel, Fischer-Tropsch, Hydroprocessed Renewable Diesel, etc.) and the concentration level for each additive are also shown. For the purposes of the offeror submission this signed statement attests that no unapproved additives or materials will be added to batches or components of batches of F- 76 for delivery under government contracts.
Signature:
Printed Name:
Title:
Company Name:
Date:
Material Percent
Additive Concentration Responsible Party for Injection
DEFENSE LOGISTICS AGENCY ENERGY
8725 JOHN J. KINGMAN ROAD
FORT BELVOIR, VIRGINIA 22060-6222
DISTRIBUTION STATEMENT – A: APPROVED FOR PUBLIC RELEASE. DISTRIBUTION IS UNLIMITED
F-76 Synthetic Component Certification
Contract or Solicitation Number:
CLIN:
Order Number:
Shipment Number:
Synthetic paraffinic materials supplied as indicated with the above contract, CLIN, order number, and shipment number is derived from either Fischer-Tropsch (FT) or Hydroprocessed Renewable Diesel (HRD) methods. This signed statement certifies that since the last certificate of analysis (COA), including table A-II or B-II results of MIL-DTL-16884P, Appendix A or B, no changes, including feedstock material, production location, or production processes have been made. In addition, no turnaround events have been executed on any units utilized to produce the synthetic paraffinic materials since the last COA, including table A-II or B-II, properties were tested. Please supply the date of the most recent COA and an identifying number for that report in the space provided below.
DATE OF COA: _
LAB REPORT ID NUMBER
Signature:
Printed Name:
Title:
Company Name:
Date:
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