Attach 10 - DD Form 1155_Order for Supplies or Services.pdf
PDF 69 KB Posted
- Attached to
- Philippines HW Removal and Disposal Federal contract opportunity
- Solicitation number
- SP4500-24-R-0012
- Issued by
- Defense Logistics Agency
About this file
This document is a DD Form 1155 - Order for Supplies or Services. It is a standard government form used to place orders against a contract or purchase agreement. The form includes details such as the contract/order number, delivery information, accounting data, item descriptions, quantities, unit prices, and signatures for acceptance and receipt. This particular form appears to be a blank template and does not contain any specifics related to a particular federal contract opportunity.
The related federal contract opportunity is for the Philippines Haz Waste Removal & Disposal requirement. The solicitation seeks a contractor to provide expertise, management, and all services required to arrange the removal, transportation, storage, disposal, and/or recycling of hazardous wastes generated by U.S. Department of Defense installations in and around the Philippine Islands. The contract will have a 30-month base period and a 30-month option period. The solicitation is being issued by the Defense Logistics Agency.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attach 5 Terms and Conditions Philippines.docx | DOCX document | |
| Attach 7 Pick Up Locations.pdf | ||
| Attach 12 - Philippines -Transporter Profile Sheet.pdf | ||
| Attach 5 Terms and Conditions Philippines.docx | DOCX document | |
| Attach 1 PI PWS_Final 022624.docx | DOCX document | |
| Attach 13 - Philippines-Facility Profile Sheet.pdf | ||
| Attach 8 - CAC Application Process.pdf | ||
| Attach 3 - Instruction to Offerors.docx | DOCX document | |
| Attach 2 PI PS 022724.xlsx | XLSX spreadsheet | |
| Attach 4 - Evaluation.docx | DOCX document | |
| List of Attachments.docx | DOCX document | |
| Attach 6 Past Performance Information PPI.pdf | ||
| Attach 11 - DLA Form 2505.xlsx | XLSX spreadsheet |
Show all 13
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Text version
14. SHIP TO
ORDER FOR SUPPLIES OR SERVICES
PAGE 1 OF
1. CONTRACT/PURCH ORDER/AGREEMENT NO. 2. DELIVERY ORDER/CALL NO. 3. DATE OF ORDER/CALL
(YYYYMMMDD)
4. REQUISITION/PURCH REQUEST NO. 5. PRIORITY
6. ISSUED BY CODE 7. ADMINISTERED BY (If other than 6) CODE 8. DELIVERY FOB
DESTINATION
OTHER
(See Schedule if other)
10. DELIVER TO FOB POINT BY (Date)
(YYYYMMMDD)
12. DISCOUNT TERMS
13. MAIL INVOICES TO THE ADDRESS IN BLOCK
11. X IF BUSINESS IS
SMALL
SMALL DISAD-
VANTAGED
WOMEN-OWNED
CODE 15. PAYMENT WILL BE MADE BY CODE MARK ALL
PACKAGES AND
PAPERS WITH
IDENTIFICATION
NUMBERS IN
BLOCKS 1 AND 2.
16.
TYPE
OF
ORDER
DELIVERY/
CALL
PURCHASE
This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract.
Reference your furnish the following on terms specified herein.
ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME.
If this box is marked, supplier must sign Acceptance and return the following number of copies:
NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED
(YYYYMMMDD)
17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE
18. 19. OF SUPPLIES/SERVICES
20. QUANTITY
ORDERED/
ACCEPTED*
21.
UNIT
22. UNIT PRICE 23.
*If quantity accepted by the Government is same as quantity ordered, indicate by X.
If different, enter actual quantity accepted below quantity ordered and encircle.
24. UNITED STATES OF AMERICA 25.
26.
DIFFERENCES
30.
27a. QUANTITY IN COLUMN 20 HAS BEEN
INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO
THE CONTRACT EXCEPT AS NOTED:
c. DATE
(YYYYMMMDD)
b. OF AUTHORIZED GOVERNMENT REPRESENTATIVE
28. SHIP.
PARTIAL
FINAL
31. PAYMENT
COMPLETE
PARTIAL
FINAL
29. D.O. VOUCHER NO.
32. PAID BY 33. FOR
34. NUMBER
35. OF LADING NO.
42.
36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT.
a. DATE
(YYYYMMMDD)
b. SIGNATURE AND TITLE OF CERTIFYING OFFICER
37. RECEIVED
AT
38. RECEIVED BY (Print) 39. DATE RECEIVED
(YYYYMMMDD)
40. TOTAL CON-
TAINERS
41. S/R ACCOUNT NUMBER
CONTRACTING/ORDERING OFFICER
9. CONTRACTOR CODE FACILITY
z z z z
NAME
AND
ADDRESS
BY:
d. NAME AND TITLE OF AUTHORIZED GOVERNMENT
REPRESENTATIVE
e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE
f. g.
ITEM NO. SCHEDULE AMOUNT
TOTAL
INITIALS
SIGNATURE
NO.
AMOUNT VERIFIED CORRECT
CHECK
BILL
S/R VOUCHER NO.
PRINTED
TELEPHONE NUMBER E-MAIL ADDRESS
DD FORM 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE.
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