Attach 13 - DLA Form 2505.xlsx
DLA Form XLSX spreadsheet 20 KB Posted
- Solicitation number
- SP450023R0016
- Issued by
-
Defense Logistics Agency
About this file
This document contains an invoice template for contractors to submit payment requests related to the removal and disposal of hazardous waste from Okinawa under solicitation number SP450023R0016. The template requires contractors to provide line item numbers, document numbers, hazardous item numbers, quantities picked up and disposed of, manifest numbers, and facility EPA IDs for all interim storage and final disposal locations. For lines requiring certificates of destruction or recycling, contractors must also provide the acceptance and disposal dates.
The related federal contract opportunity is for off-island hazardous waste removal and disposal services on Okinawa issued by the Defense Logistics Agency. Contractors should use the provided invoice template to request payment for services performed in transporting hazardous materials from Okinawa to interim storage and final approved disposal facilities elsewhere.
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Who attaches DLA Form 2505
| Agency | Files |
|---|---|
| Defense Logistics Agency | 43 |
| Defense Logistics Agency Disposition Services | 13 |
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Text version
| Invoice | Prescribe by: FAR 32.9/DLAM 4140.15 Sponsor: Disposition Services | ||||
| COMPANY NAME: | CONTRACT #: | TO #: | INVOICE AMOUNT ($): | DATE: |
| "I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT THIS CONTRACT PERFORMANCE SUPPORTING DATA IS ACCURATE, COMPLETE AND MEETS ALL REQUIREMENTS SET FORTH IN THE CONTRACT." | ||||||||||
| NAME: | Signature: | |||||||||
| 1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | 9. | 10. | 11. |
| Line Item # | Document # | HIN # | P/U Qty | P/U Mnfst # | Mnfst Pg/Li | Qty Disposed or Received | Interim/Disp Manifest # | Interim/ Disposal Facility EPA ID # | Interim/ Disposal MMC | TSDF Accept Dates/ PCB Dates (DD/MMM/YY) |
DLA Form 2505, FEB 2022 Page 1 of 2 PDF (DLA)
2505 04/2021 (Draft Revision) &P
INSTRUCTIONS
| NOTE 1: For special service and supply items, complete only blocks 1, 2, 3 and 7. |
| NOTE 2: For foreign contract disposal lines, complete all columns. |
| NOTE 3: For US contracts, complete all columns only when the task order contains line(s) requiring a Certification of Destruction (CD) or Certification of Recycling (CR) or contains HIN 650300. Complete only columns 1 thru 4, 6, 7 and 11 when the task order DOES NOT contain line(s) requiring a certificate of destruction (CD) or a certificate of recycling (CR) or HIN 650300. |
Column 1: Line Item # - DD Form 1155 or SF30 line-item number for the supply or service ordered. (Four digits - e.g.: 0001)
Column 2: Document # - Document number as it appears on DD Form 1155 or SF30 (Six characters -e.g.: NR04C7)
Column 3: Hazardous Item Number (HIN) # - HIN Number as it appears on DD Form 1155 or SF30 (Six characters -e.g.: NR04C7)
Column 4: Picked Up (P/U) QTY - Actual quantity picked up.
Column 5: P/U Mnfstr # - Manifest document number assigned to each manifest or shipping paper used to ship the waste to the initial TSDF (5 or 12 characters - e.g.: 02034; 123456789GBF)
Column 6: Manifest Page/Line- Identify the page and manifest line number that the document number has been placed on from manifest block 9a, 27a, etc…. (Does not apply for foreign contracts.)
Column 7: Final QTY Disposed or Received – Actual quantity of item disposed or service/supply performed/delivered.
Column 8: Interim/ Disposal Manifest # - Manifest document number assigned to each manifest or shipping paper used to ship all, or parts of the waste to other TSDFs, including all interims and finals, after receipt at initial TSDF. EXCEPTION: If final treatment/ disposal is accomplished by the initial TSDF, insert "Same as # 4 or SAC4" and do not need to fill out columns 6 thru 11. (EXCEPTION #2 Lines requiring a CD/CR will require block 11 CD date entry DD/MMM/YY)
Column 9: Interim/Disposal Facility EPA# - EPA Identification number (or DLA Disposition Services "dummy" number) assigned to each facility involved in the treatment, storage, and final disposal. (As defined in section 5.0 of the contract) of the item. Use additional lines as necessary. (Twelve digits - e.g.: PAD456123912) NOTE: If final disposal did not occur at the initial facility, then the initial facility is considered an interim facility for tracking purposes. In those instances, the initial facility's EPA ID number should be included in Column 9 when information is submitted.
Column 10: Final Disposal MMC Codes - List the appropriate Management method code(s) listed in the Hazardous Waste Report Instructions and Forms online (https://www.epa.gov/sites/production/files/2015-06/documents/codes.pdf). (40 CFR 264, Appendix 1, Table 2 no longer applies), performed by any final disposal facilities. Note: Include any treatment and/or handling performed at initial TSDF, which was NOT identified in initial facility.
Column 11: Interim/Disposal TSDF Accept Date and Disposal Date (CD/CR required lines Only) - Actual date listed on the shipping paper next to the signature of the representative of each and every interim and final TSDF's accepting, treating, and/or disposing of the waste (dd/mmm/yy). NOTE - Date of actual final disposal of CD/CR required lines item (dd/mmm/yy).
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