Attachment 11 - F76 Trace Sig Page.pdf

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Attached to
Bulk Petroleum Products - Atlantic/Europe/Mediterranean (AEM) Program - SPE60224R0700
Solicitation number
SPE60224R0700
Issued by

About this file

This document contains two signature pages for certifying traceability and synthetic components of F-76 fuel supplied under federal contracts.

The first signature page is required to certify traceability of the materials composition, additives, and their concentration levels in F-76 fuel supplied under the contract, CLIN, order number, and shipment number. The signature confirms that no unauthorized materials or additives have been blended in and that all materials and additives, along with their percentages and additive concentration levels, are documented. The second signature page is needed to certify that synthetic paraffinic materials derived from Fischer-Tropsch or Hydroprocessed Renewable Diesel processes have not changed in feedstock material, production location, or production processes since the last certificate of analysis. It also confirms that no turnaround events have occurred on production units since the last certificate of analysis. Both signature pages require documentation of the date and identification number of the most recent certificate of analysis.

The related federal contract opportunity is solicitation number SPE60224R0700 from the Defense Logistics Agency Energy for bulk petroleum products under the Atlantic/Europe/Mediterranean program.

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Text version

DEFENSE LOGISTICS AGENCY ENERGY Attachment 4

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:

File details come from the government source that posted it. Updated .