Attachment 3 Djibouti CM Request Form.pdf

PDF 983 KB Posted Oct 13, 2022

Attached to: DLA Disposition Services Equipment Maintenance in Djibouti Africa
Solicitation number: SP4510-23-R-1001
Issued by: Defense Logistics Agency

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Other files

File	Type	Posted
Attachment 1 - Djibouti Equipment Listv2.xlsx	XLSX spreadsheet	Oct 13, 2022
Attachment 2 - 5520.1R BASE ACCESS POLICY.pdf	PDF	Oct 13, 2022
Attachment 4 PWS_Djibouti MHE Maintenance.docx	DOCX document	Oct 13, 2022
Attachment 6 Past Performance Questionairre.doc	DOC document	Oct 13, 2022
Attachment 5 Price Schedule_Djibouti MHE Maintenancev2.xlsx	XLSX spreadsheet	Oct 13, 2022

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Djibouti Corrective Maintenance Request Form

Item

DLA

Number Manufacturer Model Number Part Number Serial Number Description Qty Unit Price Cost Estimate

Qty Received

TOTALS

COR APPROVAL:

Description of Deficiency:

REQUEST NUMBER:

DATE REQUESTED:

TASK ORDER:

SIGNATURE:

LOCALLY GENERATED FORM JMB v. 20140305

Name:

ORDER NUMBER:

DLA Number1:

Manufacturer1:

Model Number1:

Part Number1:

Serial Number1:

Description1:

Qty1:

Unit Price1:

Cost Estimate1: 0

Qty Received1:

DLA Number2:

Manufacturer2:

Model Number2:

Part Number2:

Serial Number2:

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Qty2:

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Cost Estimate2: 0

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Description14: Labor Hours

Qty14:

Unit Price14:

Cost Estimate14: 0

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Description15: Trip Fee

Qty15:

Unit Price15:

Cost Estimate15: 0

Qty Received15:

QtyTOTALS:

Unit PriceTOTALS:

Cost EstimateTOTALS: 0

Qty ReceivedTOTALS:

ADDITIONAL INFORMATION:

NAME2:

Option:

Date1_af_date:

Labor Cost: Parts Shipping

File details come from the government source that posted it. Updated Oct 13, 2022.