Attachment 4 - Invoice_DLA Form 2505.xlsx
XLSX spreadsheet 20 KB Posted
- Attached to
- Hazardous Waste Disposal Barstow China Lake
- Solicitation number
- SP450026R0012
- Issued by
-
Defense Logistics Agency
About this file
This is a DLA Form 2505 invoice template prescribed by FAR 32.9 and DLAM 4140.15 for use by contractors performing hazardous waste disposal services under Defense Logistics Agency contracts. The form serves as the primary billing document for contractors to invoice DLA Disposition Services for waste removal, transportation, and disposal activities.
The invoice template requires contractors to document line-item-level details including the line item number, Hazardous Item Number (HIN), quantity picked up, manifest document numbers, container information, final quantity disposed or received, interim and final disposal manifest numbers, EPA identification numbers of facilities involved, Management Method Codes (MMC), and acceptance/disposal dates. The form accommodates multiple disposal pathways, including situations where waste is transferred between Treatment, Storage, and Disposal Facilities (TSDFs) as well as direct final disposal at the initial facility. Special instructions distinguish between foreign contracts, U.S. contracts requiring Certificates of Destruction (CD) or Recycling (CR), and contracts involving HIN 650300, each with specific column completion requirements. The template is designed to ensure complete tracking and documentation of hazardous waste from pickup through final disposal, supporting compliance with RCRA regulations and contract performance verification requirements.
View the file
Other files
Show all 14
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
| Invoice | Prescribed by: FAR 32.9/DLAM 4140.15 Sponsor: DLA 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 # | HIN # | P/U Qty | P/U Mnfst # | Mnfst Pg/Li | CTN No & Type | 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 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 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: Hazardous Item Number (HIN) # - HIN Number as it appears on DD Form 1155 or SF30 (Six characters -e.g.: NR04C7)
Column 3: Picked Up (P/U) QTY - Actual quantity picked up.
Column 4: 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 5: 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 6: Containers (CTN) No & Type – Identify the number of containers and type of containers from block 10, 28, 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).
File details come from the government source that posted it. Updated .