Attachment 5 - Invoice_DLA Form 2505.xlsx

DLA Form XLSX spreadsheet 20 KB Posted

Attached to
Hazardous Waste Removal and Disposal at Iwakuni, Japan
Solicitation number
SP450026BE038
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About this file

This file is a DLA Form 2505 Invoice template prescribed by FAR 32.9 and DLAM 4140.15, used for invoicing hazardous waste removal and disposal contracts under DLA Disposition Services. The form serves as a template for contractors to document contract performance and invoice for services rendered related to waste disposal operations.

The invoice template requires contractors to certify the accuracy and completeness of contract performance supporting data. It contains 11 data columns for line-item tracking: Line Item Number, Hazardous Item Number (HIN), Picked Up Quantity, Pickup Manifest Number, Manifest Page/Line, Container Number and Type, Final Quantity Disposed or Received, Interim/Disposal Manifest Number, Interim/Disposal Facility EPA ID, Final Disposal Management Method Codes, and TSDF Accept/Disposal Dates. The form includes conditional completion requirements based on contract type (special service/supply items, foreign contracts, or U.S. contracts with Certification of Destruction/Recycling requirements or HIN 650300). The instructions specify that contractors complete only columns 1-4 for standard U.S. contracts without certification requirements, while all columns must be completed for contracts containing certification requirements or hazardous items. This template is essential for documenting the complete waste management chain from pickup through final disposal at Treatment, Storage, and Disposal Facilities (TSDFs), including interim handling and transportation documentation.

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Other versions and copies of DLA Form 2505

File Revision Posted Attached to
Attachment 8_DLA Form 2505 Invoice_Riley Minot Ellsworth_23-D-0001_Contract Renewal_25-BE-049_v2Feb25.xlsx Feb 2, 2025 Riley / Minot / Ellsworth Hazardous Waste and Disposal
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Attachment 14- DLA Form 2505.xlsx Revision not stated Sierra-Bridgeport Hazardous Waste Removal and Disposal
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InvoicePrescribed 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 QtyP/U Mnfst #Mnfst Pg/LiCTN No & TypeQty Disposed or ReceivedInterim/Disp Manifest #Interim/ Disposal Facility EPA ID #Interim/ Disposal MMCTSDF 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 .