Attachment 5 - QA Materials Testing Call Order Form Sample.docx
DOCX document 21 KB Posted
- Attached to
- QA Material Testing Blanket Purchase Agreement
- Solicitation number
- W9127N23Q0WGG
About this file
This document is a sample call order form for quality assurance materials testing under the Department of the Army Corps of Engineers Engineering District Portland blanket purchase agreement number W9127N23Q0WGG. The form requests information on the specific contract and project location for testing, lists the testing items and estimated costs from the blanket purchase agreement price schedule, and provides points of contact and requirements for reports, billing, and delivery. Testing will be used to verify other contractor tests and ensure accurate payment, with official reports due within 24 hours of completion and formal reports within three calendar days. Invoices should be emailed to the specified government purchase card holder and payment will be made by credit card for tests under $2,500 or electronic check for tests over $2,500 within timeframes outlined in the document.
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| Attachment 3 - BPA Terms Conditions 10May2023.docx | DOCX document | |
| Attachment 2 - QA Mat Test PWS 14 June 2023.pdf | ||
| Attachment 8 - Clauses Provisions.docx | DOCX document | |
| Attachment 6 - BPA Call Order Tracking Sheet Sample.xlsx | XLSX spreadsheet | |
| Attachment 4 - NWP Supplement HECP.pdf | ||
| Attachment 1 - BPA Tests and Sampling Schedule and Price List 10May2023.xlsx | XLSX spreadsheet | |
| Attachment 7 - BPA Wage Determination List.docx | DOCX document |
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Text version
Attachment 5 - QA Materials Testing Call Order Form Sample
(Name and Address of Lab/Contractor from BPA Selected) Blanket Purchase Agreement No. _______________ For _________ Office
1. PROJECT/CONTRACT INFORMATION.
| Contract No.: | ________________ | ||
| Contract Name (or Design Title): | ________________ | ||
| Location: | ________________ |
2. PROJECT LOCATION. (Include specific location of the project and location of testing or samples to be taken, include entrance to the contract site, to include the City, and State)
3. STATEMENT OF WORK/OBJECTIVES. Government Estimate below is based upon the Blanket Purchase Agreement No. ____________ Price Schedule (make sure to identify FY Price Schedule, for example: FY23 Price Schedule). The Contractor shall provide all labor, equipment and materials to perform the following:
(fill in this information from the specific BPA Price Schedule)
| ITEM NO. |
| DESCRIPTION (Title/description of tests as stated in Price Schedule) |
| Qty |
| Unit |
| Est Unit total $ |
| Est Total $ |
| $0.00 |
| $0.00 |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
| $ |
Total
4. COORDINATION WITH GOVERNMENT.
Primary/On-site Point of Contact is _________, whose phone number is ______.
Alternate POC is _______, whose phone number is _________.
5. FORMAL REPORTS AND DOCUMENTATION. Official reports/results shall be emailed to the Government, ATTN: __________ (also include the applicable COR), within 24 hours after completion of the tests, formal letters reports shall follow within 3 calendar days.
Email address to provide items to is: __________________.
6. SPECIAL CONSIDERATIONS. Reference Blanket Purchase Agreement and Performance Work Statement provided with agreement for specific testing requirements and performance standards. This testing will be used to assure the accuracy of the other contractor’s tests and may be used to verify accurate payment.
(Include specific and special information/considerations that will need to be known by the contractor/lab personnel coming to the construction site to take the samples/perform the testing. Example, any security requirements, HECP-AP training needs, how to find the site or general site access route, even consider providing an alternate contact person for the scheduled day.)
7. DELIVERY REQUIREMENTS.
Anticipated date of testing needed: ___________.
Estimated start time: ______________.
Request Tech arrive at or about ________ hrs.
8. BILLING REQUIREMENTS. Invoices shall be emailed to the Government, ATTN: (List the GPCC holder), whose email address is ____________________. Payment for tests under $2,500 will be made by credit card VISA payments, within seven calendar days of receipt of invoice and all testing requirements were met satisfactory. For tests over $2,500 payment will be made by USACE Finance Center via electronic check payment within 30 calendar days of testing requirements completed satisfactory and invoiced received.
File details come from the government source that posted it. Updated .