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
- W9127N23Q0XPW
About this file
This document is a sample call order form for quality assurance materials testing under Blanket Purchase Agreement W9127N23Q0XPW with the Department of the Army Corps of Engineers Engineering District Portland. The form outlines project and location details to identify the specific testing required. It includes line items from the BPA price schedule for various testing services with estimated quantities, unit costs, and total costs. Coordination points of contact are identified for the government and testing lab or contractor. The form specifies requirements for formal test reports and documentation to be provided electronically within timeframes. Special considerations note any security, training, or site access needs and provide an alternative point of contact for scheduled testing. Finally, billing instructions require invoices to be emailed to the government's designated credit card holder or finance center depending on total costs.
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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 .