ATTACHMENT 7_All Services Call Order Form.pdf

USFS TOILET PUMPING AND WASTEWATER SERVICES BPA CONTRACT

CALL ORDER FORM

USFS REQUESTING UNIT

Date of USFS task order issued:_________________________________________________________

USFS Office requesting unit (Forest/District):______________________________________________

USFS Representative Name:____________________________________________________________

Phone:______________________________________________________________________________

Email:______________________________________________________________________________

CONTRACTOR

Company Name:______________________________________________________________________

Address:_____________________________________________________________________________

Phone:_______________________________________________________________________________

Email:________________________________________________________________________________

CALL ORDER INSTRUCTIONS

Call orders will be issued by the USFS designated Contracting Officer’s Representative (COR). Call order(s) will be issued by the Forest Service via email, fax, or text to the contractor. Within five (5) business days the contractor will confirm receipt and send back to the USFS Contracting Officer. Date and time when work will start will be confirmed on the call order and signed by both the USFS CO and the contractor. Work schedule must be approved by the FS unit (forest) COR prior to commencement.

USFS REQUESTING FOREST UNIT - CALL ORDERING INSTRUCTIONS

1. These instructions are for the USFS requesting unit.

2. Check the task requesting to be performed by a contractor.

3. Fill out the ordering table below to include the list of sites to be serviced in accordance with each task checked.

4. Provide a map, directions, or specific entrance instructions to the contractor.

Remember to provide access to locked facilities.

5. If FS Requesting Unit requires services that exceed the micro-purchase threshold, the FS

Unit must complete an IAS requisition package (including this document as the Call Order form).

CONTRACTOR INSTRUCTIONS

1. For each task requested, ensure that the appropriate form is filled out: For Task 1 – Pumping Services Form & Basic Inspections Form, and Task 2 – Cleaning Services Call Order Form.

2. See the list included below.

3. Contact and coordinate USFS Ordering Unit to discuss times/dates for services.

4. All services issued from each task order in a call order must be completed within 10 days call from the date of the issued call order. For Emergency or single services, contractor must provide services within 48 hours of the date listed on each call order issued.

5. All deliverables (required forms) must be submitted to the Forest Unit COR within 5 business days of the completed on-site services requested in this call order.

SELECT THE FOLLOWING TASKS FOR THIS CALL ORDER

TASK 1 - PUMPING SERVICES: ☐

See USFS requesting unit supplemental information for each request as checked below:

Septic Tank ☐ Vault Toilet Restroom ☐

Holding Tank ☐ Other:____________________________ ☐

NOTES: After each pumping service, an inspection is required for each toilet serviced. Complete inspection form and submit to the Forest Unit. All disposal receipts must be included in that inspection form.

TASK 2 - CLEANING SERVICES: ☐

Perform basic cleaning services as described in the Statement of Work.

Start Date to clean toilets:_______________________________________________________________

Cleaning Certification: I verify that the information cleaning was completed to the best of our ability and in accordance with the statement of work.

Contractor Name:______________________________ Signature:_______________________________

Date:_____________________________Address:____________________________________________

Phone:____________________________Email:______________________________________________

EXAMPLE

CALL ORDERING FORM

XX National Forest XX Ranger District

Zone X of the BPA contract

SITE LOCATION OR

FACILITY ID

TASK 1 – PUMPING SERVICES TASK 2 – CLEANING SERVICES

USFS ESTIMATED

TOTAL Capacity

(GALLONS)

Small (<500 gallons) Medium (501-1,000 gallons) Large (1,001 – 2,500 gallons) Extra Large

(2,500 – 4,000 gallons) Lagoon (per 1,000 gallons)

ACTUAL GALLONS

PUMPED

DATE OF

ACTUAL

SERVICE

CLEANING

SERVICE

REQUESTED

Power wash acceptable (yes or no)

Placement of Government

Furnished toiletry (yes or no)

DATE SERVICE

COMPLETED

Example:

Smokey’s

Campground

Toilet # 1 near site 25

500 400

Toilet # 2 host site

1000 700

Toilet # 3 near group site

Red Campground

Toilet # 1 X YES YES DATE

Toilet # 2 X YES NO DATE Toilet # 3 X NO YES DATE

Blue Campground

Vault toilet # 2 X NO YES DATE Flush Toilet # 1 X YES YES DATE

Zone X of the BPA contract

SITE LOCATION OR

FACILITY ID

TASK 1 – PUMPING SERVICES TASK 2 – CLEANING SERVICES

USFS ESTIMATED TOTAL

Capacity (GALLONS)

Small (<500 gallons) Medium (501-1,000 gallons) Large (1,001 – 2,500 gallons)

Extra Large (2,500 – 4,000 gallons)

Lagoon (per 1,000 gallons)

ACTUAL

GALLONS

PUMPED

DATE OF

ACTUAL

SERVICE

CLEANING

SERVICE

REQUESTED

Power wash acceptable (yes or no)

Placement of Government

Furnished toiletry (yes or no)

DATE SERVICE

COMPLETED

Zone X of the BPA contract

SITE LOCATION OR

FACILITY ID

TASK 1 – PUMPING SERVICES TASK 2 – CLEANING SERVICES

USFS ESTIMATED TOTAL

Capacity (GALLONS)

Small (<500 gallons) Medium (501-1,000 gallons) Large (1,001 – 2,500 gallons)

Extra Large (2,500 – 4,000 gallons)

Lagoon (per 1,000 gallons)

ACTUAL

GALLONS

PUMPED

DATE OF

ACTUAL

SERVICE

CLEANING

SERVICE

REQUESTED

Power wash acceptable (yes or no)

Placement of Government

Furnished toiletry (yes or no)

Zone X of the BPA contract

SITE LOCATION OR

FACILITY ID

TASK 1 – PUMPING SERVICES TASK 2 – CLEANING SERVICES

USFS ESTIMATED TOTAL

Capacity (GALLONS)

Small (<500 gallons) Medium (501-1,000 gallons) Large (1,001 – 2,500 gallons)

Extra Large (2,500 – 4,000 gallons)

Lagoon (per 1,000 gallons)

ACTUAL

GALLONS

PUMPED

DATE OF

ACTUAL

SERVICE

CLEANING

SERVICE

REQUESTED

Power wash acceptable (yes or no)

Placement of Government

Furnished toiletry (yes or no)