Attachment J - H14 Transport Equipment Delay Certificate.pdf

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Attached to
Amendment 0002 Carbon Dioxide( CO2) East PPN 9. 4C Federal contract opportunity
Solicitation number
SPE601-24-R-0306
Issued by
Defense Logistics Agency Energy

About this file

This solicitation seeks liquid carbon dioxide and related services to support Defense Logistics Agency Energy customers. The contractor shall provide all materials, supplies, product, management, tools, equipment, labor, and transportation necessary to deliver liquid carbon dioxide into government-owned tanks at specified military installations. The period of performance is from October 2024 through September 2029. The solicitation will be competed amongst suppliers able to provide the required liquid carbon dioxide product but has been issued on a sole-source basis due to only one supplier possessing unique capabilities to meet the entire agency requirement. The government intends to award a firm-fixed price requirements contract using commercial item procedures.

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Text version

TRANSPORT EQUIPMENT DELAY CERTIFICATE

1. CONSIGNOR 2. CONSIGNEE 3. PRODUCT

4. CARRIER 5. TRAILER NUMBER 6. DATE SHIPPED

7. FREIGHT BILL NUMBER 8. CBL NUMBER 9. SEAL NUMBER

10. LOADING/UNLOADING INFORMATION

DATE RECEIVED TIME DATE RECEIVED TIME

A. ARRIVED D. FINISH

B. ACCEPTED FOR

LOADING/UNLOADING E. UNIT RELEASED

C. START F. TOTAL HOUR HELD

11. REASON FOR DELAY (Make a complete statement adequately describing each segment of delay, amount of time on each delay, and whether delay was the responsibility of carrier or consignee/consignor)

12. DETENTION CERTIFICATION STATEMENT : I certify that the above information is true and correct to the best of my knowledge.

SIGNATURE AND TITLE OF CONSIGNEE SIGNATURE AND TITLE OF SHIPPER SIGNATURE OF DRIVER

13. NOTE TO CARRIER: A copy of "TRANSPORT EQUIPMENT DELAY CERTIFICATE" must accompany each detention invoice to provide documentation for invoice certification and payment.

FORM H-14

Sheet1

File details come from the government source that posted it. Updated .