Attachment JA2 Coal Attestation Forms.pdf
PDF 197 KB Posted
- Solicitation number
- SPE60426R0400
- Issued by
-
Defense Logistics Agency Energy
About this file
This is an attestation form attachment for federal contract SPE604-26-R-0400 regarding coal-based power supply compliance. The document provides directions and two required forms that contractors must submit to verify the source and quantity of coal-based electricity delivered to the government during an annual compliance period.
The contractor must submit Form A, completed by the Retail Energy Supplier, which declares under penalty of perjury that all coal-based power was generated by CFPF (Coal and Fuel Production Facility) generators as defined in the contract, obtained through direct contractual agreements with CFPFs, and that all data sourced from Form B is accurate. Form A requires reporting total kilowatt hours generated during the compliance period and broken down by three CLINs: CLIN 0001-Scott AFB, CLIN 0002-USACE, and CLIN 0003-IL ANG. The contractor is responsible for providing Form B to every coal-fired production facility with which it has a contractual agreement that fulfilled government requirements during the compliance period. Form B, completed by the CFPF generator facility, requires facility information including name, address, eGRID subregion, facility ID number (EIA or qualifying facility number), fuel type capacity in megawatts, total kilowatt hours sold to the supplier during the compliance period, date the facility became operational, and period of delivery. The generating facility must declare under penalty of perjury that the information is accurate and that the kilowatt hours were sold exclusively to the named retail energy supplier. Both forms require authorized agent signatures and dates.
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Other files
| File | Type | Posted |
|---|---|---|
| SF30_SPE60426R04000001.PDF | ||
| Attachment JA1 - Installation Data Sheet.xlsx | XLSX spreadsheet | |
| Solicitation SPE60426R0400.pdf | ||
| Attachment JA3 FAR DFARS Prov Clauses in Full Text.pdf | ||
| Attachment JA5 - Pricing Sheet.xlsx | XLSX spreadsheet | |
| Attachment JA4 - Small Business Subcontracting Plan Form.pdf | ||
| Attachment JA6 - Proposal Requirements.pdf |
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Text version
Subject: SPE604-26-R-0400 Attachment JA2- CFPF Attestation Forms
Page | 1
CFPF Attestation Form Directions:
The Contractor must submit both Form A and Form B for electricity from coal-based power supplies. Form A, provided to the Government, details the total amount of coal-based power delivered during the Annual Compliance Period. This form includes the total electricity supplied under the contract and a breakdown of each CLIN's consumption.
The Contractor is responsible for providing Form B to every coal-fired production facility that it has a contractual agreement with that fulfilled the government's requirements during the contract compliance period. These facilities must then complete the form and return the completed and signed document to the Contractor for submission to the Government.
Subject: SPE604-26-R-0400 Attachment JA2 – CFPF Attestation Forms
FORM A: COAL BASED POWER SUPPLY ATTESTATION FROM RETAIL ENERGY SUPPLIER
I, (print name and title) , declare under penalty of perjury, on behalf of (name of Retail Energy Supplier) , that
1) all coal based power supply associated with this Annual Compliance Report and delivered to the Government were generated by CFPF generators as defined in the subject Contract.
2) all coal-based power supply was obtained by the Retail Energy Supplier through a direct contractual agreement with a CFPF(s); and
3) all data on Form B is accurate and sourced from the specific CFPF(s).
Total CFPF Product Supplied
Total kWh Generation
From (date) To (date)
CLIN 0001-Scott AFB Total kWh Supplied
CLIN 0002-USACE
CLIN 0003-IL ANG
As an authorized agent of the aforementioned Company, I have authority to submit this report on the company’s behalf.
Signature and Title Date
Subject: SPE604-26-R-0400 Attachment JA2 – CFPF Attestation Forms
FORM B: COAL BASED POWER SUPPLY ATTESTATION FROM CFPF GENERATOR
Facility Information
Name of Facility:
Address of Facility:
eGRID Subregion of Facility:
Facility ID Number1:
Fuel Type Capacity
(MW)
Total kWh Sold to
Supplier During
Compliance Period
Date Facility First Operational
Period of Delivery (mm/yy)
Coal
1 Please enter Energy Information Administration (EIA) identification number for the generating facility. If the facility does not have an EIA number, please enter the utility-assigned Qualifying Facility (QF) identification number, other identification number or indicate not applicable (N/A).
Declaration:
I, (print name and title) , declare under the penalty of perjury, that the information provided on this form is true and correct to the best of my knowledge.
Further, I declare that the (indicate) kilowatt hours listed above were sold exclusively to (name of the Retail Energy Supplier) .
As an authorized agent of (generating company name) , I attest that the above statements are true and correct.
Signature: Date:
Address of Generating Company:
Phone Number:
Contact Person: Title:
Telephone: Email:
| CFPF Attestation Form Directions: |
| Total CFPF Product Supplied |
| FORM B: COAL BASED POWER SUPPLY ATTESTATION FROM CFPF GENERATOR |
File details come from the government source that posted it. Updated .