C9 - PWS Technical Exhibit 07 - Certificate of Deformation Sample.docx

DOCX document 15 KB Posted

Attached to
JBLM Recycling Services
Solicitation number
W911S822R0027
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Other files

File Type Posted
1 - W911S8-22-R-0027 Amend 0005.pdf PDF
1 - W911S8-22-R-0027 Conformed Copy thru Amendment 0005.pdf PDF
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C2 - PWS - Attachment A - JBLM Recycling Services 12 Aug 2022.docx DOCX document
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Technical Exhibit 07 - Certificate of Deformation Example

Certificate of Deformation

Origination Location:JBLM ASP
Address:1116th Squadron Rd. Bldg. M0001
Joint Base Lewis McChord, WA 98433

Shipments: Seal Number and Dispatch Numbers or Shipping Memo for all loads included in the deformation batch.

Description of Items: Inert Uncrushed Brass Casings

Method of Deformation:

Date of Deformation: DD MMM YYYY

Company XXX certifies that the described items above were deformed, rendering them useless for any other purpose than to recover scrap metal.

Signature of Company Representative:

Date: DD MMM YYYY

21 July 2022

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