Attachment_3_-_Fuel_Report_Template.pdf

PDF 15 KB Posted

Attached to
Thule Air Base Air Transportation Services Federal contract opportunity
Solicitation number
HTC71118RC004
Issued by
Department of Defense United States Transportation Command

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Fuel Report Template

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HTC711-18-R-C004.pdf PDF
DRAFT_Performance_Work_Statement.docx DOCX document

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Solicitation HTC711-18-R-C004 Attachment 3 – Fuel Report Template

Fuel Report Summary

1. Required Information:

Miles flown in support of the USTRANSCOM contract = XX,XXX

Burn rate for aircraft type (in schedule) = X.XX gallons per mile

Base price of fuel established in the contract = $3.15

Actual average cost per gallon = $X.XX

EPA Variance = $X.XX

EPA Variance is the difference between the average price per gallon paid and the established base price in the contract

2. Calculation

Calculation:

Miles * Burn Rate * EPA Price Variance = Adjustment

3. Carrier Certification

Must be signed by a person authorized to legally bind company Date

BY SIGNING THIS FORM, YOU ARE CERTIFYING AS TO THE ACCURACY OF

ALL INFORMATION AND AGREE TO KEEP BACKUP RECORDS FOR A

PERIOD OF 5 YEARS. THIS INFORMATION IS SUBJECT TO AUDITS.

Contracting Officer Signature Date

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