QMAE-BD-160001-D_Attachment_18_-_GSA_Form_1611.xlsx
XLSX spreadsheet 27 KB Posted
- Attached to
- 2017 Medium & Heavy Duty Trucks/Wreckers & Carriers Program Federal contract opportunity
- Solicitation number
- QMAE-BD-160001-D
- Issued by
- GSA Federal Acquisition Service
About this file
GSA Form 1611
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Text version
form1611
TRANSPORTATION SERVICE ORDER DATE OF APPLICATION
| INSTRUCTIONS | REQUISITION NUMBER | ||
| In order that the most eonomical transportation may be arranged, all information requested MUST BE FURNISHED as accurately as possible. | |||
| CONTRACT | PURCHASE ORDER | ||
| LETTER OF TRANSMITTAL IS NOT REQUIRED. | |||
| NAME AND ADDRESS OF APPLICANT | NAME AND ADDRESS TO WHOM GOVERMENT SHIPPING INSTRUCTIONS SHOULD BE MAILED (Note: Shipping instructions are sent via express service with next AM delivery. A physical delivery address (no post office boxes) is required. |
TELEPHONE AND FAX NUMBERS
| e-MAIL ADDRESS | Fax or e-mailadditional copy to: | |
| e-Mail to GSA @ | gsa.export@gsa.gov |
| COMMODITY TENDERED (Purchase Order item number and description) | DATE SHIPMENT AVAILABLE | ||
| QUANTITY | COMMODITY/ITEM DESCRIPTION & NATIONAL STOCK NUMBER | ||
| GROSS SHIPMENT WEIGHT (Lbs.) | |||
| REMARKS | EACH | TOTAL |
CUBE (Ft)
| VALUE OF SHIPMENT | |
| SINGLE ITEM | TOTAL VALUE |
| FOR GSA USE ONLY | |
| PCFN | |
| DESCRIPTION OF PACK (SHIPPING) UNIT TENDERED INCLUDING THE TOTAL NUMBER OF CONTAINERS BY TYPE,KIND, SUCH AS DRUMS, CASES, BAGS BUNDLES, LOOSE PIECES, ETC, AND IF SET-UP, KNOCKED DOWN, NESTED OR OTHERWISE, AND THE WEIGHT DIMENSIONS AND CONTENTS OF EACH (When an attachment, such as: packing list, shipping document or equivalent, provides this information in sufficient detail and is self-explanatory, the applicant may insert "See Attachment". |
| INSERT THE DIMENSIONS OF THE LARGEST SINGLE ITEM IN ITS SHIPPING CONFIGURATION: | |||||
| LENGTH | WIDTH | HEIGHT | DIMENSIONS ARE EXPRESSED IN INCHES ROUNDED UP | ||
| ORIGIN INFORMATION (Company Name, City, State, Zip, Contact Name and Phone) | CONTRACT DELIVERY TERMS (FAS,FOB,etc) | ||||
| NAME & FULL ADDRESS WHERE VEHICLE IS LOCATED TO INCLUDE ZIP CODE | FOB Origin (Loading Point) | ||||
| FOB Destination (Port/CCP) | |||||
| OVERSEAS ADDRESS MARKINGS |
| CONTACT: | COMMERCIAL PHONE/E-MAIL: |
| CONTAINER REQUIREMENT. Shipments (other than vehicles) 10,000LBS/800 cft MUST BE CONTAINERIZED at the manufacrer. |
| SEAVANS: | SIZE: | TYPE OF SEAVAN: | (STANDARD OR HIGH-CUBE) | |||||
| PIECES: | WEIGHT: | CUBE: | ||||||
| SEAVAN TOTAL SEAVAN TOTAL SEAVAN TOTAL | ||||||||
| SEAVANS: | SIZE: | TYPE OF SEAVAN: | (STANDARD OR HIGH-CUBE) | |||||
| PIECES: | WEIGHT: | CUBE: | ||||||
| SEAVAN TOTAL SEAVAN TOTAL SEAVAN TOTAL | ||||||||
| SEAVANS: | SIZE: | TYPE OF SEAVAN: | (STANDARD OR HIGH-CUBE) | |||||
| PIECES: | WEIGHT: | CUBE: | ||||||
| SEAVAN TOTAL SEAVAN TOTAL SEAVAN TOTAL | ||||||||
| OVERFLOW | PIECES: | WEIGHT: | CUBE: |
TOTAL PIECES: WEIGHT: CUBE:
mailto:gsa.export@gsa.gov image1.emf image2.emf
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