QMAE-EV-190002-D_Attachment_16_-_GSA_Form_1611.xlsx
XLSX spreadsheet 27 KB Posted
- Solicitation number
- QMAE-EV-190002-D
- Issued by
-
GSA Federal Acquisition Service
About this file
This document is a GSA Form 1611 used to request transportation services. It collects shipping details such as commodity description and quantity, shipment weight and dimensions, origin and destination addresses, and container requirements. The related federal contract opportunity is GSA's 2020 Medium & Heavy Duty Trucks and Wreckers & Carriers Program under solicitation QMAE-EV-190002-D. The solicitation seeks trucks and wreckers for delivery in 2020 and refers to an attached Questions & Answers document and Amendment 0002 for additional details.
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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