Attachment_10_DLA_FORM_2503_Transporter_Qualification_Ap.pdf
PDF 1 MB Posted
- Attached to
- Hazardous Waste Removal and Disposal for Spain
- Solicitation number
- SP4500-20-R-0002
- Issued by
-
Defense Logistics Agency
About this file
This document is a Transporter Qualification Review Application form for the Defense Logistics Agency. The form collects information from waste transporters such as permit numbers, safety records, insurance coverage, and foreign transportation licenses if applicable. It requests details on the transporter's hazardous materials safety training program and processes for using contractor or leased vehicles. The form is to be completed electronically and submitted under the name of the carrier, along with backup documentation where specified.
The related federal contract opportunity is a solicitation for Hazardous Waste Removal and Disposal services at locations in and around Rota and Moron, Spain. Work will include waste stream management services at pick-up points in the specified areas. The contract period is anticipated as a 30-month base term and a 30-month option period, running from January 2020 through December 2024. The estimated period of performance start date is January 1, 2020. The solicitation number provided is SP4500-20-R-0002 and will be posted within two weeks. The contracting agency is the Defense Logistics Agency.
Attachment 10 DLA Form 2503
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TRANSPORTER QUALIFICATION REVIEW APPLICATION
Prescribed by: DRMS I 4160.14 Sponsor: Disposition Services
PDF (DLA)
DLA FORM 2503, SEP 2016
Smith, William R Smith - Defense Logistics Agency 10.0.2.20120224.1.869952 Instructions: Complete all sections and provide backup documentation where requested. If the requested information is not applicable, please identify as N/A.
Instructions: Please complete form electronically and save file using name of carrier.
4. List primary waste transporter permit numbers:
Motor Carrier Safety (CONUS Only)
8. Has the company had any traffic citations or hazardous materials incidents within the last three years?
If yes, provide enforcement agency copies of traffic citations or hazardous materials incident report.
Risk Mitigation
10. Does company have a written hazardous materials safety training program?
If yes, provide a copy of the training program.
11. Does company maintain general, property, bodily injury and pollution liability insurance coverage?
If yes, provide copy of insurance certificates.
12. Are all loads transported by company owned/leased vehicles?
If no, all contractors must meet same criteria to qualify as a DLA approved transporter.
13. Will carrier be providing transportation services using marine vessels?
If question 13 was yes, carrier is required to submit International Maritime Dangerous Goods (IMDG) transportation licenses.
14. Will CONUS carrier be required to transport material outside the continental United States or is this an overseas transporter?
If yes to question 14, provide list of countries below and submit foreign country license documentation.
Company Representation
16. Phone number and e-mail of primary contact person for transporter:
For DLA Use Only As the verifier, I certify that the information provided on this form is true and correct.
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File details come from the government source that posted it. Updated .