Att.12_DLA Form 2505 Oct 2023.xlsx
DLA Form Oct 12, 2023 XLSX spreadsheet 21 KB Posted
- Attached to
- Amendment 0002 - Richmond Hazardous Waste Removal and Disposal Combined Synopsis/Solicitation SP450024R0002
- Solicitation number
- SP450024R0002
- Issued by
-
Defense Logistics Agency
About this file
This document contains an invoice template for Defense Logistics Agency hazardous waste disposal contracts. The template collects line item details including document numbers, hazardous item numbers, manifest numbers, quantities picked up and disposed of, interim facility EPA IDs, final management method codes, and facility acceptance dates.
Relevant details include instructions for completing columns collecting line item numbers, quantities, manifests, interim and final facility EPA IDs, management method codes, and acceptance/disposal dates. The template is to be used for invoicing under Defense Logistics Agency contract SP450024R0002, a solicitation for hazardous waste removal and disposal services in Richmond, Virginia. Contractors should submit the completed invoice template with certifications of performance to receive payment for hazardous materials handled under the contract.
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Other versions and copies of DLA Form 2505
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Who attaches DLA Form 2505
| Agency | Files |
|---|---|
| Defense Logistics Agency | 43 |
| Defense Logistics Agency Disposition Services | 13 |
Other files
| File | Type | Posted |
|---|---|---|
| SF 30 Amendment 0002.doc | DOC document | |
| SF 30 Amendment 0001.doc | DOC document | |
| Order History SP450019D0006 15Jun21-15Dec23.xlsx | XLSX spreadsheet | |
| Att.9_Contractor Work Surveillance Checklist (ROB).pdf | ||
| Att.7_CAC Application Process.pdf | ||
| Att.6_Additional Contract Terms and Conditions.docx | DOCX document | |
| Att.4_PPI Questionnaire.pdf | ||
| Att.1_Richmond_PWS.docx | DOCX document | |
| Att.3_Richmond_PUL.xlsx | XLSX spreadsheet | |
| Att.8_Contractor Work Surveillance Checklist (ICS).pdf | ||
| Att.10_Addenda to 52.212-1 Instructions to Offerors.pdf | ||
| Att.5_WD 1996-0223 REV 60 6-30-2023.pdf | ||
| Att.11_ Addenda to 52.212-2 Evaluation.pdf | ||
| Att.2_Richmond _Price Schedule.xlsx | XLSX spreadsheet |
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Text version
| Invoice | Prescribe by: FAR 32.9/DLAM 4140.15 Sponsor: Disposition Services | ||||
| COMPANY NAME: | CONTRACT #: | TO #: | INVOICE AMOUNT ($): | DATE: |
| "I CERTIFY TO THE BEST OF MY KNOWLEDGE THAT THIS CONTRACT PERFORMANCE SUPPORTING DATA IS ACCURATE, COMPLETE AND MEETS ALL REQUIREMENTS SET FORTH IN THE CONTRACT." | ||||||||||
| NAME: | Signature: | |||||||||
| 1. | 2. | 3. | 4. | 5. | 6. | 7. | 8. | 9. | 10. | 11. |
| Line Item # | Document # | HIN # | P/U Qty | P/U Mnfst # | Mnfst Pg/Li | Qty Disposed or Received | Interim/Disp Manifest # | Interim/ Disposal Facility EPA ID # | Interim/ Disposal MMC | TSDF Accept Dates/ PCB Dates (DD/MMM/YY) |
DLA Form 2505, FEB 2022 Page 1 of 2 PDF (DLA)
2505 04/2021 (Draft Revision) &P
INSTRUCTIONS
| NOTE 1: For special service and supply items, complete only blocks 1, 2, 3 and 7. |
| NOTE 2: For foreign contract disposal lines, complete all columns. |
| NOTE 3: For US contracts, complete all columns only when the task order contains line(s) requiring a Certification of Destruction (CD) or Certification of Recycling (CR) or contains HIN 650300. Complete only columns 1 thru 7 and 11 when the task order DOES NOT contain line(s) requiring a certificate of destruction (CD) or a certificate of recycling (CR) or HIN 650300. |
Column 1: Line Item # - DD Form 1155 or SF30 line-item number for the supply or service ordered. (Four digits - e.g.: 0001)
Column 2: Document # - Document number as it appears on DD Form 1155 or SF30 (External PR) (Eight digits - e.g., ABCD1234)
Column 3: Hazardous Item Number (HIN) # - HIN Number as it appears on DD Form 1155 or SF30 (Six characters -e.g.: NR04C7)
Column 4: Picked Up (P/U) QTY - Actual quantity picked up.
Column 5: P/U Mnfstr # - Manifest document number assigned to each manifest or shipping paper used to ship the waste to the initial TSDF (5 or 12 characters - e.g.: 02034; 123456789GBF)
Column 6: Manifest Page/Line- Identify the page and manifest line number that the document number has been placed on from manifest block 9a, 27a, etc…. (Does not apply for foreign contracts.)
Column 7: Final QTY Disposed or Received – Actual quantity of item disposed or service/supply performed/delivered.
Column 8: Interim/ Disposal Manifest # - Manifest document number assigned to each manifest or shipping paper used to ship all, or parts of the waste to other TSDFs, including all interims and finals, after receipt at initial TSDF. EXCEPTION: If final treatment/ disposal is accomplished by the initial TSDF, insert "Same as # 5 or SAC5" in column 8.
Column 9: Interim/Disposal Facility EPA# - EPA Identification number (or DLA Disposition Services "MOCK" number) assigned to each facility involved in the treatment, storage, and final disposal. (As defined in section 5.0 of the contract) of the item. Use additional lines as necessary. (Twelve digits - e.g.: PAD456123912) NOTE: If final disposal did not occur at the initial facility, then the initial facility is considered an interim facility for tracking purposes. In those instances, the initial facility's EPA ID number should be included in Column 9 when information is submitted.
Column 10: Final Disposal MMC Codes - List the appropriate Management method code(s) listed in the Hazardous Waste Report Instructions and Forms online (https://www.epa.gov/sites/production/files/2015-06/documents/codes.pdf). (40 CFR 264, Appendix 1, Table 2 no longer applies), performed by any final disposal facilities. Note: Include any treatment and/or handling performed at initial TSDF, which was NOT identified in initial facility.
Column 11: Interim/Disposal TSDF Accept Date and Disposal Date (and CD/CR required lines when applicable) - Actual date listed on the shipping paper next to the signature of the representative of each and every interim and final TSDF's accepting, treating, and/or disposing of the waste (dd/mmm/yy). NOTE - Date of actual final disposal of CD/CR required lines item (dd/mmm/yy).
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