TE-D Deformation Certificate.docx

DOCX document 13 KB Posted

Attached to
Joint Base Lewis-McChord Commercial Recycling Service
Solicitation number
W911S8-26-R-A016
Issued by

About this file

This is a template document for a Certificate of Deformation, which serves as official documentation that items have been rendered unusable through the deformation process. The certificate is specific to the Joint Base Lewis-McChord (JBLM) recycling program and includes fields for recording the origination location (1116th Squadron Rd., Bldg. M0001, JBLM, WA 98433), seal numbers, dispatch numbers or shipping memoranda for all loads in the deformation batch, and a description of items being deformed. The template specifies fields for the method and date of deformation, along with signature and date fields for a company representative to certify that the described items—such as inert uncrushed brass casings—have been deformed and rendered useless for any purpose other than scrap metal recovery.

This certificate template directly supports the commercial recycling services contract (W911S8-26-R-A016) for JBLM, which requires collection, transportation, and management of recyclable materials including expanded brass collection at Yakima Training Center. The deformation certificate serves as a verification mechanism ensuring that materials have been properly processed and are suitable only for scrap metal recovery, thereby supporting the contractor's accountability and compliance with the Performance Work Statement requirements.

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Text version

Technical Exhibit D - Certificate of Deformation Example

Certificate of Deformation

Origination Location:JBLM ASP
Address:1116th Squadron Rd. Bldg. M0001
Joint Base Lewis McChord, WA 98433

Shipments: Seal Number and Dispatch Numbers or Shipping Memo for all loads included in the deformation batch.

Description of Items: Inert Uncrushed Brass Casings

Method of Deformation:

Date of Deformation: DD MMM YYYY

Company XXX certifies that the described items above were deformed, rendering them useless for any other purpose than to recover scrap metal.

Signature of Company Representative:

Date: DD MMM YYYY

File details come from the government source that posted it. Updated .