# DLAD PART 53 – FORMS

- SUBPART 53.2 – PRESCRIPTION OF FORMS

- 53.201 Federal acquisition system.
- 53.201.603-1-90(b)(1) Request for Appointment of a Contracting Officer - DLA Warrant Approval Form (5001), OCT 2012.
- 53.201.603-1-90(b)(2) Contracting Officer Warrant Program Selection Statement DLA Warrant Application Form (5002), OCT 2012.

- 53.201-92 Contract file content list (DLA Form 678).
- 53.201-93 Request for waiver of preaward contract review and approval (DLA Form 1694).

- 53.213 Small purchase and other simplified purchase procedures.

- 53.213-90 Blanket purchase agreement delivery ticket (DLA Form 470).
- 53.213-91 Shipping Instruction (DLA Form 1224).
- 53.213-92 Request for Quotation (DLA Form 1231).

- 53.219 Small business and small disadvantaged business concerns.

- 53.219-90 Referral of Small Business for Certificate of Competency (CoC) Consideration (DLA Form 1756).

PART 53 – FORMS

TABLE OF CONTENTS

(Revised April 23, 2013 through PROCLTR 2013-45)

SUBPART 53.2 – PRESCRIPTION OF FORMS

53.201 Federal Acquisition System.

53.201.603-1-90(b)(1) Request for Appointment of a Contracting Officer - DLA Warrant Approval Form

(5001).

53.201.603-1-90(b)(2) Contracting Officer Warrant Program Selection Statement DLA Warrant Application

Form (5002).

53.201-91 Request for review and approval of contract/solicitation action (DLA Form 677).

53.201-92 Contract file content list (DLA Form 678).

53.201-93 Request for waiver of preaward contract review and approval (DLA Form 1694).

53.204 Administrative matters.

53.204-70 [Reserved.]

53.204-71 [Reserved.]

53.205 [Reserved.]

53.213 Small purchase and other simplified purchase procedures.

53.213-90 Blanket purchase agreement delivery ticket (DLA Form 470).

53.213-92 Request for quotation (DLA Form 1231).

53.219 Small business and small disadvantaged business concerns.

53.219-90 Referral of small business for certificate of competency (CoC) consideration (DLA Form 1756).

SUBPART 53.2 – PRESCRIPTION OF FORMS

(Revised February 8, 2013 through PROCLTR 2013-31)

53.201 Federal acquisition system.

53.201.603-1-90(b)(1) Request for Appointment of a Contracting Officer - DLA Warrant Approval Form (5001), OCT 2012.

Request for Appointment of a Contracting Officer The following findings and determinations are made pursuant to applicable law and regulations: There is a clear and convincing need to appoint a contracting officer with the ability to perform at the ______________________________________ (basic/ DAWIA Level I, intermediate/ DAWIA Level II, senior/ DAWIA Level III) contracting officer warrant level for the following reasons: (Include discussion of organizational need, quantity, type and average dollar amount of documents to be obligated as contracting officer, and the warrant threshold requested.) Additionally, include details on how the candidate’s experience and education has prepared him/her to exercise sound business judgment to fulfill the responsibilities of this position. The contracting officer candidate is: (Name, title, series and grade) ____________________________________________________________________________________ The contracting officer candidate is replacing __________________________________________ or this is a new position created as a result of ______________________________________________ The contracting officer candidate will occupy the following organizational level described below: (Division/branch/section, include office symbol) _______________________________________ The completed DLA Warrant Application Form which identifies the candidate’s background is enclosed. It was found that: (check as applicable.) _____ The candidate’s experience and training meet the established selection criteria in FAR 1.603, DFARS 201.603, and DLAD 1.603. _____ The candidate does not meet the minimum criteria __________________________ (experience and/or training) as indicated in enclosed justification; therefore, an interim appointment for a period not to exceed one year is requested. These experiences and/or training needs will be identified in the candidate’s individual development plan and will be completed by _____________________. _____ The candidate’s current Confidential Financial Disclosure Report, OGE-450, is on file with the appropriate standards of conduct counselor. _____ The candidate has a security clearance of _________________. In addition to the Defense Logistics Acquisition Directive, the DoD FAR Supplement, the FAR, laws, Executive Orders, and other applicable regulations, the following additional warrant limitations are imposed: Dollar threshold _______________________________________________________ Date temporary appointment to expire ______________________________________
Typed Name of Test Proctor | Signature | Date
Typed Name Of Supervisor (Procurement) | Signature | Date
Typed Name of Activity Focal Point (Procurement) (Concur) | Signature | Date
Typed Name of Director or Deputy Director of Supplier Operations (Concur) | Signature | Date
Typed Name of Division Chief or Senior Contracting Official (Concur) | Signature | Date
Typed Name of Chief of the Contracting Office (CCO) (Approved) | Signature | Date
DLA Warrant Approval Form (5001), OCT 2012

53.201.603-1-90(b)(2) Contracting Officer Warrant Program Selection Statement DLA Warrant Application Form (5002), OCT 2012.

Contracting Officer Warrant Program Selection Statement (To be completed by the candidate) Privacy Act Statement - Read before completing this form. Authority: 10 U.S.C. Chapter 137, Section 2311, DLAD 1.603. Principal purpose(s): To ascertain the qualification of individuals applying for or being selected to the position of contracting officer. Routing uses: Information used only to select individuals as contracting officers who meet the selection criteria prescribed in FAR 1.603, DFARS 201.603 and DLAD 1.603. The information is used by the Head of the Contracting Activity or his designee. A copy of each selection statement is maintained by the Chief of the Contracting Office (CCO) and may be reviewed by Staff or DoD Auditors to determine the general quality of DLA contracting officers. Whether disclosure is mandatory or voluntary and effect on individual of not providing information: Disclosure is voluntary. Failure to provide the information will preclude the individual from becoming a contracting officer.
A | Information pertaining to contracting officer position for which warrant is requested
Name Of Candidate | Office Symbol | Supply Chain/Location
Title | Series/Grade/Rank
Description of contracting officer duties: (Include quantity, complexity, type and average dollar amount of documents obligated)
B | Applicant’s relevant contracting experience (Begin with most recent position and work back four relevant positions)
1. Employer or DLA supply chain | 2. Dates employed From: _____________________ To: _______________________
3. Title of position | 4. Series/grade/rank | 5. Employer or supply chain office symbol
6. Description of work (Include quantity, complexity, type and average dollar amount of documents obligated, if applicable)
1. Employer or DLA Supply Chain | 22. Dates employed From: ________________ To: ___________________
3. Title of position | 4. Series/grade/rank | 5. Employer or supply chain office symbol
6. Description of work (Include quantity, complexity, type and average dollar amount of documents obligated, if applicable)
1. Employer or DLA Supply Chain | 2 2. Dates employed From: ______________ To: _________________
3. Title of position | 4. Series/grade/rank | 5. Employer or supply chain office symbol
6. Description of work (Include quantity, complexity, type and average dollar amount of documents obligated, if applicable)
1. Employer or DLA Supply Chain | 2 2. Dates employed From: ______________ To: _________________
3. Title of position | 4. Series/grade/rank | 5. Employer or supply chain office symbol
6. Description of work (Include quantity, complexity, type and average dollar amount of documents obligated, if applicable)
C | Other relevant special qualifications, certifications or skills/honors awards or fellowships including warrant history (dates and thresholds)
D | DAWIA certified
1. ___ No ___ Yes (If “Yes”, attach certificate. If no, complete section e below) | 2. Career field (e.g., purchasing, contracting, etc.) | 3. Level (e.g., I, II, III)
E | Education
1A. Highest level completed (“X” One) ____ H.S. Diploma ____ Associate ____ Bachelors ____ Masters ____ Post Graduate ____ Other
1.b. Major field of study | Year of degree | Name and location of college/university
Undergraduate: |  |
Graduate: |  |
Other: |  |
2. a. Number of credits completed: | Semester hours: _______________________ | Quarter hours: _____________________
2. b. Do you have 24 credit hours of business courses? (Note: Include courses in any of the following disciplines: Accounting, Business, Finance, Law Contracts, Purchasing, Economics, Industrial Management, Marketing, Quantitative Methods, and Organization Management (DoDI 5000.66) (“x” one) ______ Yes _______ No
F | Contracting Officer Warrant Test
Test Date: | Proctor’s Signature |
3. Mandatory DAU courses required for DAWIA contracting certification. (Note: If the candidate answered no in section D, complete the table below.)
Course | Previous Course Title | School/ Location | Dates
Federal Acquisition Regulation (FAR) Fundamentals (CON 90) | Personnel serving in a Contracting Coded position on 30 Sep 2010 are exempt from CON 090 through 30 Sep 2012 |  |
Shaping Smart Business Arrangements (CON 100) | Mission Support Planning (online) (CON 110); Mission Strategy Execution (online) (CON 111); Mission Performance Assessment (online) (CON 112) |  |
Contracting Fundamentals (CON 115) | Fundamentals of Contracting (Basic) (CON 101) |  |
Introduction to Contract Pricing (CLC 058) | Principles of Contracting Pricing Part A (CON 104A) |  |
Fundamentals of Cost and Price Analysis (CON 170) | Principles of Contracting Pricing Part B (CON 104B) |  |
Contract Format And Structure For DOD E-Business Environment (CLC 033) | Contracting for Mission Support (CON 120) |  |
Fundamentals of Systems Acquisition Management (ACQ 101) |  |  |
Business Decisions for Contracting (CON 200) | Business Decisions for Contracting (online) (CON 214) |  |
Legal Considerations in Contracting (online) (CON 216) | Government Contract Law (CON 210) |  |
Intermediate Cost and Price Analysis (CON 270) | Intermediate Contract Pricing (CON 204) |  |
Source Selection and Acquisition of Service Contracts (CON 280) | Intermediate Contracting (Advanced) (CON 202) |  |
Source Selection and Acquisition of Service Contracts (CON 290) | Advanced Contracting for Mission Support (CON 218) |  |
Managing Government Property in the Possession Of Contractors (CLC 051) | Advanced Contracting for Mission Support (CON 218) |  |
Analyzing Contract Costs (CLC 056) | Intermediate Contract Pricing (CON 204) |  |
Performance Based Payments and Value of Cash Flow (CLC 057) | Intermediate Contract Pricing (CON 204) |  |
Negotiating (HBS 428) | Intermediate Contracting (Advanced) (CON 202) |  |
Intermediate Systems Acquisition, Part A (ACQ 201a) |  |  |
Contracting for Decision Makers (CON 360) | Executive Contracting (CON 301) Management for Contracting Supervisors (CON 333) and (CON 353) |  |
CON Level III additional requirements: One course from Harvard Business Management modules and One of the following: ACQ 265 Mission-Focused Services Acquisition; ACQ 370 Acquisition Law; CON 232 Overhead Management of Defense Contracts; CON 235 Advanced Contract Pricing; CON 244 Construction Contracting; CON 250 Fundamentals of Cost Accounting Standards Part I; or CON 334 Advanced Contingency Contracting Officer's Course. Education: At least 24 semester hours in accounting, law, business, finance, contracts, purchasing, economics, industrial management, marketing, quantitative methods, or organization and management, and a Baccalaureate degree (any field of study). Experience: CON Level I: 1 year of contracting experience; CON Level II: 2 years of contracting experience; CON Level III: 4 years of contracting experience.
I hereby certify that the above information is accurate and complete to the best of my knowledge.
Signature of applicant | Telephone number | Date
DLA Warrant Application Form (5002), OCT 2012

53.201-92 Contract file content list (DLA Form 678).

(a) General. DLA Form 678 shall be used as prescribed in 1.690-7(g).

(b) General instructions for preparation and use of DLA Form 678. The blocks shall be "X'd" and/or filled in as appropriate.

(1) Filing instructions.

(i) Contract file sections shall be identified by inclusion of a divider annotated with the section identification and title, e.g., "Section A Planning and Solicitation." Sections A and B shall be filed on the left side of the file folder with section A on the bottom. Sections C and D shall be filed on the right side of the file folder with section C on the bottom.

(ii) The lowest numbered tab within each section shall be placed at the bottom of that section. When multiple documents are present under a numbered tab, e.g., correspondence, memoranda, they shall be filed chronologically with the most recent document on top.

(iii) It is impossible to enumerate all of the factors or conditions which may require specific documentation over and above that normally required. Therefore, as circumstances dictate, contracting officers shall describe, under the appropriate "blank" tab numbers, e.g., numbers 15-17; 30-32, such documentation as may be peculiar to the acquisition involved and file same in the analogous contract file section, e.g., tab 31, Certificate of Competency.

(2) Contract documentation.

(i) The documents identified on DLA Form 678 are those which are normally required to support a sealed bid/negotiated acquisition, other than a small purchase. The file sections provided establish the logical acquisition cycle sequence of documentation. The completed file will constitute a complete chronological history of the transaction and permit ready reconstruction of the actions taken in processing the acquisition.

(ii) The following sections discuss those elements of contract documentation which merit special attention.

(3) Section A - planning and solicitation.

(i) Tab number 1 PR/MIPR. The file must reflect the manner and extent to which the needs of the requiring activity have been met. It is essential, therefore, that in addition to the basic purchase authority, any changes and justifications be included under this TAB. In the case of amendments, the basis for change must be evidenced, e.g., in those instances where items on the purchase request have been completely lined out or quantities changed, indication must be made of the identity or authority of the individual or activity which requested/authorized the change. In other instances where contracts have been issued calling for something other than that specified on the PR/MIPR, explanation must be included as to the authority/approval for the change and from whom received. Memoranda must adequately identify individuals referred to in memoranda (e.g., statements such as "this was discussed with and concurred in by Mr. Smith in the supply function" are inadequate). An individual's full name, title, or position, and the individual's relationship to the subject matter of the memorandum must be clearly established; this is of particular importance should postaward questions arise. Requirements shall be revalidated in those instances where excessive time has elapsed between the issuance of the purchase request and consummation of the contract (see 1.693).

(ii) Tab number 2 specification/drawing. These documents in many instances either dictate source selection or indicate to the Contracting Officer the extent of possible competition. Any change either prior or subsequent to solicitation may affect final source selection. When such changes are effected, documentation supporting the change must be included in the file indicating as a minimum: the basis and authority for initiating specification/drawing change; coordination received from appropriate technical personnel; and approval/concurrence of the requiring activity. When specification/drawing changes are initiated/confirmed by the requiring agency on a PR/MIPR amendment, the documentation should be included in tab number 1 with an annotation in tab number 2 identifying the amendment number.

(iii) Tab number 3 acquisition plan/amendments. The acquisition plan will include, as a minimum, the information included in 90.1101. The use of preprinted forms for this purpose is acceptable.

(iv) Tab number 6 non-personal services determination. A statement by the Contracting Officer that the services proposed for acquisition have been determined to be non-personal in nature is not by itself sufficient to meet the requirements of FAR 37.103(a). Such determination must include the reasons and all of the facts which were deemed to substantiate the nonpersonal aspect of the services. Examples of criteria for characterizing services as non-personal rather than personal are set forth in FAR 37.104(d).

(v) Tab number 7 Department of Labor (DOL) Wage Determinations. DOL wage determinations are normally effective for a period of 120 days after issuance and must be in effect at the time of solicitation and at the time of award. When it is necessary to obtain extensions on determinations in order to carry them through the period until award is to be made, the documentation authorizing such extension by the DOL must be included under this tab. A copy of the request and any enclosures sent to DOL shall be included.

(vi) Tab number 8 small business set-aside determination. The determination required under FAR 19.5 must be accurate and complete insofar as the reason given for not having a small business set-aside. Statements such as "a set-aside was not considered because of insufficient quantity" must be supported. The information included in this determination must accurately reflect the consideration given to compliance with FAR 19.5; the information included therein imposes, in turn, a responsibility to make a realistic evaluation of requirements and a current review of possible sources to substantiate the information used in determining the proposed acquisition method.

(vii) Tab number 11 source list. The list of sources initially solicited and those to whom solicitations were subsequently issued as a result of requests are to be included; in the latter case, the date requested solicitation was issued will be indicated.

(viii) Tab number 14 solicitation and amendments. The contract file must include the solicitation document and any amendments thereto. Amendments must accurately reflect their issuance dates. In case of oral solicitations, the requirements of FAR 15.402(f) must be satisfied.

(4) Section B - Preaward support data.

(i) Tab number 18 abstract of offers. Include on the abstract any conditions of the offers which are related to their evaluation; if lengthy, the "Remarks" column shall be annotated with information indicating the location in the offer of the condition, e.g., "See page _____ of the proposal for exception to specification."

(ii) Tab number 19 packaging/transportation/freight rate data. Inclusion of transportation/freight rate data, are essential in determining the manner in which transportation costs were applied in arriving at the evaluated prices. Files must also include sufficient information to substantiate that packaging costs are equitable.

(iii) Tab number 20 cost/pricing data. All cost or pricing data received from the offeror in support of its proposal shall be included under this tab. If any data should be included in correspondence dealing with other matters which are pertinent to the final contract, e.g., delivery schedule, contract clauses, etc., the original correspondence will be filed under this tab and a cross-reference (or copy of such correspondence) placed in tab number 44.

(iv) Tab number 21 audit report/waiver/field pricing report. When field pricing support is requested from the cognizant contract Management Agency activity pursuant to FAR 15.404-2(a), the report obtained, together with any attached assist reports shall be included under this tab.

(v) Tab number 25 certificate of current cost or pricing data. Often a Contractor will provide a certificate of current cost or pricing data at the close of the negotiation session and will subsequently confirm, by letter, details of the agreements reached. In some instances, the confirming letter will include data which, although previously discussed and accepted, have not previously been presented in writing. In such cases, the certificate of current cost or pricing data presented at the close of negotiations becomes invalid; a new certificate must be obtained to reflect the Contractor's last data submission upon which the final price agreement was concluded.

(vi) Tab number 29 bid/offer evaluation worksheets, computer run. (Include documentation pertinent to source selection.)

(vii) Tab number 30. This tab will be used to incorporate, when applicable, information received from a cognizant ACO relative to the acceptability of the Contractor's disclosure statement when the firm has indicated submission of same.

(5) Section C - Other support data.

(i) Tab number 34 unsuccessful bid/proposal. Include the notification to the offerors (either that already issued or that proposed to be issued) that bids/offers were unacceptable and the reasons therefor.

(ii) Tab number 36 determination of late/bid proposal. All actions taken in accordance with the procedures prescribed under FAR 14.304 and 15.412 shall be included under this tab.

53.201-93 Request for waiver of preaward contract review and approval (DLA Form 1694).

DLA Form 1694 shall be used as prescribed in 1.690-8.

53.204 Administrative matters.

53.204-70 DD Form 350, Individual Contracting Action Report.

(b) Part B of the DD Form 350.

Block B4, Completion Date. When preparing a template (see 4.670-6(b)(4)(i)) use this item to enter the expiration date.

Block B5A, Contractor Identification Number. This block is for reporting the Contractor’s nine position DUNS number according to DFARS 253.204-70(b)(5)(ii)(A).

Block B5B, Commercial and Government Entity (CAGE) Code. The additional reporting requirement at Subpart 90.9, Updating Small Disadvantaged Business Status and Women-Owned Business Status in the DD Form 350 CAGE File, applies when the small disadvantaged business status or women-owned business status is incorrect in DCARS.

Block B7, Type of Obligation. For DLA contracting offices, the DCARS will generate Code 3 to indicate a template record whenever an IDC is being reported pursuant to 4.670-6(b)(4)(i), or when a template record is being created for a blanket purchase agreement (BPA) or Federal Supply Schedule.

Block B12C, System or Equipment Code. Enter the three position DLA Weapons or System code from the Purchase Request trailer or other source. If not known or the item in B12A is not part of a listed weapon or system, enter "000." DCARS will convert these data into the DoD codes for DoD reporting purposes.

(c) Part C of DD Form 350.

Block C2, Reason Not Synopsized. Enter Code A, Urgency, only when Item C9, Authority for Other Than Full & Open Competition, is coded 2A and Item C8, Solicitation Procedures is coded N, Other Than Full and Open Competition.

Line C3, Extent Competed: Enter “A” on this line (in accordance with DFARS 253.204-70, line C3(A)(3), full and open procedures after exclusion of sources) whenever award is made as a set-aside to a service-disabled veteran-owned small business entity. For sole-source SDVOSB awards, enter “A” on this line (in accordance with DFARS 253.204-70, line C3(A)(3), full and open competition after exclusion of sources – set-asides) whenever more than one offer is received; if only one offer is received, enter “D” on this line (in accordance with DFARS 253.204-70, lines C3(A)(3) and C3(D), not competed). For both set-asides and sole-source awards to SDVOSBs, also code Block C8 in accordance with the instructions below.

Block C7, Number of Offers Received. Offers, for the purpose of completing C7, shall only be offers from responsible Contractors capable of satisfying Government requirements. If an offer is an alternate offer and is rejected, or if award must be made before evaluation can be completed, the alternate offer is not to be counted.

Line C8, Solicitation Procedures: Enter “K” on this line (in accordance with DFARS 253.204-70, line C8(B)(8), set-aside) whenever award is made as a set-aside to a service-disabled veteran-owned small business (SDVOSB) entity. Enter “N” here (in accordance with DFARS 253.204-70, line C8(B)(9), authority for other than full and open competition) whenever award is made on a sole-source basis to an SDVOSB.

Line C9, Authority for Other Than Full and Open Competition: Enter “5A” on this line (in accordance with DFARS 253.204-70, line C9(B)(11), authorized by statute) whenever award is made on a sole-source basis to a service-disabled veteran-owned small business entity.

(d) Part D of DD Form 350.

The DFARS requires blocks D2, D3, D5, D7, and D8 be blank under certain circumstances. If the Contracting Officer completes any of these items in one of those circumstances, the DCARS will convert the entry to a blank and pass the record to DoD in the required format. Block D4E, Premium Percent. DLA contracting offices may enter "000" for this item when D4B is coded A or B and D4C is Coded A. The DCARS will convert the record passed to DoD into the required format.

Line D1, Type of Contractor, line D1(E), Veteran-Owned Small Business: Enter “A” on this line (in accordance with DFARS 253.204-70, line D1(E)(1), service-disabled veteran), whenever award is made (including set-asides or sole-source awards) to a service-disabled veteran-owned small business entity.

Line D4, Set-Aside or Preference Program, line D4(A), Type of Set-Aside: Even though the instructions at DFARS 253.204-70, line D4(A)(2), have not been updated to reflect set-asides for service-disabled veteran-owned small businesses, the DLA Contract Action Reporting System (DCARS) is able to accommodate the reporting of the SDVOSB set-aside or sole-source award. Enter “M” on this line whenever award is made as a set-aside to a service-disabled veteran-owned small business entity; enter “N” if award is made to an SDVOSB on a sole-source basis.

Block D5, Ethnic Group. For DLA, if the Small Disadvantaged Business Concern Representation, (see DFARS 252.219-7000), indicates the offeror is claiming eligibility in the Minority Small Business and Capital Ownership Development Program, Section 8(a) of the Small Business Act, then the ethnic group must also be completed and the appropriate code entered. This item must be completed for all awards made to a small disadvantaged business.

(e) Part E of DD Form 350.

Block E9 may be entered in Part E of the DD Form 350 in the margins or on the reverse side for manual reports. DCARS will provide for these items on the input screen.

(5) Block E9, National Stock Number. Enter the 13 position National Stock Number (NSN) or Local Stock Number (LSN) which defines the item of supply. Do not enter dashes, slants, or similar punctuation marks and do not show spaces between numbers or letters in the stock number. Leave blank when acquiring services (position 1 of B12A is alpha). If more than one NSN or LSN is the subject of this action, enter the stock number of the predominant item as determined by dollar value. If no stock number applies, enter the FSC shown in B12A followed by the word "NONE" without spaces between the two (e.g., "8905NONE").

(g) Special instructions for DD Forms 350 on actions of $25,000 or less under the Small Business Competitiveness Demonstration Program.

(2)(i) Block B5A, Contractor Identification Number. Enter the Contractor’s nine position DUNS number.

53.213 Small purchase and other simplified purchase procedures.

53.213-90 Blanket purchase agreement delivery ticket (DLA Form 470).

This form may be used when supplies or services are acquired by means of a blanket purchase agreement (BPA).

(a) General. The Defense Logistics Agency (DLA) Form 470 is a cut sheet form and is designed to be used by the vendor as an acknowledgment of a call, notice of shipment, packing list, and invoice. This form eliminates the need for preparation, by the Contractor, of separate forms for these purposes. Also, Government personnel requiring information on these forms will receive it on a standard format.

(b) Procedure. A supply of the forms may be provided by the contracting office to each Contractor who has entered into a BPA with the center. Upon the placing of a call, the Contractor may be required to complete the BPA delivery ticket based on information contained in the written or oral call in accordance with detailed instructions to be provided by the contracting office.

(c) General instructions for preparation of DLA Form 470. After the placing of each call, complete the call, complete the form in accordance with the general instructions below, and any specific instructions received with the placing of the call.

(1) Block 11. This is the date the supplies are to reach destination, not the date of shipment. Convert the number of delivery days the Government offered to an actual date. For example, if the Government offered a 30-day delivery and received the oral or written call on 1 October, enter 10/31/YY as the required date.

(2) Block 12. This is the date the supplies are to be shipped, not delivered.

(3) Blocks 13 through 19. Information for these blocks will be furnished by the contracting office at the time of the call. Enter the name and address of the consignee in block 15.

(4) Blocks 21 through 23. Entries in these blocks will be made at the time of shipment. Enter actual date shipped or delivered. No partial shipments to a particular destination may be made. If more than one shipment is made against a call, prepare two copies of this form for shipment. Copies of the shipping documents may be attached as an alternative to completing blocks 21 and 22.

(5) When using the form as an acknowledgment of call. Place a check mark on "*" copies of the form in the box "Acknowledgment of call" (block 9).

(6) When using this form as a notice of shipment. Place a check mark in the box "Packing list" (block 9) on "*" copies of the form in the box "Notice of shipment" (block 9).

(7) When using the form as a packing list. Place a check mark in the box "packing list" (block 9) on "*" copies of the reproduced form for each consignee. Be sure blocks 21 through 23 have been completed, as applicable, on the forms used. Send "*" copies to each consignee by placing copies inside the container or in an envelope attached to the exterior of the container.

(8) When using this form as an invoice. At the end of the billing period, fill in "*" copies of the reproduced form which includes the shipment data for all destinations of that call as follows:

(i) Place a mark in the box marked invoice (block 9) of each copy of the form.

(ii) Sign and date blocks 24 and 25 of the top copy only of the form. If the BPA under which this call was issued does not provide for the fast payment procedure, the top copy must contain the signature and date (blocks 27A and 27B) of the authorized Government representative receiving and/or accepting for the Government.

"*" The number required shall be in accordance with the needs of the contracting office.

53.213-91 Shipping Instruction (DLA Form 1224).

This form is used against automated simplified acquisitions.

53.213-92 Request for Quotation (DLA Form 1231).

This form is used against automated simplified acquisitions.

53.219 Small business and small disadvantaged business concerns.

53.219-90 Referral of Small Business for Certificate of Competency (CoC) Consideration (DLA Form 1756).

(a) DLA Form 1756 may be used to provide information for CoC referrals as required by FAR 19.602-1, DFARS 219.602-1 and DLAD 19.602-1.

(b) General instructions for preparation of DLA Form 1756:

(1) The name, size status, and total dollar value of the next low offeror should be identified, however, referrals shall not urge a conclusion based upon the size status of the second low offeror.

(2) The remaining blocks of the form are self-explanatory.