SUBPART 53.2 – PRESCRIPTION OF FORMS

(Revised September 19, 2016 through PROCLTR 2016-09)

Parent topic: PART 53 – FORMS

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 and DFARS 219.602-1.

(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.