I-19 Complete.pdf - SDDC - U.S. Army

ORIGINAL PAGE 4-30INTERNATIONAL PERSONAL PROPERTY RATE SOLICITATION I-19JUSTIFICATION CERTIFICATE FOR USE OF A FOREIGN FLAG AIRCRAFTAMC CONTROL #: ______________________________AMC Receipt Date: ______________________________SUBMISSION DATE: ___________Transportation Service Provider: ______________________ SCAC: ______________________Award Date: ___________________________________ PPGBL #: ______________________OTO #: ______________________Pickup Date: ___________________________________ RDD: _________________________Origin: ______________________________________ Destination: ___________________Name of U.S. Flag Transportation Service Provider(TSP): ______________________________________U.S. Flag TSP will be utilized between _________________________________________________and ____________________________________________.Cubic Feet: __________________ Gross Weight: ________________Net Weight: __________________ Air Freight Charge/CWT: ________________Name of foreign flag Transportation Service Provider:____________________________________________________________Foreign flag Transportation Service Provider will be utilized between___________________________________________and _____________________________________.Date of departure: _____________________.Property owner's name and rank: _________________________________________________________I certify that it is necessary to transport the household goods and/or personal effects of the above-namedproperty owner by foreign flag Transportation Service Provider as designated above for the followingreasons:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(A FULL EXPLANATION IS REQUIRED)NOTE: The explanation must include documented description of efforts made to secure U.S. flagTransportation Service Provider including points of contact (with names and telephone numbers) witha least two U.S. flag Transportation Service Providers contacted. Copies of telephone notes,telegraphic, and facsimile message or letters will be sufficient for this purpose if adequate details areincluded therein to support conclusions that provisions of the Fly American Act (49 U.S.C. 1517) havebeen met._____________________________________(Signature TS Provider Official)_______________________________________(Signature of AMC Official)_____________________ ____________ _____________________ ___________(Title) (Date) (Title) (Date)Concur _______ / Nonconcur _______Attached:PPGBL: Yes / NoOTO Award Message: Yes / No(If no, provide explanation.)The PPGBL rate on file with SDDC will be protected to the extent provided by paragraph 33e of the Tenderof Service.