BPA F 6410.41e Contract Construction Material Request

U.S. DEPARTMENT OF ENERGY – BONNEVILLE POWER ADMINISTRATION (BPA)

BPA F 6410.41e
(04-2023)
Page 1 of 2

CONTRACT CONSTRUCTION MATERIAL REQUEST

OMB Control Number: 1910-5190
Expiration Date: XX/XX/XXXX

Prepare form immediately upon discovery of a design issue/change, missing, damaged or misfabricated material
INSTRUCTIONS:
1. Submit the completed form in accordance with Section 01 33 00 – Submittal Procedures and Section 01 64 02 – BPA Furnished Materials to the Construction Administration Information
System (CAIS) via the Request for Information (RFI) module and e-mail to BPA project Acquisition Analyst (AA). The request will be routed to appropriate reviewer: Reviewer will approve or deny
request in (CAIS). Reviewer will advise as appropriate the AA, Contracting Officer (CO) and Contracting Officer’s Technical Representative (COTR). Reviewer will update (CAIS) with M.R.
information as appropriate.
2. If this request constitutes a contract change, submit a Change Order Request (COR) via CAIS.
3. Some columns in table below may be left bank (Tower/Structure Type, Piece-mark, and Bundle).
4. Retain a copy of the form for your records.
Project Name

Contractor Name

Requestor (Contractor Material Representative Name)

Date Discovered

Project Work Order Number (Submit New Form for Each Work Order)

Date Material Required

Contract/ Release Number

Request For Information Number (RFI)

Catalog/
Component
ID

Tower/
Structure
Type

Piece-mark

Bundle

Structure Location/
Tower Site

Quantity
Requested

Description

Reason for Request
(Design Issue/Change, Material
Damaged, Lost, Shortage, MisFab)

Comments:

File Code: FE-1190; Retention: Destroy 5 years after project completion or termination, but longer retention is authorized if required for business use.

BPA F 6410.41e
(04-2023)
Page 2 of 2

CONTRACT CONSTRUCTION MATERIAL REQUEST

OMB Control Number: 1910-5190
Expiration Date: XX/XX/XXXX

Paperwork Reduction Act Burden Disclosure Statement
This data is being collected to ensure stewardship of BPA’s purchased materials. The data you supply will be used by BPA to ensure that credit is appropriately provided and materials are used
economically and efficiently. Public reporting burden for this collection of information is estimated to average 5 minutes (.08 hours) per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Office of the Chief Information Officer,
Enterprise Policy Development & Implementation Office, IM-22, Paperwork Reduction Project (OMB control number 1910-5190), U.S. Department of Energy, 1000 Independence Ave SW,
Washington, DC 20585-1290; and to the Office of Management and Budget (OMB), OIRA, Paperwork Reduction Project (OMB control number 1910-5190), Washington, DC 20503.
Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with a collection of information subject to
the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number.
The Paperwork Reduction Act (PRA) of 1995 requires each Federal agency to seek and obtain approval from the Office of Management and Budget (OMB) before undertaking a collection of
information directed to 10 or more persons of the general public, including persons involved in or supporting the operations of Government-owned, contractor-operated facilities.
Submission of this data is voluntary, however failure to submit the information could result in assessment of waste, loss, and/or damages.

File Code: FE-1190; Retention: Destroy 5 years after project completion or termination, but longer retention is authorized if required for business use.