1300877238-IOA-1.pdf

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Report on the characterization of polymer coatings
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N00173-21-Q-0042
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Email:

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Division Identification Number: ERP PR Number (if applicable):

Contract Number (if applicable):

GT&C Number:

Type of Action:

Description of Action:

Period of Performance / Delivery Date:

Total Value:

Phone:

REQUIREMENT APPROVALS

Print Name:

Signature / Date:

Print Name:

Signature / Date:

Print Name:

Signature / Date:

1 2

13 14

Do you have an NWA?: Yes No 10 11

Requested Award Date: 9

Signature / Date: Signature / Date:

COR / Technical POC: 12

REQUIREMENT SUMMARY SHEET

Procurement Office: Purchasing Contracts Funding (POGA)

Print Name: Print Name:

FINANCIAL REVIEW: CERTIFIED FOR PURPOSE, TIME, AND AMOUNT OF FUNDS16

PROCUREMENT REQUESTOR15

APPROVING AUTHORITY

OTHER APPROVAL OTHER APPROVAL17 18

14 Email:
2 ERP #: 1300877238
4 Contract Number:
5 GT&C Number:
7 Description of Action: Reports on the characterization of polymer coatings using unique techniques for capturing contributions from deformability, incorporated free molecules, adhesion, and capillary action. The period of performance will be for one year from award date.
8 POP / DD: 1 year
11 Total Value:
13 Phone:
Print Name_1:
Print Name_2:
Print Name_5:
9 Requested Award Date:
12 COR / Technical POC:
Print Name_3:
Print Name_4:
1 DIN: 69-2032-20
6 Type of Action: [Services </= $250k]
Procurement Office?: Purchasing
NWA?: Yes
Clear Pg 1:

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