Attachment_I_Fact_Sheet_on_Procurement_Restrictions_-_Annex_2.docx

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GLOBAL ADVISORY AND SUPPORT SERVICES Federal contract opportunity
Solicitation number
19AQMM19R0193
Issued by
Department of State Office of Acquisition Management

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Attachment I PKO Restrictions Annex 2

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Fact Sheet: Procurement Restrictions Under the Foreign Assistance Act Annex 2: 604(a)(1) Waiver Template General Procurement (including Vehicles) For all items recommended to be purchased outside a 604(a)(1) compliant country, the below template shall be completed for each type of item (e.g. vehicles, tents, ambulance, armored personnel carrier, radios, etc.) (a separate sheet shall be submitted for each type of item).

Receiving Country: __________ Item Type: _________________ Quantity to Procure: _________

Vendor
Location of Item
604(a)(i) Compliant
Present in Vendor Inventory
Meets Task Order Solicitation Specifications
Explanations for Deviations and Waivers
Spec Problems
Timeline Issues
Cost Variance
A
United States
Yes
N/A
No
Explanation

(e.g. not right hand drive, not dirty diesel compatible, not produced in U.S.)

Explanation (e.g. will arrive 90 days later than Government requires in Task Order)

Explanation

B
Recipient Country
Yes
No
No
Explanation

Explanation

Explanation (e.g. cost will be 30% cheaper than procuring from USG)

C
Other non-Advanced Developing Country
Yes
Yes
No
Explanation

Explanation

Explanation

D
Other non-Advanced Developing Country
Yes
Yes
No
Explanation

Explanation

Explanation

E
Other non-Advanced Developing Country
No
Yes
Yes
Explanation

Explanation

Explanation

F
Proposed location
TBD
TBD
Yes
Explanation
Explanation
Explanation

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