Attachment 18-SCWR-FTC-ADM-61.pdf
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- Attached to
- Training Support Services
- Solicitation number
- 70LART25RPFB00006
About this file
This is a Service Contract Work Request form (FTC-ADM-61) used by the Department of Homeland Security Federal Law Enforcement Training Centers (FLETC) to request contractor services. The form is a template that includes fields for contract number, place of performance, award date, request number, order number, FY call number, and serial number.
The form contains sections for labor categories, CLIN/Sub-CLIN details (including description, quantity, unit of issue, unit cost, estimated cost, fee, and total), delivery/performance schedule, place of delivery, accounting and appropriation data, and justification. It requires signatures from the originator, approval authority, and contracting officer. The form includes distribution instructions for the original to go to the contractor with copies to the Fund Administrator, COR, and Contract File. This appears to be a blank template that would be filled out to request specific contractor services under an existing contract.
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Text version
DEPARTMENT OF HOMELAND SECURITY
FEDERAL LAW ENFORCEMENT TRAINING CENTERS
SERVICE CONTRACT WORK REQUEST
CONTRACT NO. PLACE OF PERFORMANCE: Award Date:
REQUEST NO. Order #
FY CALL # Ser # Complete with an appropriate/applicable labor category and rate for the described work:
Labor Category: Labor Category:
Labor Category: Labor Category:
Labor Category: Labor Category:
ITEM # CLIN
SUB CLIN DESCRIPTION QUANTITY UNIT OF
ISSUE
UNIT COST ESTIMATED
COST
FEE TOTAL
GRAND TOTAL
Delivery or Performance Schedule/Date Place of Delivery or Performance Accounting & Appropriation Data
JUSTIFICATION
Originator (Print/Sign) Date Approval (Print/Sign) Date
Delivery/Performance Schedule Method of Payment & Payment Office (if not specified in the contract)
Contracting Officer (Print/Sign) Date
Original - Contractor Copy to: Fund Administrator
COR
Contract File
FTC-ADM-61 (5/17) Page 1 of 1
9.0.0.2.20120627.2.874785
DEPARTMENT OF HOMELAND SECURITY
FEDERAL LAW ENFORCEMENT TRAINING CENTERS
SERVICE CONTRACT WORK REQUEST
Complete with an appropriate/applicable labor category and rate for the described work:
ITEM #
CLIN SUB CLIN
DESCRIPTION
QUANTITY
UNIT OF ISSUE
UNIT COST
ESTIMATED COST
FEE
TOTAL
GRAND TOTAL
Original - Contractor Copy to: Fund Administrator
COR
Contract File
FTC-ADM-61 (5/17)
| Contracting Officer (Print/Sign): |
| Date 2 digit month, 2 digit day, 4 digit year: |
| Labor Category:: |
| Delivery or Performance Schedule/Date: |
| Accounting & Appropriation Data: |
| Reset Form Button: |
File details come from the government source that posted it. Updated .