A4.0 Attachment 4 (CTP Form).pdf

PWS Attachment 4

Consent to Purchase (CTP) Form Contract #: Task Order Number:

Directions for use of this form: This form shall be used to request travel, materials purchases, and other direct costs (shipping) that are within the scope of the associated task order and/or contract. All materials procured on behalf of the Government whereby the Government takes title at the time the items are paid for, shall be the property of the Government and shall be managed in accordance with FAR 52.245-1. All materials procured shall be used for official Government related business only, which is directly associated with the performance of this task order. Other Direct Costs (or ODCs) are items that are an integral part of the performance of the requirement, and are within the scope of the overall requirement, but are not specifically list and pre-priced on the contract vehicle. The contractor may insert and copy lines as needed in the spreadsheet. No sole source or brand name only items shall be procured unless required and properly documented by the Government CO in writing.

Required Documentation: All supporting documentation shall be submitted with this CTP request to include, as required, the following:

Price analysis showing the price is fair and reasonable.

Justification for Limiting Competition

Failure to provide the proper documentation and follow the proper purchasing processes in accordance with the approved purchasing system, or a system otherwise approved in this contract, shall result in no reimbursement to the contractor. This form, and the approvals received via email or hard copy, shall be submitted with the invoices to substantiate the reimbursable costs.

Procurement Tracking (CTP)

Date of Request: MM/DD/YY CLIN #: Need Date: MM/DD/YY

Type of Procurement: ODC Materials ODC Labor/Services Travel Shipping

Description of the Procurement: [Insert specific description of this purchase here] EXAMPLE - Justification for the purchase: [Name of Traveler(s)] to travel from [City, ST] to [City, ST] to support [Description to include client you are supporting].

[Travel dates are DD-DD Mon YYYY]. Funds available for travel have been verified by [Name of Task Lead].

PROCUREMENT TYPE:

FAR 51 Deviation (Against FSS) Open Market Procurement

Competitive Brand Name (justification required) Sole Source (justification required)

ATTACHMENTS:

_x_ Price Analysis Brand Name Justification Sole Source Justification Other (Describe):

ITEM

SELECTED SOURCE ITEM DESCRIPTION QTY

UNIT OF

ISSUE

UNIT

PRICE

REQUESTED REIMBURSEMENT PRICE

Example: Travel: [#]-Day Trip from [ST] to [ST]

Subtotal of All Request Costs for Direct Reimbursement to the Contractor

Associated Fees (XX%) (If Negotiated in the Contract/Task Order)

Total Costs Reimbursable Request:

APPROVAL ROUTING CHAIN: (Send this form via email to all of the following, per the PWS requirements.)

FAR 51 or Open Market < applicable micro-purchase threshold: E-mail approval along with this form with COR signature.

FAR 51 or Open Market > applicable micro-purchase threshold: 3 Quotes Solicited along with this form with COR, APM & CO approval.

Brand Name or Sole Source (regardless of value): Brand Name/Sole Source justification required along with this form with COR, APM & CO signatures

CONTRACTING OFFICER REPRESENTATIVE (COR)

CONCURRENCE TO PROCUREMENT:

COR Signature: First & Last Name/first.last@us.af.mil mailto:Name/first.last@us.af.mil

GSA ACQUISITION PROJECT MANAGER (APM)

COORDINATION:

APM Signature

CONTRACTING OFFICER (CO) APPROVAL AND

OBLIGATION OF FUNDING TO PROCUREMENT:

CO Signature