Att J-5 Over and Above Requirement Request Form 08-18-20.docx

DOCX document 14 KB Posted

Attached to
Pilot and Aircrew Curriculum Revision and Maintenance (PACRM)
Solicitation number
N6134020R0082
Issued by

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This document is an Over and Above Requirement Request Form used by contractors to request authorization for additional work from the Naval Air Warfare Center Training Systems Division on existing contracts. The form includes fields for the contractor to provide details of needed repairs or corrective actions required, estimated man-hours and costs to complete the work, and spaces for the Contracting Officer's Representative and Contracting Officer to review and approve or disapprove the request. The related federal contract opportunity is a solicitation for a Pilot and Aircrew Curriculum Revision and Maintenance Multiple Award Contract to support the ongoing revision and maintenance of Navy and Marine Corps training programs' curricula and electronic classroom systems. The solicitation was issued by the Department of the Navy Naval Air Systems Command to establish indefinite delivery/indefinite quantity contracts for these services.

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Attachment J-5

OVER AND ABOVE REQUIREMENT REQUEST FORM

Sequential Task Number ________ Date ________

To: Procuring Contracting Officer Via: COR

Subj: REQUEST FOR AUTHORIZATION TO PROCEED WITH AN OVER AND ABOVE WORK

REQUIREMENT

Ref: (a) _________________________________________(Device/Site)

1. The undersigned Contractor requests authorization to proceed with an over and above work requirement under Item __________ of Contract _________________, Task Order ________ in accordance with the Over and Above Work Requirement Request clause of the contract schedule as described below:

NEEDED REPAIRS:________________________________________________

CORRECTIVE ACTION REQUIRED:__________________________________

ESTIMATED MAN-HOURS:_________________________________________

ESTIMATED COST: $______________________________________________

Detailed cost breakdown: (submit on separate sheet) (include any necessary parts and materials)

SUBMITTED BY: (Contractor) REVIEWED BY: (COR)

(Signature/Date) (Signature/Date)

COR Recommend: / / Approval / / Disapproval

2. PCO: [ ] Approved [ ] Disapproved for the following reason(s)______________________________

CONTRACTING OFFICER DATE

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