Attachment 18-SCWR-FTC-ADM-61.pdf
PDF 543 KB Posted
- Attached to
- Transportation Service FLETC Artesia, NM
- Solicitation number
- 70LART25RPFB00007
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 contract services. The form is a template that allows for specifying contract details including contract number, place of performance, labor categories, CLINs (Contract Line Item Numbers), quantities, unit costs, fees, and total costs.
The form includes sections for delivery/performance schedule, accounting and appropriation data, justification, and requires signatures from the originator, approval authority, and contracting officer. The document appears to be a standard form template that would be filled out to initiate service contract work requests at FLETC facilities. Distribution copies are designated for the contractor, fund administrator, COR (Contracting Officer's Representative), and contract file.
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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 .