Attachment 2 - Unplanned Work Request.docx
DOCX document 20 KB Posted
- Attached to
- MITSUBISHI PLUNGE and WIRE EDM
- Solicitation number
- N3904026Q5223
About this file
This is an Unplanned Work Request form used to authorize and document unscheduled repair or maintenance work under an existing contract. The form serves as a template for contractors to submit requests for corrective maintenance activities, requiring detailed documentation of scope, materials, labor, and costs before work authorization.
The form requires contractors to provide a concise description of the repair needed and affected equipment in Section 1. Sections 1A and 1B address parts and materials, with 1A covering OEM (original equipment manufacturer) parts requiring proof of cost and fair and reasonable price justification, and 1B covering non-OEM parts requiring cost comparison analysis against OEM equivalents and detailed specifications for approval. Section 2 requires documentation of contractor markups on materials at pre-approved rates specified in the contract, with costs and markups to be separated on invoices. Section 3 addresses labor costs, requiring estimated hours and agreed-upon labor rates by category. Work authorization requires sequential approvals: the Project Manager must verify that parts are appropriate and effort level is commensurate with work; the Contracting Officer's Representative must confirm sufficient funds and rate compliance; and the Contracting Officer must provide final authorization before work commences. All supporting documentation for material costs, markup calculations, and labor rates must be provided and must align with previously approved contract rates.
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 1 Statement of Work.pdf | ||
| Attachment 4 ID Proofing Docs.pdf | ||
| Attachment 5 CDRL A001 - Maintenance Service Report.pdf | ||
| Attachment 3 Wage Determination.pdf | ||
| RFQ N3904026Q5223.docx | DOCX document |
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Text version
WORK REQUEST UNSCHEDULED REPAIR AUTHORIZATION REQUEST -
Date of Request:
Work Request Number: (e.g. 1, 2) Project Name/Number: Contract Number:
1. Contractor Signature: __________________________ Date: __________________________
SECTION 1: SCOPE OF WORK & REPAIR DESCRIPTION
1.1 Provide a concise description of the repair or service needed, referencing the affected equipment, issue(s) observed, and any relevant background details:
SECTION 1A: OEM Parts/Materials – Complete as applicable or see attached estimate
| Item (Part/material) Description |
| QTY |
| Cost to Contractor |
| Discounts Passed to Government |
| Total Cost to Government |
· Supporting Documentation: Contractor must provide “proof of cost” Fair and Reasonable Price Justification (e.g., catalog prices, commercial invoices, online listings)
· Parts must be genuine, manufacturer-approved unless expressly waived (fill out section 1B) Section 1B: Non-OEM Parts/Materials – Complete as applicable or see attached estimate
| Item (Part/material) Description |
| QTY |
| Cost to Contractor (Non-OEM) |
| Cost of OEM Equivalent |
| Non-OEM Specifications |
| Total Cost to Government |
· Additional Requirements for Non-OEM:
1. Contractor must provide cost comparison (OEM vs. Non-OEM) for fair and reasonable determination.
2. Contractor must provide detailed Non-OEM specifications for CM to verify suitability.
SECTION 2: CONTRACTOR APPROVED MARKUP ON MATERIALS
| Total Cost of Parts/Materials (OEM + Non-OEM) |
| Pre-Approved Markup Rate (%) |
| Markup Amount ($) |
| Total Cost with Markup |
· Notes: Cost of parts and markup must match contract approved rates and be separated on the contractor’s invoice.
SECTION 3: LABOR
| Description of Work |
| Estimated Hours |
| Agreed-Upon Labor Rate ($/hr) for each labor category |
| Total Unburdened Labor Cost ($) |
SECTION 4: APPROVAL AND AUTHORIZATION
Statement: Work may commence only upon approval of this Work Request by the Project Manager (PM), Contracting Officer’s Representative (COR) and Contracting Officer (KO).
Contractor will Separate costs on invoice, all labor and markup rates match approved rates, and support material costs with approved supporting documentation. No work will commence until PM/KO signs below and returns to Contractor.
PM approves Section 1A or 1B: Part/Material OEM or waived for Non-OEM are needed for the work being performed.
PM approves Section 3: The level of effort (number of hours) is commensurate with the work being performed.
2. Project Manager (PM): __________________________ Date: __________________________ Title: __________________________ COR approves Section 1A or 1B, 2, and 3: Sufficient funds are available to cover the Part/Materials, markup, and the markup rate matches the agreed-upon rate in the contract. Labor rate matches the contract, and sufficient funds are available to cover the labor cost.
3. Contracting Officer Representative_________________________ Date:_______________________
4. Contracting Officer: __________________________ Date: __________________________
File details come from the government source that posted it. Updated .