Attachment 2 Work Request Template.pdf
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- Attached to
- CNC Machine Service
- Solicitation number
- N39040400T4884
About this file
This document is a Work Request Unscheduled Repair Authorization Request form designed to facilitate and document emergency or unanticipated repair work within a federal contract. The form is structured in four key sections: Scope of Work & Repair Description, Contractor Approved Markup on Materials, Labor, and Approval and Authorization. It requires detailed documentation of parts/materials (both OEM and non-OEM), labor hours, and associated costs, with specific requirements for contractors to provide supporting documentation such as proof of cost, fair and reasonable price justification, and specifications for non-OEM parts.
The form mandates a multi-step approval process involving the Contractor, Project Manager (PM), Contracting Officer's Representative (COR), and Contracting Officer (KO), who must individually review and approve different sections of the request. Critical stipulations include that work may only commence upon full approval, costs must match contract-approved rates, invoices must separate labor and markup costs, and all supporting documentation must be provided. The form serves as a comprehensive mechanism for tracking, authorizing, and documenting unscheduled repair work while ensuring financial transparency and adherence to contractual terms.
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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) o 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 PM 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: __________________________
Additional Notes or Special Conditions:
Use.this.space.or.see.attachment.for.any.special.instructions¡.
File details come from the government source that posted it. Updated .