Attachment 2 Work Request Template UPPR.pdf
PDF 233 KB Posted
- Attached to
- INTENT TO SOLE SOURCE: Preventative Maintenance and Repair Services Federal contract opportunity
- Solicitation number
- N3904025Q0062
About this file
This document is a Work Request Unscheduled Repair Authorization Request template designed for federal contract repair and maintenance services. The template requires contractors to provide detailed information about repair work, including a scope of work description, parts/materials needed (both OEM and non-OEM), associated costs, markup rates, and labor hours. The form includes multiple sections for documenting repair specifications, with specific requirements for cost justification, such as providing "proof of cost" documentation, comparing OEM and non-OEM part costs, and detailing specifications for non-standard parts. The template mandates approval signatures from the Project Manager, Contracting Officer's Representative, and Contracting Officer before any work can commence, ensuring thorough documentation and cost control for unscheduled repair activities.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N3904025Q0062 Combined Synopsis Solicitation.pdf | ||
| Attachment 1 Enclosure 2 PNSY OPSEC_Sig Redacted.pdf |
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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 a ected 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 O icer’s Representative (COR) and Contracting O icer (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 e ort (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: Su icient 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 su icient funds are available to cover the labor cost.
3. Contracting O icer Representative_________________________ Date:_______________________
4. Contracting O icer: __________________________ 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 .