Attachment 2 Work Request Template UPPR.pdf
PDF 89 KB Posted
- Attached to
- Barge Maintenance
- Solicitation number
- N39040400T4815
About this file
This document is a Work Request Unscheduled Repair Authorization Request form used to document and obtain approval for repair services and associated costs. The form is structured into four primary sections: Scope of Work & Repair Description, Contractor Approved Markup on Materials, Labor, and Approval and Authorization. Contractors must provide detailed information about repair needs, including specific parts/materials (both OEM and non-OEM), quantities, costs, and labor hours. The form requires comprehensive documentation, such as proof of cost, fair and reasonable price justification, and specifications for non-OEM parts.
The approval process mandates signatures from multiple parties, including the Contractor, Project Manager (PM), Contracting Officer's Representative (COR), and Contracting Officer (KO). Each party must verify specific elements, such as parts suitability, labor hours, funding availability, and compliance with contract-approved rates. No work can commence until all required approvals are obtained and the form is signed and returned to the Contractor. The form emphasizes transparency in cost breakdown, requiring separate invoicing for parts, labor, and markup, with all rates matching pre-approved contract terms.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit C Rev 2.xlsx | XLSX spreadsheet | |
| Exhibit A Rev 2.xlsx | XLSX spreadsheet | |
| Exhibit B Rev 2.xlsx | XLSX spreadsheet | |
| N39040400T4815 Combined Synopsis Solicitation Rev 1.pdf | ||
| N39040400T4815 Questions and Answers.pdf | ||
| Attachment 1 Performance Work Statement Rev 1.pdf | ||
| Exhibit C Rev 1.xlsx | XLSX spreadsheet | |
| Exhibit A Rev 1.xlsx | XLSX spreadsheet | |
| N39040400T4815 Question and Answer.pdf | ||
| Exhibit B Rev 1.xlsx | XLSX spreadsheet | |
| Attachment 6 Wage Determination 2025-4111 Rev 32.pdf | ||
| Exhibit B.xlsx | XLSX spreadsheet | |
| N39040400T4815 Combined Synopsis Solicitation.pdf | ||
| Attachment 1 Performance Work Statement.pdf | ||
| Attachment 4 Quality Assurance Surveillance Plan.pdf | ||
| Attachment 5 PNS Operations Security Contract Requirements.pdf | ||
| Attachment 6 Wage Determination 2025-4011 Rev 31.pdf | ||
| Exhibit C.xlsx | XLSX spreadsheet | |
| Attachment 3 DD1423 Data Requirements.pdf | ||
| Exhibit A.xlsx | XLSX spreadsheet |
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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¡.
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