Attch 3 Designation of Representatives.doc

Designation of Representative, CLRD Poudre Steps II Project

DESIGNATION OF REPRESENTATIVES

SOLICITATION NO. / CONTRACT NO.

1240LQ22Q0012

PROJECT

Rifle Ranger District Office Janitorial Services Multi-Year

UNIT

White River NF

TO

Rebecca Schowalter, Purchasing Agent

Rebecca.l.schowalter@usda.gov

CONTRACTOR NAME, ADDRESS & POC EMAIL

Contractor Name

Street Address

City, State + Zipcode POC Name, Email

Key Personnel In accordance with the above specified contract number, the following personnel are assigned to this contract:

Contract Manager

Overwrite Here Phone

Overwrite Here Email

Overwrite Here

Site Lead/Supervisor

Overwrite Here Phone

Overwrite Here Email

Overwrite Here

Reserved

Overwrite Here Phone

Overwrite Here Email

Overwrite Here

Reserved

Overwrite Here Phone

Overwrite Here Email

Overwrite Here

Designated Representative

This delegation extends authority to take any action necessary with respect to the execution of work, including acknowledging receipt of Notice to Proceed, Suspend and Resume Work Orders, and Notices of Noncompliance. The individual named below is designated as my representative for this contract and, in my absence, is authorized to act in my behalf. The items check below indicate additional authority authorized by this delegation:

☐ Sign progress payment estimates and invoices.

☐ Sign contract modifications.

☐ Sign final payment estimate and invoice and contract release.

☐ Execute contract termination settlement agreement.

☐ Full authority in all contractual matters.

Name Overwrite Here Title Overwrite Here

(Date)

(Signature)

(Title)