C04_1-12445526Q0061-Att7-KTRKeyPersonnel.doc
DOC document 42 KB Posted
- Attached to
- MOF FR86 Base Repair and Resurfacing
- Solicitation number
- 12445526Q0061
- Issued by
-
Department of Agriculture Forest Service
About this file
This is a Key Personnel Designation form for contract number 12445526Q0061, the MOF FR86 Base Repair and Resurfacing project on the Monongahela National Forest. The form is a template requiring contractors to identify and designate key personnel who will execute the work, including a Contractor Representative, Project Foreman/woman, Project Manager, Inspector, and other titled positions. Each designated personnel entry requires name, phone number, and email address.
The Contractor Representative holds delegated authority to execute work on behalf of the contractor, with the ability to acknowledge Notice to Proceed, process Suspend and Resume Work Orders, and issue Notices of Noncompliance. The form provides checkboxes to authorize the Contractor Representative with additional specific authorities, including signing progress payment estimates and invoices, signing contract modifications, signing final payment estimates and invoices with contract release, executing contract termination settlement agreements, or exercising full authority in all contractual matters. The form requires the designated representative's name and title to be specified. This document is submitted to Matthew Killian, the Contracting Officer, and serves as formal documentation of the contractor's organizational structure and decision-making authority for the contract.
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Text version
Designation of Representative, CLRD Poudre Steps II Project
DESIGNATION OF REPRESENTATIVE
SOLICITATION NO.
12445526Q0061
CONTRACT NO.
PROJECT
MOF FR 86 Base Repair and Resurfacing
UNIT
Monongahela National Forest
TO
Matthew (Matt) Killian, Contracting Officer
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:
Personnel identified herein may hold multiple roles/positions.
| Contractor Representative Name |
| Phone |
| Overwrite Here |
| Overwrite Here |
| Overwrite Here |
| Project Foreman/woman Name |
| Phone |
| Overwrite Here |
| Overwrite Here |
| Overwrite Here |
| Project Manager Name |
| Phone |
| Overwrite Here |
| Overwrite Here |
| Overwrite Here |
| Inspector Name |
| Phone |
| Overwrite Here |
| Overwrite Here |
| Overwrite Here |
| Other Title Name |
| Phone |
| Overwrite Here |
| Overwrite Here |
| Overwrite Here |
| Other Title Name |
| Phone |
| Overwrite Here |
| Overwrite Here |
| Overwrite Here |
| Other Title Name |
| Phone |
| Overwrite Here |
| Overwrite Here |
| 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 items check below indicates additional authority authorized by this delegation to the key person identified as the Contractor Representative above:
☐ 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
File details come from the government source that posted it. Updated .