D1Atch04AppCOCONUSLOA.doc
DOC document 54 KB Posted
- Attached to
- Systems Engineering and Technical Assistance (SETA) IV Federal contract opportunity
- Solicitation number
- FA0021-09-R-0004
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Attachment 4 Appendix C - OCONUS LOA
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DRAFT Solicitation FA0021-09-R-0004
## June 2009
SAMPLE LETTER OF AUTHORIZATION FROM SYNCHRONIZED PREDEPLOYMENT OPERATIONAL TRACKER (S.P.O.T)
| LETTER OF AUTHORIZATION |
| DATE OF REQUEST |
OCONUS TRAVEL
| GOVT AGENCY SUPPORTING MISSION |
| GOVT AGENCY POC |
| GOVT AGENCY POC PHONE |
| GOVT AGENCY POC EMAIL |
| NAME (Last, First, Middle Initial) |
| SSN |
| DATE OF BIRTH |
| PLACE OF BIRTH |
| HOME ADDRESS |
| CITIZENSHIP |
| PASSPORT # / EXPIRATION (MM/DD/YYYY) |
| DEPLOYMENT PERIOD START (MM/DD/YYYY) |
| DEPLOYMENT PERIOD END (MM/DD/YYYY) |
| AKO EMAIL |
| THEATER EMAIL |
| CLEARANCE LEVEL w/ AGENCY |
| CLEARANCE DATE(MM/DD/YYYY) |
| JOB TITLE |
| GRADE EQUIV (GS12 or GS 13) |
| COMPANY (full name) |
| COMPANY POC |
| COMPANY POC TELEPHONE |
| COMPANY POC EMAIL |
| CONTRACT NUMBER/ TASK ORDER |
| CONTRACT PERIOD START (MM/DD/YYYY) |
| CONTRACT PERIOD END (MM/DD/YYYY) |
| CONTRACT ISSUING AGENCY |
NEXT OF KIN (NOK) NAME (Last, First, Middle Initial)
| NOK RELATIONSHIP |
| NOK TELEPHONE |
| NOK ALTERNATE TELEPHONE |
| IN-THEATER CONTACT |
| CONTACT’S PHONE |
| CONTACT’S EMAIL |
| COUNTRIES TO BE VISITED |
| PRIVILEGES |
· BILLETING
· DODI Essential
· DFACS
· COMMISSARY
· MEDICAL / DENTAL Emergency Only
· CAC / ID CARD
· DEPENDENTS AUTHORIZED
· FUEL AUTHORIZED
· (gov’t vehicles only)
· MWR
· MIL CLOTHING
· MIL ISSUED EQUIP
· MIL EXCHANGE
· APO / FPO
· MIL BANKING
· TRANSPORTATION (gov’t business only)
· EXCESS BAGGAGE
· MILAIR
PURPOSE
FUND CITE w/ BILLING ADDRESS
| WEAPON AUTHORIZED |
| WEAPON TYPE: |
The government organization specified above, in its mission support capacity under the contract, authorizes the individual employee identified herein, to proceed to the location(s) listed for the designated deployment period set forth above. Non-supervisory positions shall be rated GS-12 or equivalent. Supervisory / Managerial positions shall be rated as GS-13 or equivalent. Upon completion of the mission, the employee will return to the point of origin. Travel being performed is necessary and in the public's service. Travel is in accordance with FAR 31.205-36 and the maximum per diem allowable under the appropriate travel regulations (Joint Travel Regulation (for AK, HI and outlying areas of the United States and US possessions), Federal Travel Regulation for CONUS and US Territories, and Dept of State's Standardized Regulations for OCONUS Foreign Areas designated by DOS).
Emergency medical support will be determined by the appropriate supported commander. Contractor authorization aboard military aircraft will be determined by the supported commander. Necessary identification badges will be determined and provided by the supported command.
This Contractor is considered as “Key Personnel, Government Civilian” in connection with “Non-Combatant Evacuation Orders” at the civil service grade indicated above.
REMARKS
Contracting Officer
Signature
Print Name
Phone
NOTE: SPOT GENERATES A BAR CODE ON BOTH PAGES OF THE LOA. THE BAR CODE IS NOT REPLICATED ON THIS SAMPLE.
Attachment 4, Appendix C
File details come from the government source that posted it. Updated .