Attachment_4C_-_PWS_Appendix_C_OCONUS_LOA.pdf

FA0021-15-R-0004

Attachment 4C

3 Nov 2014

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

DEPLOYMENT PERIOD END

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

CONTRACT PERIOD END

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:

PWS Appendix C

FA0021-15-R-0004

Attachment 4C

3 Nov 2014

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

Email

Phone

NOTE: SPOT GENERATES A BAR CODE ON BOTH PAGES OF THE LOA. THE BAR CODE IS NOT REPLICATED ON THIS

SAMPLE.

PWS Appendix C