06Attachment_J-4_JGASS_Government_Furnished_Life_Support_Form_FINAL.pdf

OCSDC Tracking Number: ___________________

Government Furnished Life Support Validation (GFLSV) Request and Approval Form

The GFLSV form must be submitted prior to release of solicitation; if any changes in required support are identified between approval of the pre-solicitation GFLSV and award, activities must submit a new GFLSV form prior to award. Only the most current (approved) GFLSV form shall be attached with the TBC request. Activities should allow ten (10) days for GFLSV review and approval.

“Requiring Activities will use this form to request GFLS from the Operational Contract Support Drawdown Cell (OCSDC) and the Base Operations Support–Integrator (BOS-I) / Garrison Commander for employees of DoD contractors performing in Afghanistan. Individual forms are required if GFLS is requested from different installations. Contract offices and requiring activities will complete and submit the GFLS Form to the C-JTSCC Contract Support, Plans and Operations Office (C-SPO), and OCSDC via: CJOA-LifeSupport.Request.ORG@afghan.swa.army.mil for review and action. The contracting office and requiring activity will notify the OCSDC and BOS-I/Garrison Commander of any change to the number of supported contractor personnel within five (5) business days. The BOS-I/Garrison Commander will notify the contracting office/requiring activity of any changed conditions that affect the provision of GFLS.”

The requesting organization needs to ensure expected government provided life support is verified as available before contractor personnel arrive. The following is a summary of the type of support the Government may provide the contractor, on an “as-available” basis. As noted in the Government Furnished Contractor Support memorandum, the contractor should be notified that the levels and types of support may be lowered to expeditionary standards. Contracting Officers will check the boxes to identify the requested GFLS and then submit the form to the OCSDC and Base Operation Support- Integrator (BOS-I)/local Garrison Commander.

Previously submitted GFLSV form for this requirement (OCDSC Tracking # or N/A):_________ Type of Request:

Location: _____________________________________________________________________ Number of Supported personnel at this location: __________ Total Number of Supported Personnel for this requirement: ______________________________ Length of stay: _________________ From: ___________ To: ____________ Requirement Type:

Description of Requirement:

Justification for Requirement:

If existing requirement: Current Contract/Task Order Number: ___________________________ Current Contractor Name: ________________________________________________________ Number of supported personnel currently on-site (this location):__________________________ Additional Information (Special Circumstances impacting GFLS, etc…):

mailto:CJOA-LifeSupport.Request.ORG@afghan.swa.army.mil

U.S. Citizens

APO/FPO/MPO/DPO/Postal Services DFAC Access Mil Issue Equip Authorized Weapon Excess Baggage MILAIR Billeting (Primary Duty Location) Fuel Authorized MWR CAAF* Govt Furnished Meals Resuscitative Care Common Access Card (CAC) Military Banking Transportation Installation Access Badge Military Clothing NA All Commissary Military Exchange None

NA Dependents Authorized Laundry Embassy Services Kabul**

Third-Country National (TCN) Employees

NA N/A DFAC Access Mil Issue Equip

Authorized Weapon Excess Baggage MILAIR Billeting (Primary Duty Location) Fuel Authorized MWR CAAF* Gov’t Furnished Meals Resuscitative Care Common Access Card (CAC) Military Banking Transportation Installation Access Badge Military Clothing NA All Commissary Military Exchange None

NA Dependents Authorized Laundry

Local National (LN) Employees

NA N/A DFAC Access Mil Issue Equip

Authorized Weapon Excess Baggage MILAIR Billeting (Primary Duty Location) Fuel Authorized MWR CAAF* Govt Furnished Meals Resuscitative Care Common Access Card (CAC) Military Banking Transportation Installation Access Badge Military Clothing NA All Commissary Military Exchange None

NA Dependents Authorized Laundry

* CAAF means Contractors Authorized to Accompany Forces.

** Applies to US Embassy Life Support in Afghanistan

SPECIAL NOTE – US Embassy Afghanistan Life Support: The type and amount of support that the U.S. Embassy Mission in Kabul, Afghanistan, provides to contractors, if any, must be coordinated in advance between the U.S. Mission and the contracting agency in accordance with Department of State Foreign Affairs Handbook, 2-FAH-2. Contractors are not authorized to deploy personnel requiring US Mission support prior to receiving clearance from the contracting officer.

Requiring Activity POC:

Name: _________________________________________________ Title: _________________________________________________ Email: _________________________________________________ Phone: _________________________________________________ Location: _______________________________________________ Unit: ___________________________________________________

CJOA-A Sponsoring Organization POC:

Name: _________________________________________________ Rotation Date: __________________________________________ Title: _________________________________________________ Email: _________________________________________________ Phone: _________________________________________________ Location: _______________________________________________ Unit: ___________________________________________________

CJOA-A Contracting Officer’s Representative:

Name: _________________________________________________ Rotation Date: __________________________________________ Title: _________________________________________________ Email: _________________________________________________ Phone: _________________________________________________ Location: _______________________________________________ Unit: ___________________________________________________

The requested Government Furnished Life Support is:

Comments (if Non-concur):

Undersigned agree to coordinate any changes to the number of deployed contractor personnel or available support in the CJOA-A. Questions may be addressed to undersigned

Requester/Requiring Activity Signature & Date hollande Text Box CDR Thomas A. Murphy

CJOA-A BOS I/Garrison Commander:

Name: _________________________________________________ Rotation Date: __________________________________________ Title: _________________________________________________ Email: _________________________________________________ Phone: _________________________________________________ Location: _______________________________________________

BOS-I/Garrison Commander’s Additional Comments:

BOS-I/Garrison Commander Signature & Date

CJOA-A OCSDC Representative:

Name: _________________________________________________ Rotation Date: __________________________________________ Title: _________________________________________________ Email: _________________________________________________ Phone: _________________________________________________ Location: _______________________________________________

OCSDC’s Additional Comments:

OCSDC Signature & Date