Attch 9 ODC Appr Sample.doc

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ice Information Technology Field Operations (ITFO)
Solicitation number
HSCETC-11-R-00002
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Attachment 9 ODC Sample Approval Form

HSCETE-11-R-00002

SAMPLE - ODC/Special Request Form/Checklist

1. Organization.
2. Date of Request
3. Project Point of Contact.
4. ODC Track ID #:
5a. ODC CLIN
5b. ODC Support CLIN
6. Requisition
7. Release No. _Item-MDL
8. Estimated Total Cost

9. ODC Categories. (Please Check One)

FORMCHECKBOX

Computer (Hardware).

FORMCHECKBOX

Computer (Software)

FORMCHECKBOX

Computer Services

FORMCHECKBOX

Supplies for Deliverables

FORMCHECKBOX

Program Mgmt Support ODC

FORMCHECKBOX

Special Project

FORMCHECKBOX

Other: ______________________________

FORMCHECKBOX

Reproduction, Graphics, Communications.

FORMCHECKBOX

Staff Expenses

FORMCHECKBOX

Sub-contractor /Temporary Labor/Consultant

FORMCHECKBOX

Material Buy

FORMCHECKBOX

Travel - Local

FORMCHECKBOX

Travel - CONUS

FORMCHECKBOX

Travel - OCONUS

9. Task Area Coordination

a. Description (Purpose of Work, Special Project, Work Objectives, etc…)

b. Period of Performance:
Required Start Date
Projected Completion Date (PCD)
c. Deliverables
See Attachment

7. Task Area Coordination:

a. Financial or Analyst: : I certify to the best of my knowledge that funds have been identified and are available for this ODC to support this requirement, work activities, and/or projects

Print Name
Signature

Date

b. Government Project Lead: I certify to the best of my knowledge this ODC is required to support the DHS-ICE-OCIO work activities and projects.

Print Name
Signature

Date

c. Assigned COTR: : I certify to the best of my knowledge based on the information provided above that this ODC was identified as required to support the DHS-ICE-OCIO work activities and projects.

Print Name

Signature
Date

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