Section_J_-_Atch_37_-_SCWR_(FTC-ADM-61).pdf

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Student Support Services
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HSFLAR-17-R-00001
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Section J - Atch 37

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FTC-ADM-61 (3/90) CONTRACT NO._______________________

REQUEST NO.________________________

FY CAT# SER#

SERVICE CONTRACT WORK REQUEST

CHECK APPROPRIATE CATEGORY

CATEGORY I CATEGORY III

CATEGORY II CATEGORY IIII RETURN BY

ITEM a. b. c.

NO. DESCRIPTION OF SERVICE UNIT UNIT COST TOTAL COST

JUSTIFICATION

GRAND TOTAL

ORIGINATOR NAME (Type/Print) APPROVAL (Initials)

ORIGINAL - Contracting Officer

ORIGINATOR SIGNATURE DATE COPY - Originator

COPY - COTR

COPY - Contract Administrator

Atch 37 (Page 1 of 1)

Sheet1

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