Attachment_3_Travel_Request_Authorization_Form_-_Blank.xlsx
XLSX spreadsheet 26 KB Posted
- Solicitation number
- N00421-19-R-0064
About this file
This document contains a sample form for contractor travel authorization requests under a federal contract. The form requires contractors to provide details of planned travel such as the purpose, locations, travelers, trip requirements, estimated costs including airfare, lodging, meals and expenses, rental cars, and gas. Approval signatures are included from the technical point of contact, contracting officer's representative, and procuring contracting officer if required. The related federal contract opportunity notice is for technical support services at the Air Combat Environment Test and Evaluation Facility, solicited by the Department of the Navy Naval Air Systems Command with a closing date of October 28, 2019.
Travel Authorization Request Form
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Text version
Sample TDY Request This is a sample form for TDY Authorization Requests. Other forms/formats may be used. The forms to be used shall be approved by the COR. A single form shall be used across the contract for all prime and sub contractors.
Contractor TDY Request Form
| Contract Number | ||
| Delivery / Task Order Number | ||
| Govt POC | ||
| Full Name | Role / Justification | |
| List of Travelers |
| Purpose |
| Location(s) |
| Travelling with: (Gov if app) |
| Specific Trip Requirements |
| (Identify non-standard aspects of trip and why it is needed. E.g. multiple rental cars, high expense travel, use of govt transport, staying aboard ship, etc) |
SPOT LOA / Deployment Req'd:
| Location 1 | Location 2 | Location 3 | |
| Location/Area | |||
| Per Diem - Lodging | |||
| Per Diem - Meals & Expenses |
| Start | End | # of Days | |
| Travel Dates |
| Travel Cost Estimate | Daily | Total |
| - Airfare | $0 | |
| - Hotel | $0 | |
| - M&IE | $0 | |
| - Rental Car | $0 | |
| - Gas/Parking/Tolls | $0 | |
| - Baggage | $0 | |
| - Other (Iist below) |
| Total | $0 | $0 |
| Government Approval(s): | ||
| TPOC / Gov Project Lead: | ||
| COR: | ||
| PCO (if required): |
Sample Travel Authorization Request Form N00421-17-R-0071
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File details come from the government source that posted it. Updated .