N3904025Q4350 Attachment 2 UPPR Work Request.pdf
PDF 233 KB Posted
- Attached to
- PNSY- On-Site PM for (2) Kodak M37 Processors Federal contract opportunity
- Solicitation number
- N3904025Q4350
About this file
This document is a Work Request Unscheduled Repair Authorization Request form used to document and authorize emergency repairs. The form requires detailed documentation of repair needs, including sections for OEM and non-OEM parts/materials, with specific requirements for cost justification and specification verification. Contractors must provide supporting documentation such as catalog prices, commercial invoices, or online listings to prove fair and reasonable pricing for materials.
The form includes multiple approval sections requiring sign-off from the Project Manager (PM), Contracting Officer's Representative (COR), and Contracting Officer (KO). Key sections cover parts/materials costs, contractor markup rates, labor hours and rates, and a strict authorization process that mandates work cannot commence until all required signatures are obtained. The document emphasizes accurate cost separation, adherence to contract-approved rates, and comprehensive documentation of repair details and associated expenses.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N3904025Q4350 Combined Synopsis Solicitation rev 1.pdf | ||
| N3904025Q4350 Combined Synopsis Solicitation.pdf | ||
| N3904025Q4350 Attachment 1 OPSEC Encl 2_Redacted.pdf |
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Text version
WORK REQUEST UNSCHEDULED REPAIR AUTHORIZATION REQUEST -
Date of Request:
Work Request Number: (e.g. 1, 2) Project Name/Number: Contract Number:
1. Contractor Signature: __________________________ Date: __________________________
SECTION 1: SCOPE OF WORK & REPAIR DESCRIPTION
1.1 Provide a concise description of the repair or service needed, referencing the aƯected equipment, issue(s) observed, and any relevant background details:
SECTION 1A: OEM Parts/Materials – Complete as applicable or see attached estimate
Item (Part/material) Description QTY Cost to
Contractor Discounts Passed to Government Total Cost to Government
Supporting Documentation: Contractor must provide “proof of cost” Fair and Reasonable Price Justification (e.g., catalog prices, commercial invoices, online listings) o Parts must be genuine, manufacturer-approved unless expressly waived (fill out section 1B)
Section 1B: Non-OEM Parts/Materials – Complete as applicable or see attached estimate
Item (Part/material) Description QTY Cost to
Contractor (Non-OEM)
Cost of
OEM
Equivalent
Non-OEM Specifications
Total Cost to Government
Additional Requirements for Non-OEM:
1. Contractor must provide cost comparison (OEM vs. Non-OEM) for fair and reasonable determination.
2. Contractor must provide detailed Non-OEM specifications for PM to verify suitability.
SECTION 2: CONTRACTOR APPROVED MARKUP ON MATERIALS
Total Cost of Parts/Materials (OEM + Non-OEM)
Pre-Approved Markup Rate (%)
Markup Amount
Total Cost with Markup
Notes: Cost of parts and markup must match contract approved rates and be separated on the contractor’s invoice.
SECTION 3: LABOR
Description of Work Estimated
Hours
Agreed-Upon Labor Rate ($/hr) for each labor category
Total Unburdened Labor Cost ($)
SECTION 4: APPROVAL AND AUTHORIZATION
Statement: Work may commence only upon approval of this Work Request by the Project Manager (PM), Contracting OƯicer’s Representative (COR) and Contracting OƯicer (KO).
Contractor will Separate costs on invoice, all labor and markup rates match approved rates, and support material costs with approved supporting documentation. No work will commence until PM/KO signs below and returns to Contractor.
PM approves Section 1A or 1B: Part/Material OEM or waived for Non-OEM are needed for the work being performed.
PM approves Section 3: The level of eƯort (number of hours) is commensurate with the work being performed.
2. Project Manager (PM): __________________________ Date: __________________________
Title: __________________________
COR approves Section 1A or 1B, 2, and 3: SuƯicient funds are available to cover the Part/Materials, markup, and the markup rate matches the agreed-upon rate in the contract. Labor rate matches the contract, and suƯicient funds are available to cover the labor cost.
3. Contracting OƯicer Representative_________________________ Date:_______________________
4. Contracting OƯicer: __________________________ Date: __________________________
Additional Notes or Special Conditions:
Use this space or see attachment for any special instructions.
File details come from the government source that posted it. Updated .