N42158-17-R-0004_Attachment_3_-_DCAA_Rate_Check_Form.xls

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Amendment 0001-Accomplish MRC-003 Inspection and Repairs
Solicitation number
N42158-17-R-0004
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Attachment 3 DCAA Rate Check Form

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Sheet1

SOLICITATION # N42158-17-R-0004 Attachment 3
PART 1 (To Be Completed by Contractor)
1. Contractor Name:3. Contractor CAGE and DUNS Code:
1A. Contractor POC Name/Phone:4. RFP No. and/or Contractor's Prop. No.:SOLICITATION # N42158-17-R-0004
2. Contractor's Address
5. Total Dollar Amount:
6. Type of Proposal (FFP/CPFF/CPAF/CPIF/Other:CPFF
7. Subcontractor To: (if applicable)
8. Period of Performance:
9. PROVIDE NAME, ADDRESS, TELEPHONE NUMBER AND E-MAIL ADDRESS FOR THE FOLLOWING (if available)
A. CONTRACT ADMINISTRATION OFFICEB. AUDIT OFFICE
10. WILL YOU REQUIRE THE USE OF ANY GOVERNMENT PROPERTY IN THE PERFORMANCE OF THIS WORK? (If "Yes," identify)11A. DO YOU REQUIRE GOVERNMENT CONTRACT FINANCING TO PERFORM THIS PROPOSED CONTRACT?(FFP ONLY) (If "Yes," complete Item 11B)11B. TYPE OF FINANCING (X ONE)
12. HAS THE CONTRACTOR BEEN AWARDED ANY CONTRACTS OR SUBCONTRACTS FOR THE SAME OR SIMILAR ITEMS WITHIN THE PAST 3 YEARS? (If "Yes," identify item(s), customer(s), and contract number(s))13. IS THIS PROPOSAL CONSISTENT WITH ESTABLISHED ESTIMATING AND ACCOUNTING PRACTICES AND PROCEDURES AND FAR PART 31 COST PRINCIPLES? (If "No," explain)
14. COST ACCOUNTING STANDARDS BOARD (CASB) DATA (Public Law 91-379 as amended and FAR PART 30)
A. WILL THIS CONTRACT ACTION BE SUBJECT TO CASB REGULATIONS? ('If "No," explain)B. HAS THE CONTRACTOR SUBMITTED A CASB DISCLOSURE STATEMENT (CASB DS-1 0R 2)? ('If "Yes,'" specify in proposal the office to which submitted and if determined to be adequate)
C. HAVE YOU BEEN NOTIFIED THAT YOU ARE OR MAY BE IN NONCOMPLIANCE WITH YOUR DISCLOSURE STATEMENT OR COST ACCOUNTING SYSTEM? ('If "Yes," explain in proposal)D. IS ANY ASPECT OF THIS PROPOSAL INCONSISTENT WITH DISCLOSED PRACTICES OR APPLICABLE COST ACCOUNTING STANDARDS? ('If "Yes," explain in proposal)

&C &CPage &P of &N

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