Sec J Att 5 Add Instruction Request-Authorization-Completion.doc
DOC document 34 KB Posted
- Attached to
- Advanced Helicopter Training System Program for Ground Based Training System (N61340-19-R-0096)
- Solicitation number
- N6134019R0096
About this file
This document outlines a form used to request, authorize, and report on additional instruction time for contractor instructors. The form is used under contract number _________ for advanced helicopter training provided by the Naval Air Systems Command. It allows training officers to request additional hours or missions for contractor instruction at specific locations and times, including the type and purpose of instruction. The contracting officer's representative then authorizes and assigns a sequential number to the premium time, not to exceed available funds on the contract. Finally, the contractor site manager reports the actual additional instruction time worked, including dates, times, number of personnel, hourly rates, and total costs, and obtains concurrence from the contracting officer's representative. Copies are kept on file by both parties.
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Text version
CI ADDITIONAL INSTRUCTION TIME REQUEST/AUTHORIZATION/ COMPLETED SERVICES FORM
Contract #:
| From: (Training Authority) |
| Task Order: |
| To: (CI COR) |
| Request Date: |
Subj: ESTABLISH REQUIREMENT FOR CI ADDITIONAL INSTRUCTION TIME (AIT) SERVICES
1. Request instructor services under additional instruction time at _____________________(location(s)):
a. [ ] Contractor Instruction:
Date: Time: Total Total
Rqrd: From: End: Hrs: Missions: Type and purpose of instruction:
1) _____ ____ ____ _______ or _______ ________________________________
2) _____ ____ ____ _______ or _______ ________________________________
3) _____ ____ ____ _______ or _______ ________________________________
b. [ ] Other requirement:______________________________________________________
Training Officer Signature Date
AUTHORIZATION: Date: _________
From: ________________________ (COR)
To: ________________________ (CI Site Mgr)
Subj: CI PREMIUM TIME AUTHORIZATION
1. A total of _______ hours of CI additional training time is authorized to meet the above requirements requested above as follows:
a. CLIN/SLIN______________ AIT [ ] Hrs or [ ] Mission Authorized:__________#
b. CLIN/SLIN______________ AIT [ ] Hrs or [ ] Mission Authorized:__________#
c. CLIN/SLIN______________ AIT [ ] Hrs or [ ] Mission Authorized:__________#
2. Under no circumstances shall the CI additional instruction time authorized exceed the additional instruction time funding available on the contract/task order be exceeded. For this requirement request, the COR assigned tracking sequential No. is: _____________.
AUTHORIZED BY: __________________________ ________
COR Signature Date
COMPLETED SERVICES: Date: ________
From: _______________________ (CI Site Mgr)
To: _______________________ (COR)
Subj: REPORT OF ACTUAL CI ADDITIONAL INSTRUCTION TIME WORKED FOR SEQ NUMBER ________
1. Actual additional instruction time worked by the CI contractor is as follows:
Time: [ ] Hrs No. of (Hrs/Missions)X PT Total
Date: From: To: [ ] Missions Pers: (No Pers): Rate: Cost:
a. _____ ____ ____ _____ x _____ = ______ x $_______ = $________
b. _____ ____ ____ _____ x _____ = ______ x $_______ = $________
c. _____ ____ ____ _____ x _____ = ______ x $_______ = $________
TOTAL $________
Contractor Site Manager Signature Date
COR Concurrence:_________________________ ________
CI COR Signature Date
Note: Complete copies to be kept on file by COR and CI Contractor Site Manager.
Attachment- 5
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