Attachment_4_Consent_to_Purchase_Request.pdf

USG

COMPANY NAME: CONTRACT/TO NUMBER: ISRA

ADDRESS: PERIOD OF PERFORMANCE: SING

SPAI

KOR

CPT REQUEST DATE: REQUESTOR NAME:

PROJECT NAME: REQUESTOR CONTACT INFO:

RECOMMENDED VENDOR: VENDOR OFFICE NUMBER: DELIVERY ADDRESS:

ADDRESS: VENDOR FAX NUMBER:

VENDOR EMAIL ADDRESS:

VENDOR POC: ATTENTION:

SHIPPING METHODS: OVERNIGHT 2 DAY

UNIT PRICE QTY

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

CHIEF INFORMATION OFFICER DATE CONTRACTING OFFICER'S REPRESENTATIVE DATE

$0.00

EXT. PRICE

PICKUP

PART # DESCRIPTION

CONSENT TO PURCHASE TOOLS, ODCS, MATERIALS AND SERVICES (CTP)

CLIN DESCRIPTION/NUMBER:

FUNDING TO BE USED:

FUNDS EXPENDED TO DATE: $0.00

FUNDS REMAINING: $0.00

$0.00FUNDED TO DATE:

$0.00 $0.00 $0.00 $0.00

GROUND (5-7 DAYS)

TOTAL COST: $0.00

$0.00 $0.00 $0.00

$0.00 $0.00

TAXES:

$0.00

$0.00

JUSTIFICATION AND/OR PURPOSE:

$0.00 $0.00

SHIPPING/HANDLING:

SUBTOTAL:

All material purchases shall be made in accordance with customer requirements. All materials shall become the property of the Government and shall be regarded as Government Furnished Property (GFP), and unless previously approved by the Contracting Officer Representative, shall be used only in performance of this Contract/Task Order. All materials will be purchased in accordance with regulations contained in the FAR (need cited#) approved purchasing procedures. All tools, ODCs, materials and services shall be procured in accordance with Contract/Task Order requirements and shall not exceed the funded amount on this Contract/Task Order. It is the responsibility of the Contractor to ensure that the prices quoted are fair and reasonable at the time of submission and are in the best interest of the customer. The Contractor is to provide price quotes at the time Consent To Purchase is submitted.

$0.00 $0.00

PR #:

CTP-#