S02 - Attachment C - TRAVEL AUTHORIZATION REQUEST.doc

24 KB Posted

Attached to
R410--External Peer Review Program (EPRP) (VA-25-00000450)
Solicitation number
36C77624R0117
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This is a Travel Authorization Request form template to be used for requesting approval for travel under the External Peer Review Program (EPRP) contract with the Department of Veterans Affairs Technology Acquisition Center. The form captures essential travel information including requestor details, organization, position, travel dates, origin and destination locations, trip purpose, associated tasks/deliverables, and duration. It includes fields for itemizing approximate costs broken down by transportation, lodging, per diem, and other expenses, with a total cost calculation. The form requires approval from an authorizing official who must sign and indicate approval status with optional comments.

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36C77624R0117 0005.docx DOCX document
S02 - Attachment H - Small Business Subcontracting Plan Amendment 0005.docx DOCX document
36C77624R0117 0004.docx DOCX document
S06 - Attachment A - PWS EPRP 1132025 - Amend 0004.docx DOCX document
S06 - 36C77624R0117 Section B Price Schedule - Amend 0003.xlsx XLSX spreadsheet
36C77624R0117 0003.docx DOCX document
S06 - Attachment A - PWS EPRP 1102025 - Amend 0003.docx DOCX document
S02 - Attachment A - PWS EPRP 12.31.24.docx DOCX document
36C77624R0117 Price Schedule.xlsx XLSX spreadsheet
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36C77624R0117 0002.docx DOCX document
36C77624R0117 0001.docx DOCX document
S02 - Attachment B - FY24 FACILITY LIST.xlsx XLSX spreadsheet
36C77624R0117_1.docx DOCX document
S02 - Attachment E - Sample Instrument.docx DOCX document
S02 - Attachment G - VHA 1605.05 BUSINESS ASSOCIATE AGREEMENT.docx DOCX document
S02 - Attachment F - Business Associate Profile Questionnaire Fillable.pdf PDF
S02 - Attachment H - Small Business Subcontracting Plan.docx DOCX document
S02 - Attachment A - PWS EPRP 10.31.24.docx DOCX document
S02 - Attachment D - Sample Algorithm.pdf PDF
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Travel Authorization Request Requestor Name:

Organization:

Position Title:

Travel Dates:

Traveling from:

Traveling to:

Purpose of trip:

Associated Task, Subtask and/or Deliverable:

Duration of Trip (excluding travel days):

Approximate Costs:

· Transportation:

· Lodging:

· Per Diem:

· Other:

· TOTAL:

Approving Official Name:

Approved: o Yes oNo

Approving Official Signature:

Comments:

File details come from the government source that posted it. Updated .