S02 Deliverable Support Information Document.pdf

ITAM SW Deliverable Support Information Form v2.0 04/19/22 Page: 1 of 2

Deliverable Support Information Form

1. Manufacturer

2. Awardee

3. Product Name Description

4. Purchase Type(s)

5. Fiscal Year

6. Contract #

7. Task/Delivery Order #

8. VA Purchase Order #

9. Performance Start Date

10. Performance End Date

11. End Date (Including All Options)

12. Contracting Officer Rep

13. Customer Portal (TAC ID)

14. Change Order #

Vendor Fillable Fields (To Be Completed by Awardee):

15. Coverage

16. Type of Support

17. End of Life Date

18. End of Service Life Date

19. Level of Service

20. Manufacturer Contract #

21. Technical Support Name

22. Technical Support Phone

23. Technical Support Email

24. Technical Support Website

25. Hardware Serial Numbers

26. Software Serial Numbers

27. SW Licensing Key(s)

28. Comments/Add’l Info Required for Support

29. Completed By Name

30. Completed By Phone

31. Completed By Email

32. Attachment(s)

For VA Use Only:

ITAM SW Deliverable Support Information Form v2.0 04/19/22 Page: 2 of 2

Instructions – Deliverable Support Information Form

Block 1-14 to be Completed by VA ITAM SW Team Personnel Blocks 15-32 to be Completed by Awardee

15. Coverage List the Coverage being provided as part of this contract (in hours/day-days/week-response time in hours format). Example: 24x7, 8x5x2. If coverage varies by CLIN, please attach additional information outlining the coverage for each CLIN and note the attachment in Block 32.

16. Type of Support List the type of support being provided as part of this contract. Example: Telephone, Online, Updates, Upgrades, Email. Chose the most complete response. If the Type of Support varies by CLIN, please attach additional information outlining the Type of Support for each CLIN and note the attachment in Block 32.

17. End of Life Date Provide the Date the asset will reach its end of life (if applicable).

18. End of Service Life Date Provide the Date the OEM will no longer provide updates & firmware or will no longer maintain the asset (if applicable).

19. Level of Service List the level of service being provided. Example: Platinum, Premium, Gold. IF the Level of Service varies by CLIN, please attach addition information outlining the Level of Service for each CLIN and note the attachment in Block 32. (If correct response is not available in pull-down menu, please type in the correct response).

20. Manufacturer Contract # Provide the Contract number between the Awardee and the OEM (if applicable).

21. Technical Support Name Provide the name of the technical support contact.

22. Technical Support Phone Provide the telephone number that VA personnel should use to contact the OEM for support. Include appropriate extensions (if applicable).

23. Technical Support Email Provide the email address that VA personnel can contact for support (if applicable).

24. Technical Support Website Provide the Web address that VA personnel can use to access support (if applicable).

25. Hardware Serial/Part #(s) List the Serial numbers by CLIN of the products being acquired or maintained. If the list exceeds the space allotted on this form, include an attachment with the relevant information and reference the attachment in this block (if applicable) and note the attachment in Block 32.

26. Software Serial/SKU#(s) List the Serial numbers by CLIN of the products being acquired or maintained. If the list exceeds the space allotted on this form, include an attachment with the relevant information and reference the attachment in this block (if applicable) and note the attachment in Block 32.

27. SW Licensing Key(s) List the Software Licensing Key(s) by CLIN of the products being acquired or maintained. If the list exceeds the space allotted on this form, include an attachment with the relevant information and reference the attachment in this block (if applicable) and note the attachment in Block 32.

28. Comments/Addl. info required to contact support

Add any additional information that the will be required for VA personnel to obtain support.

29. Completed By (Name) List the Name of the person that provided the information contained on this form and who can be contacted in case additional information is needed.

30. Completed By (Phone) Provide the telephone number of the person completing this form.

31. Completed By (Email) Provide the email address of the person completing this form.

32. Attachment(s) Provide any additional attachments that may be needed to obtain support and/or any attachments referenced in in Blocks 15-31.