Attach_7_Request_New_Items_Form.pdf

Controlled Unclassified Information (CUI)

Controlled Unclassified Information (CUI)

Source Selection Information – See FAR 2.101 and 3.104

NEW ITEM REQUEST FORM

Note: not all fields will apply. Please fill out as much information as applicable.

Requested by (Vendor Name):

Contract Number:

CONUS/OCONUS (City, State):

Item Name and Brief Description:

Manufacture/Brand Name (if available):

Product Price: Dist. Fee (If Applicable): Total Price:

Estimated Monthly Usage: Cases per month

Vendor Part Number:

Vendor Unit of Measure (How the Vendor Sells/Prices the Item, CS, BX, PG, LB, etc.):

Vendor UoM Weight (How Much does CS, BX, PG, LB, etc. Weigh):

Individual Package Type? (Bag in BX, CAN, JAR, PG, etc.):

Individual Package Weight: Count Per Case (If Applicable):

Processing (Raw, Sliced, Fully Cooked, Par Boiled, Breaded, Fillet (Skin On/Off, Ground, etc.):

Does This Item Require Refrigeration?

Fresh/Frozen/Chilled/Shelf Stable?

Product Grade (if known): NAMP # (if known):

Additional Product Features / Descriptions: (Lactose Free, Just Add Water, Add Milk, No Bake, etc.) (If Light is used in The Product Description, What Does It Imply? Low Sodium, Low Calorie, Color, etc.?)

NOTE: PLEASE ATTACH SPEC SHEET AND ANY SUPPORTING DOCUMENTS YOU MAY

HAVE TO AID IN CATALOGING (NUTRITION SPECIFICATIONS, LABELS, ETC.).

Controlled by: DLA Troop Support Indo-Pacific Controlled by:

CUI Category: Source Selection (SSEL) Distribution/Dissemination Controls: FED ONLY

POC: